Inspection on 13/03/07 for Landmere Care Home

This inspection was carried out on 13th March 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

Landmere Care Home 23/08/08

Landmere Care Home 04/03/08

Landmere Care Home 12/09/07

Landmere Care Home 03/05/06

Landmere Care Home 22/11/05

Landmere Care Home 02/08/05

Landmere Care Home 08/03/05

Landmere Care Home 07/10/04

Landmere Care Home 25/03/04

Similar services:

Hunter`s Lodge

Lester Hall Apartments

Harvey House

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

CARE HOMES FOR OLDER PEOPLE Landmere Care Home Ruddington Lane Wilford Nottingham NG11 7DD Lead Inspector Wendy Taylor Key Unannounced Inspection 13th March 2007 09:15 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 Landmere Care Home DS0000026450.V331548.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. Landmere Care Home DS0000026450.V331548.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Landmere Care Home Address Ruddington Lane Wilford Nottingham NG11 7DD 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) 0115 945 5940 0115 982 7341 manager.landmere@lifestylecare.co.uk Lifestyle Care PLC Ms Yolanda Wasylko Care Home 70 Category(ies) of Past or present drug dependence over 65 years registration, with number of age (70), Dementia (10), Mental disorder, of places excluding learning disability or dementia (10), Mental Disorder, excluding learning disability or dementia - over 65 years of age (70) Landmere Care Home DS0000026450.V331548.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The 10 or fewer service users who may be accommodated in categories MD and DE must be aged between 55 and 65 years. 26th June 2006 Date of last inspection Brief Description of the Service: Landmere Care Home is a purpose built home divided into four units with a total of 70 places. The home provides nursing care for people over 65yrs with Mental Disorder, Dementia, past or present drug dependence. Ten places can accommodate people from 55yrs with a mental Disorder or Dementia. The home was registered with the Commission in 2002 and has very recently been taken over by a new provider called Southern Cross Healthcare. The home is situated in a residential area of Wilford, south of and on a bus route to the city of Nottingham. West Bridgford is close by and provides shops, library and leisure facilities. The range of fees are from £351:00 to £630.00 Landmere Care Home DS0000026450.V331548.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key unannounced inspection took place during March 2007 and the visit to the home was carried out over approximately 7 hours on one day. Two inspectors carried out the inspection visit. The main methodology used on inspection is called case tracking. This means that the care received by five residents was followed in detail. Some residents were able to speak about the experience of living at the home; and their personal records, general house records and staff records were looked at. The registered manager and the deputy manager were not available on the day of the visit, however another manager and a representative of the new providers was also present throughout the visit. Relatives, staff and a manager were spoken with and the care being provided was observed. Information already held by the commission was also used as part of the inspection process. The commission received surveys before the visit took place, one from a resident and twelve from relatives. Information contained in the surveys is mentioned in the main body of the report. A resident said ‘I love living here’. Relatives made comments such as ‘the staff care with patience’ and ‘there could be more activities’. Other comments made by residents, relatives and staff can be seen in the main body of the report. What the service does well: What has improved since the last inspection? Since the last inspection most of the requirements set at that time have been achieved. Information contained in care plans and risk assessments has been improved in regard to needs such as falls, mobility and restrictive practices. Landmere Care Home DS0000026450.V331548.R01.S.doc Version 5.2 Page 6 There is now evidence in personal records to show that residents are assessed and their care is planned before retuning to the home from hospital. There is also a system in place to make sure staff take enough relevant information about a resident to appointments and hospital visits. Wheelchairs that are in use all have footplates fitted, and the footplates are being used appropriately. What they could do better: A number of requirements have been made at this visit. With regard to care planning there must be more consultation with residents and/or their representatives so that their needs, preferences and views are included in the plans. There must also be ways of replacing broken equipment immediately, such as weighing scales; if that piece of equipment is needed to make sure that residents health care needs can be fully met. The dignity of all residents must be maintained at meal times by them being given individual attention when they are supported to eat; and the cultural needs of all residents must be given attention, for example private spaces to pray with family and access to culturally relevant TV and music if and when they wish. These issues must also be incorporated in individual care plans so that all staff know how to support residents with these needs. The arrangements for providing adequate numbers of staff to work directly with residents when there is a staff meeting must be reviewed, and they must be able to demonstrate this. In the absence of the registered manager or the deputy manager, there must be systems in place to make sure that all records kept in the home are available to be inspected at any time; and there must be good communication between the senior staff so that they all have enough information about the overall management of the home to make sure that residents have a consistent, person centred approach to their care. Records of complaints and safeguarding adult issues must demonstrate that policies and procedures have been followed and complainants are advised of the outcomes. Also, there must be records in place to make sure that any risk to residents from having hand sanitizer placed in communal areas around the building, is minimised and managed properly. As well as requirements, a number of recommendations have also been made. The availability of drinks for residents who cannot help themselves should be reviewed to make sure that they are having the amount of drink they want and need. There should also be a review of the systems for making sure that residents only wear their own clothes, and have their nail care attended to regularly. The arrangements for supporting residents to eat their meals in the dinning room should be reviewed to make sure that no one has to watch others having Landmere Care Home DS0000026450.V331548.R01.S.doc Version 5.2 Page 7 their meal, whilst they are waiting for long periods for support to become available. It is also recommended that menus demonstrate the choices that are available to residents, and that they are available in different formats so that all residents are able to understand them. The activity programme should be reviewed to make sure that there is enough suitable activity for those residents who need full support to participate. The ways in which the safety of residents, in regard to their access to bathrooms and kitchens is managed should be reviewed to make sure that appropriate and up to date methods are used. Recommendations are also made to review the resources available for staff training, such as appropriate space and equipment, so that there is no likelihood that residents space and equipment could be used. Also it is recommended that the staff supervision arrangements and the recording of them is reviewed to make sure that all staff receive regular sessions and that records can clearly demonstrate this. Finally it is recommended, as at the last inspection visit, that the types of floor coverings used in certain areas of the home are reviewed to make management of unpleasant odours more effective. 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. Landmere Care Home DS0000026450.V331548.R01.S.doc Version 5.2 Page 8 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 Landmere Care Home DS0000026450.V331548.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 5, 6 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Information that tells people what is provided at the home is available within the home, however it is not given out to all prospective residents. This means that some residents and families are not able to make an informed choice about where to live. EVIDENCE: Pre inspection information shows that policies are available for referral and admission to the home. A comprehensive statement of purpose and service user guide is available in the main entrance to the home. Admission details are clearly recorded and they include information about the funding of the placements and personal life history. Contracts are available for the placements at the home, and a manager said that everyone gets a ‘welcome pack’ when the placement is confirmed. A ‘welcome pack’ was not Landmere Care Home DS0000026450.V331548.R01.S.doc Version 5.2 Page 10 available for the inspectors to see. Surveys from relatives and a resident indicate that they were given enough information about the home before their relative moved in, however on the day of the visit other relatives could not recall having received any information. There is no recorded evidence to indicate whether a ‘welcome pack’ is given out. This was discussed with a manager, who said that she would ensure that records demonstrate when people have been given a welcome pack. People did say that they had an opportunity to look around before their relative moved in. A survey from a resident indicated that they were given enough information before moving into the home. Assessments are available for individual residents, which include information about routines and choices, mental health needs, social and leisure needs, comprehension, end of life arrangements and identified risk. One assessment for a recently admitted resident was only partially completed. This was discussed with a manager who said that the assessment is being reviewed and would be updated. There is evidence in records that assessments for new residents are regularly reviewed. These assessments include pressure area care, eating and drinking needs and continence. Intermediate care is not provided at the home. Landmere Care Home DS0000026450.V331548.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Most residents and their relatives are not given the opportunity to participate in care planning, which means that their wishes and preferences will not be taken into account. Health care needs are not consistently met, which puts residents at risk. EVIDENCE: Care plans are in place which cover needs such as maintaining good health, maintaining healthy skin, moving and handling/falls, use of relaxation time/social activities, personal hygiene, communication and relationships. There is evidence in records that the plans are reviewed regularly, however records show that not all of the residents and/or relatives are consulted about their care plans and the reviewing of them. Care plans gave details of the tasks required to support personal care. Relatives said that staff respect the privacy and dignity of residents, and this was observed during the visit. Surveys received from a resident and relatives also indicated that this was the case. Landmere Care Home DS0000026450.V331548.R01.S.doc Version 5.2 Page 12 One file showed a reviewed needs statement and care plan for return from hospital in files. Staff said that they have clear details about residents to take with them when they escort people to hospital. During the visit an incident occurred where a resident prevented a visitor from leaving a bedroom and there were no staff in the vicinity to assist the visitor. This was discussed with a manager, who said that she would develop a risk assessment and care plan for appropriate supervision immediately. Records are kept for appointments with doctors and other healthcare professionals, and levels of dependency are reviewed and recorded on a monthly basis. Records are also kept for regular checks through the night by staff and for regular mouth care (see Standards 16-18), as specified in care plans. Records of weight have not been kept for several months as the scales have not been working, and at least two care plans specify that weight should be monitored on a monthly basis. A manager took immediate action to purchase a suitable set of scales. During the visit two relatives said there were not enough drinks provided. It was observed that drinks were freely available and within reach of residents who were able to help themselves, but not for those who required full support. Drinks were seen to be provided for them with their meals and at set times in between meals. Comments were also made about residents wearing other people’s clothes. An issue regarding one resident’s personal hygiene was reported to a manager who took immediate action to resolve the issue. Staff demonstrated a comprehensive knowledge of residents needs, and surveys received from a resident and relatives indicate that they feel medical needs are always met and there is good basic care for people with dementia. Comments were made such as ‘the staff care with patience’, I’m always kept up to date about needs’ and ‘care plans meet the assessed needs’. Medication storage, administration and records keeping practices are satisfactory. Allergies are clearly recorded, and the ways in which residents prefer and need medication administered are clearly recorded. Pre inspection information shows that policies are available for medication, continence, pressure relief, privacy, dignity and choice. Landmere Care Home DS0000026450.V331548.R01.S.doc Version 5.2 Page 13 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. 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 this service. The service meets the expectations and wishes of some residents, but the opportunities for the more dependent residents to make choices and have control in their daily lives are very limited. EVIDENCE: Pre inspection information shows that there are policies available for food safety and nutrition. Special dietary requirements and preferences are recorded in individual files. Nutritional screening tools and nutritional care plans are in place where a need is identified. Residents said that meals are very good, and relatives said the food and the kitchen staff are good. Surveys received from a resident and relatives indicate that the meals are good and they enjoy them. There was evidence in records and from speaking to relatives that cultural dietary needs are taken into account. During the lunchtime meal most residents who required full support received their meal in a timely and individualised manner. However one resident had to wait for the support whilst watching others having their meal. When the Landmere Care Home DS0000026450.V331548.R01.S.doc Version 5.2 Page 14 resident got their meal they did not receive the full attention of the staff member helping them. Resident’s requests for additional food were met straight away. Menus are balanced and varied but do not demonstrate a choice of lunchtime foods. A manager said that this is to be reviewed in the near future. Menus are displayed in communal areas but they are in a written format only, which means that some residents cannot access the information. This was discussed with a manager during the visit. The activity co-ordinator described the range of activities available to residents, such as sensory and recall activities. Pre inspection information and activity programmes displayed in the home also show that activities such as church services, shopping, painting, bowls, hand massages, dominos and baking are also offered. Resident’s files include an activities assessment and a record of participation. Some surveys received from relatives indicate that there is a good range of activities available, and others think that more could be offered to people who need cannot actively participate. During the visit some residents said that they can access plenty of suitable activities; there are sensory boards placed around the building and hand massages are provided, but there was little evidence of any other activities for those who need more support. Those relatives spoken during the visit also said that there is little stimulation available for those who require full support. Resident’s records did not demonstrate attention to cultural needs for example, the need for a resident to have a female carer only or for the provision of private places to conduct prayers. A relative also described the lack of provision of culturally relevant TV or music. There is no clear information about advocacy services available, and a manager said that noone uses an advocacy service at present. The manager agreed to look at the provision of clearer information about advocacy services. Relatives surveys indicate that they think staff provide the care and support that is expected and they help them to keep in touch with the residents. Landmere Care Home DS0000026450.V331548.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Complaints and safeguarding adult issues are not recorded or managed in a way that fully protects residents and promotes their rights. EVIDENCE: The complaints procedure is displayed in the main entrance to the home. Surveys received from a resident and relatives show that they think staff listen and act on what is raised, and they know how to make a complaint. On the day of the visit relatives said that they know how to make a complaint, and staff were able to demonstrate that they knew how to respond to complaints. Staff also said that if they have a complaint to make the registered manager always listens and sort things out. However during the visit some relatives said that they didn’t think complaints they had made had gone through the formal procedures and they didn’t think that they had been recorded. They said they had not been given any outcomes and that even though they had complained about issues little had changed. One relative complained about standards of mouth care during the visit and a manager took appropriate steps to ensure changes were effected, but it was not clear if those actions were communicated to the relative. Landmere Care Home DS0000026450.V331548.R01.S.doc Version 5.2 Page 16 Records of complaints held in the home do not correspond with the information supplied by the registered manager prior to the visit, and the records were also difficult to locate. The records that were located did not specify the actions taken or the outcomes for the complainants. Records for safeguarding adult referrals could not be found during the visit, although two referrals are recorded in pre inspection information (see Standards 31-38). Pre inspection information shows that policies are available for safeguarding adults, complaints, whistle blowing and risk assessing. During the visit some staff said they have received training in safeguarding adults training and whistle blowing, and some said they had not (see Standards 27-30). Risk assessments are in place for maintaining self esteem, falls, bathing and personal hygiene. Risk assessments and consent forms are also in place for restrictive practices such as use of stair gates, lap straps on wheelchairs and bed rails. Landmere Care Home DS0000026450.V331548.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 25, 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is generally clean and comfortable but unpleasant odours detracted from a homely atmosphere. Current risk management approaches for some residents restrict movement around the home for others. EVIDENCE: On the day of the visit the home presented as generally clean and tidy, however an unpleasant odour was noted in one area. A manager said that there was a deep cleaning regime in place but it had recently become ineffective for this area. Staff said that daily cleaning tasks are allocated by priority not by a rigid rota system. Relatives said that the cleaners were very good and bedrooms were always kept clean and tidy, however there was sometimes an unpleasant odour in another area of the home. Landmere Care Home DS0000026450.V331548.R01.S.doc Version 5.2 Page 18 Furniture and décor are in a good state of repair and bedrooms are personalised. Call bells were within easy reach of residents or relatives in communal and private areas. Pre inspection information shows that several bedrooms and a lounge area have been redecorated, and some furniture and carpets have been replaced since the last inspection visit. Bolts fixed to the outside of doors such as kitchens and bathrooms are currently being used to keep them closed to residents for whom a risk has been identified. The risks of a resident being locked in those rooms was discussed with a manager, and there are no records to show that this has ever happened. The issue of restricting other resident’s movements around the home was also discussed. The manager said that alternatives would be discussed with a consultant, who recently visited the home to advise on improvements regarding dementia care. Landmere Care Home DS0000026450.V331548.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Safely recruited and well-trained staff protect residents, but they are at risk if there are not enough staff to provide support, or staff training activity impacts on their daily lives. EVIDENCE: Pre inspection information shows that there are policies available for recruitment and employment. Recruitment files contain application forms, references, criminal record bureau checks, photographic identification and interview records. Although pre inspection information shows that there has been a high level of staff turnover in the recent past, rotas now show a full staff compliment except for one qualified nurse post. A manager said that agency staff are used to cover absences where necessary, however on three occasions the agencies were not able to provide staff. The registered manager notified the commission of this at the time of the shortages. During the inspection relatives said that staff shortages are a problem, however rotas show that there are enough staff on each staff to meet the needs of residents. Landmere Care Home DS0000026450.V331548.R01.S.doc Version 5.2 Page 20 Surveys from a resident and relatives contained comments such as ‘staff are always available when needed’, ‘staff are skilled and experienced’ and staff are friendly and always polite’. Staff were observed to have a positive approach care and support. Pre inspection information shows that staff have received training in subjects such as fire safety, management of falls, tissue viability, first aid, stoma care, food hygiene, infection control, safeguarding adults, managing behaviours and dementia care. Records seen during the visit confirmed this. There was evidence of further dates for training in management of continence, specialist feeding regimes and a nationally recognised care qualification. Staff said that although they have received training in dementia care, they would benefit from more in depth training. There is a learning resource area for staff, which contains up to date journals and other literature. A manager said that there are link nurses allocated for areas such as tissue viability and continence. There was evidence that staff have meetings on a monthly basis and this was confirmed by them during discussions. During the visit relatives said that there are not enough staff available to care for residents during staff meetings, and residents have also been moved out of a lounge area so that staff can watch a training video. A manager said that she was not aware of either of these situations having occurred, but said that staff continue to be available to residents during meetings as not all attend. Landmere Care Home DS0000026450.V331548.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35, 36, 37, 38 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. There are good health and safety practices within the home but management of records, and communication between the senior staff is ineffective. This means that residents do not always receive consistent and person centred support. EVIDENCE: On the day of the visit both the registered manager and the deputy manager were not available. Another manager was available but there was no system in place for them to have access to many of the records required for inspection. Those that could be accessed were initially difficult to locate, for example, complaints records, safeguarding adult records and staff supervision Landmere Care Home DS0000026450.V331548.R01.S.doc Version 5.2 Page 22 records. When some of the records were located they provided only limited information and were disorganised, for example, staff supervision records were in sealed envelopes, stored at the bottom of a box and the envelopes contained only the first names of many of the staff members. Also not all staff had supervision records available. Pre inspection information showed that there is a supervision and appraisal plan for 2007 but this was not in line with the records seen. Staff said that they do have supervision ‘a couple of times a year’, and supervision contracts were seen on some individual file. Pre inspection information shows that many of the residents are financially protected by legal support systems, and a manager said that they do not manage any residents’ money at the home. A manager described quality assurance activity such as care plan audits, insulin administration audits, care workers record keeping audits, health and safety audits, and accident report audits. The manager also said that nutritional, dental and eye care audits are planned for 2007. There was only evidence of the care plan audits within the home, and a manager said that other audit information was stored on computer, which was not in working order on the day of the visit. A manager also said that the registered manager carries out satisfaction surveys but no evidence was available to confirm this. During the visit relatives said that they are never asked for their views. There are however minutes available for relatives meetings. Pre inspection information shows that there are policies available for accidents, quality assurance, control of substances that are hazardous to health, emergencies and crises, equal opportunities, fire safety, first aid, health and safety and record keeping. Accident records cross reference with daily notes and daily notes cross-reference with care plans. Health and safety information is displayed in staff areas, and staff said that there is a health and safety meeting every two months. Cross infection notices for visitors are clearly displayed, as is the general moving and handling risk assessment. There are bottles of hand sanitizer available around the home, and whilst this is a good infection control practice, there are no risk assessments available. A member of staff is allocated as a fire officer for the building and their name is displayed in the entrance hall. Fire safety checks are carried out regularly and there is an up to date fire risk assessment available. Surveys received from relatives contain comments such as ‘the laundry is excellent’, ‘the manager is super’ and the home is very helpful’. Staff said that the registered manager is very supportive. Landmere Care Home DS0000026450.V331548.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 3 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 1 9 3 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 1 17 X 18 2 2 X X X X X 2 2 STAFFING Standard No Score 27 2 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 2 2 X 3 2 1 2 Landmere Care Home DS0000026450.V331548.R01.S.doc Version 5.2 Page 24 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(1)(2) (c) 23(2)(c) Requirement Where practicable, care plans must be developed and reviewed in consultation with the resident and/or their relative. Equipment provided at the home, such as weighing scales, must be maintained in good working order. The cultural needs of residents, such as same gender staff for personal care, suitable space for prayers, TV and music; must be met and recorded in individual care plans. The dignity of residents must be maintained during meal times by ensuring they receive the full attention of the member of staff supporting them. Complaints must be fully investigated in accordance with relevant policies and procedures within the home, and the complainant must be informed of any actions taken. Records, including those regarding complaints and safeguarding adult referrals must be available for inspection at all DS0000026450.V331548.R01.S.doc Timescale for action 30/05/07 2. OP8 31/05/07 3. OP12 12(4)(b) 31/05/07 4. OP15 12(4)(a) 31/05/07 5. OP16 22(3)(4) 31/05/07 7. OP37 17(2)(3) 30/04/07 Landmere Care Home Version 5.2 Page 25 8. OP38 13(4)(a) (c) times by the commission’s authorised representatives; those records must be complete and up to date. Risk assessments and management plans must be in place in regard to the placement of bottles of hand sanitizer around the home, to which residents have access. 31/05/07 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. 3. Refer to Standard OP1 OP8 OP10 Good Practice Recommendations It is recommended that a record is kept of when a ‘welcome pack’ is given out to prospective residents or their representatives. It is recommended that the availability and access to drinks for those residents who need full support is reviewed to ensure that all residents have equal access. It is recommended that the systems for monitoring that residents do not wear anybody else’s clothes and that they have regular nail care, are reviewed to ensure that they are being consistently followed. It is recommended that seating arrangements and timing of support for meals are reviewed to make sure that dignity is maintained all residents. It is recommended that activity programmes are reviewed to make sure that they include activities in which those who require full care and support can participate if they wish. It is recommended that the use of alternative menu formats be considered so that all residents have access to the information, for example, picture menus. It is recommended that the use of alternative floor coverings be considered in areas of the home that are a problem for odour control. It is recommended that the ways in which access to areas of the home for residents is restricted, are reviewed to ensure that they are in line with current good practice. DS0000026450.V331548.R01.S.doc Version 5.2 Page 26 4. 5. OP15 OP12 6. 7. 8. OP15 OP19 OP25 Landmere Care Home 9. OP27 10. OP30 11. 12. OP36 OP37 It is recommended that staff rotas are reviewed to make sure that there are enough members of staff freely available to support and care for residents when there are staff meetings within the home. It is recommended that the provision of training resources for staff, such as rooms and audio-visual equipment, is reviewed to make sure that training sessions do not impact on the daily lives of the residents. It is recommended that the staff supervision arrangements are reviewed to make sure that sessions are regular, and they are documented and stored appropriately. It is recommended that there are clear systems in place to make sure that all managers have access to records required by regulation; and that there is clear communication between managers about the day to day running of the home. Landmere Care Home DS0000026450.V331548.R01.S.doc Version 5.2 Page 27 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 Landmere Care Home DS0000026450.V331548.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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