Inspection on 12/01/07 for Landona House

This inspection was carried out on 12th January 2007.

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

The inspector 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

Landona House 05/07/07

Landona House 19/10/05

Landona House 10/05/05

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Maple Lodge

Polesworth Group 32 Station Road

Heathlands

Aston Court Nursing Home

Polesworth Group 70 Long Street

Breme

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

CARE HOMES FOR OLDER PEOPLE Landona House Love Lane Wem Shrewsbury Shropshire SY4 5QP Lead Inspector Keith Salmon Key Unannounced Inspection 12th January 2007 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Landona House DS0000062558.V293818.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. Landona House DS0000062558.V293818.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Landona House Address Love Lane Wem Shrewsbury Shropshire SY4 5QP 01939 232620 01939 232620* * Ring before faxing so that they can switch it over Mrs Radhika Lakhubhai Ramlal Sisodia Mr Kamal Sisodia Mrs Dawn Helen Burrows Care Home 27 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) Category(ies) of Dementia - over 65 years of age (12), Learning registration, with number disability (2), Old age, not falling within any of places other category (13) Landona House DS0000062558.V293818.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home may provide accommodation and personal support to a maximum of 27 service users over the age of 65 years to include 12 service users with dementia and two service users with a learning disability (under the age of 65 years). The risk assessment relating to both people with dementia must be regularly monitored, reviewed, and updated. All care staff must received training in dementia awareness and learning disability. The residents with a learning disability should be formally reviewed every six months. There must be a minimum of three care staff on duty from 7am 10pm. There must be two waking members of staff on duty throughout the night. 19th October 2005 2. 3. 4. 5. 6. Date of last inspection Brief Description of the Service: Situated on the outskirts of the small town of Wem, Landona House is within easy walking distance of various local facilities. The Home is registered with the Commission for Social Care Inspection to provide accommodation, and personal care, to a maximum of twenty-seven people. Accommodation is provided in both single and shared bedrooms, some of which have en-suite facilities. Bedrooms are located on the ground and first floor with access to the upper floor via passenger lift. Communal areas comprise a large lounge, separate dining room, and a conservatory area. Weekly fees range from £324.15 to £498.42. Landona House DS0000062558.V293818.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced ‘Key’ Inspection commenced at 9.30am, concluded at 2.30pm (a duration of 5 hours), and was conducted by Mr Keith Salmon. The main objective of this Inspection was to review all of the ‘Key’ Standards, as set out on the National Minimum Standards for Care Homes for Older People. Present during the Inspection were Mrs Dawn Burrows, Registered Manager and Ms. Alison Roberts, Senior Care Assistant (in charge at the commencement of the Inspection). This Report is a product of observations made during a tour of the Home, a review of care related documentation, staff duty rotas and staff files, plus a range of documents/records reflecting the general operation of the Home. The Inspector also held discussions with Staff and 4 Residents, all of whom were ‘case tracked’. No Relatives/Representatives were present at the time of the Inspection. What the service does well: 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. Landona House DS0000062558.V293818.R01.S.doc Version 5.2 Page 6 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. Landona House DS0000062558.V293818.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Landona House DS0000062558.V293818.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Processes to ensure appropriate and thorough care needs assessment, prior to admission, are effectively applied. These findings are applied to ensure appropriate placement. EVIDENCE: Individual files examined contained a pre-admission checklist for all those Residents ‘case tracked’. In each instance the Manager had carried out the assessment. Cross checking with individual Care Plans demonstrated evidence of the application of this information through to initial care planning. The Manager also informed the Manager that some of the Senior Carers are receiving training to enable them to undertake some of the pre-admission assessment work. Landona House DS0000062558.V293818.R01.S.doc Version 5.2 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The model of Care Plan utilised by the Home is of a comprehensive design and easy to read. The care provided by the Home is effective in meeting the Residents’ assessed care needs, and is delivered considerately and effectively. The storage, administration, and disposal of medicines are in accordance with accepted good practice. EVIDENCE: Care Plans/Files relating to 8 Residents were reviewed (including four ‘case tracked’ Residents). Discussions were held with the respective Residents, the Manager, and other Staff, together with observation by the Inspector. Landona House DS0000062558.V293818.R01.S.doc Version 5.2 Page 10 Care Plans were found to be current and easy to follow; provided evidence of involvement of the Resident, Relative or Advocate; made direct reference to ‘risk assessment’ in respect of moving and handling, use of bedrails, nutritional status/needs, and pressure areas. There was evidence of regular audit of Care Plans by the Manager. A review was undertaken of the policies/procedures relating to the management/administration of medicines, i.e. records relating to the supply, storage, and disposal of medicines (including records of ambient and medicine refrigerator temperatures), the maintenance of medicine administration records (MAR Sheets), and the maintenance of the Controlled Drugs Register. The Inspector also reviewed the contents of the medicine trolleys, secondary back-up storage and storage of medical gases. All were found to be satisfactory. Landona House DS0000062558.V293818.R01.S.doc Version 5.2 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Leisure opportunities are provided, which are consistent with Residents’ capabilities. The Home facilitates achievement of desired lifestyle through Residents conducting the pattern of their day, where possible, as they wish, including contact with family and friends, and continuation of religious practices. There is a daily choice of attractive and nutritious meals. EVIDENCE: At present the Home’s programme of activities is undergoing a review in relation to its overall management, with a view to planning and management to be the responsibility of identified staff members. To date the programme has provided trips out to local places of interest, including pub lunches, trips to Llandudno and Southport, and ‘in-house’ activities such as bingo and ‘singalongs’. The Home also holds functions at the Home, which, through use of raffles, have a fundraising aspect to help pay for leisure activities, e.g. Summer Fete, a Christmas party for Residents and their families. A number of activities are arranged aimed at meeting the leisure and educational needs of Landona House DS0000062558.V293818.R01.S.doc Version 5.2 Page 12 specific individuals, and include horse riding for the disabled, and numeracy and literacy classes. Residents are encouraged to personalise their bedrooms and stated they enjoy good meals in the pleasant dining area or in their own rooms, as they wish. Meals are of traditional style, with two choices at each main meal with individual likes and dislikes catered for. (These are clearly shown in each Resident’s Care Plan). Residents spoken with were complimentary regarding the quality of life they have at the Home, informing the Inspector they are enabled to exercise choice and control over their own lives as far as they are able. Residents also considered their Relatives/Visitors are made welcome, and given all necessary information on aspects of the Home and their welfare. This was reflected in comments made by Relatives in ‘Feedback Questionnaires’. Staff and Residents also confirmed that Family and Friends were included in events such as the Summer Fete and the Christmas Party. Landona House DS0000062558.V293818.R01.S.doc Version 5.2 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is (excellent, good, adequate or poor). This judgement has been made using available evidence including a visit to this service. 16 &18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The interests of Residents are protected through ready access, for Residents or their Representatives, to information relating to advocacy services and the Home’s Complaints Procedure. Staff are aware of their role in protecting Residents from abuse. EVIDENCE: A clear and concise Complaints Procedure, which includes reference to the Commission for Social Care Inspection as the regulatory body, together with contact details, is displayed in the main hallway. In addition, information on how to raise a complaint is included in the Service User Guide. The Home maintains a record of complaints, which was observed to be current. The Inspector noted there was one ‘on-going’ complaint and on reviewing the related records/correspondence was satisfied the investigation and response by the Home was being conducted in an appropriate and satisfactory manner. Examination of ‘Accidents/Incidents’ Records demonstrated nothing of particular concern for the Inspector. Landona House DS0000062558.V293818.R01.S.doc Version 5.2 Page 14 Residents who were able stated they would have no hesitation in raising matters if they had any concerns, and were confident these would be dealt with promptly. Policies relating to protection of Residents from abuse were observed to be in place and readily accessible, including ‘Whistle Blowing’, ‘Abuse Awareness’ and ‘Adult Protection’. Staff training files indicated that Staff had received training in respect of these Policies. Landona House DS0000062558.V293818.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The general environment within the Home is safe with noticeable improvement in the general level of décor. The general state of repair and cleanliness is good. EVIDENCE: Noticeable progress has been made in improvements to the standard of internal décor and furnishings – e.g. there are new carpets in many areas; a number of bedrooms have been totally redecorated by way of repainting and provision of new bedding, and curtains; the conservatory has been redecorated and re-roofed; parts of the Home’s electrical systems (including fire alarm/fire notification board) are being replaced as part of a new three-bedroom development which is expected to be completed during the coming weeks (see below). Landona House DS0000062558.V293818.R01.S.doc Version 5.2 Page 16 Bedrooms are personalised and meet individual needs. Gardens to the front of the house are well maintained. Records were seen which demonstrated all hot water outlets, accessible to Residents, have the water temperature tested on a weekly basis. These records showed the Standard of ‘close to 43o’ Celsius is met. A random check of hot water outlets by the Inspector found hot water temperatures to be in accordance with the Standard. Plans to develop previously redundant space above the lounge area into further resident accommodation is near to completion requiring some final decoration and the laying of carpets. The new accommodation will provide three bedrooms and an additional bathroom, shower and toilet. At the time of this Inspection the standard of hygiene and cleanliness was excellent and the domestic staff are to be commended. Landona House DS0000062558.V293818.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff numbers and skill-mix listed on the staff rota are sufficient to meet the assessed care needs of current Residents. Recruitment and employment practices are consistent with the safeguarding of Residents. The commitment of the Home to providing training for Care Staff is good. EVIDENCE: The current staffing rota, and those from the immediately preceding weeks, were examined. Staffing numbers and skill-mix enable a service provision, which meets the care needs of the Service Users. A specific aspect of the ‘shift’ structure, and worthy of note, is the way in which Senior Carers work 15 minutes longer, than other Care Staff, at the beginning and end of each shift to ensure sufficient time for effective ‘handover’ from one shift to the next. This is to be commended as good practice. Staff Personal Files demonstrated evidence of full compliance with the Standard and Schedule 2 of the Regulations. Staff are subject to a thorough, and relevant, orientation/induction programme, which is followed by comprehensive ‘foundation’ training, e.g. ‘manual handling and lifting’, ‘fire safety’, ‘first aid’, ‘simple infection control’. Landona House DS0000062558.V293818.R01.S.doc Version 5.2 Page 18 With regard to ‘fire safety’ training records showed staff attended training provided by ‘Central Fire Control’ during Sept/Oct/Nov 2006. In addition, the Home enjoys an excellent record for the continuing development of Care Staff, and for supporting Staff in undertaking appropriate training, based on a well-structured plan for determining individual training needs. Currently, the Home comfortably meets the ‘Standard’ relating to the proportion of Care Staff who have attained NVQ Level 2 or higher with a figure of over 70 . Virtually all Senior Carers have attained NVQ Level 3, with two currently undertaking the NVQ ‘Assessors’ Qualification, with a view to moving on to NVQ Level 4. Landona House DS0000062558.V293818.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35, 36, 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Operationally, the Home is very well organised, with the central purpose being ‘the best interests of Residents’. Residents’ personal financial interests are safeguarded. Staff are subject to effective support, with regular ‘supervision by the Manager, and appeared involved and happy in their work. The Home is a safe place for the Residents to live. Landona House DS0000062558.V293818.R01.S.doc Version 5.2 Page 20 EVIDENCE: The Home is well managed by the Registered Manager, Mrs Dawn Burrows, who is well supported by the (joint) Registered Provider, Mr Kamal Sisodia. Mrs. Burrows, who has achieved the ‘Registered Managers Award’, is currently working with Senior Care staff to develop the ‘management’ aspects of their role. Progress was evident in the way Senior Carer, Alison Roberts, coped well as the ‘person in charge’ during the beginning of this Unannounced Inspection, which, for her, was a totally new experience. All Staff are subject to effective support with regular supervision, and appeared involved and happy in their work. Observation by the Inspector, review of records and discussion with Residents and Staff, strongly indicated that operationally the Home is well organised with lines of accountability being clearly defined and observed. The ambience is warm, friendly, and inclusive with the central purpose being ‘the best interests of Residents’. Discussion with Residents also indicated their views on the quality of service provision are sought by the Home, and acted upon. A review of Staff Personal Records, and discussion with Staff, provided evidence they are reliably, and appropriately, supervised. Records observed demonstrated Service Users’ interests are safeguarded by the financial procedures operated within the Home with all monies managed appropriately. These relate to a very small number of Residents, in respect of small amounts of ‘pocket money’ left by Relatives to pay for sundries, e.g. hairdressing, chiropody, magazines. Health and Safety Policies/Procedures and the application of related practices were seen to be satisfactory. Landona House DS0000062558.V293818.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 3 X 3 Landona House DS0000062558.V293818.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 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. 2. Refer to Standard OP19 OP38 Good Practice Recommendations Following the improvement to the appearance of the Home inside it is recommended that the outside of the building also receive some redecoration. That the Proprietor provide additional administrative time to the Manager to allow her to complete her management review in order to develop the ‘management’ role of Senior Care Staff. As new skills are developed by Senior Care Staff the increased administrative time for the Manager could then be reduced. Landona House DS0000062558.V293818.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Shrewsbury Local Office 1st Floor, Chapter House South Abbey Lawn Abbey Foregate SHREWSBURY SY2 5DE 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 Landona House DS0000062558.V293818.R01.S.doc Version 5.2 Page 24 - 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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