Inspection on 27/04/07 for Lands House Care Home

This inspection was carried out on 27th April 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Lands House Care Home 29/04/09

Lands House Care Home 24/04/08

Lands House Care Home 03/07/06

Lands House Care Home 17/03/06

Lands House Care Home 06/02/06

Lands House Care Home 18/01/05

Lands House Care Home 14/09/04

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

CARE HOMES FOR OLDER PEOPLE Lands House Care Home New Hey Road Rastrick Brighouse West Yorkshire HD6 3QG Lead Inspector Cheryl Stovin Key Unannounced Inspection 27th April 2007 10:30 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 Lands House Care Home DS0000060872.V337841.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. Lands House Care Home DS0000060872.V337841.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Lands House Care Home Address New Hey Road Rastrick Brighouse West Yorkshire HD6 3QG 01484 716633 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) Mrs Georgina Copley vacant post Care Home 30 Category(ies) of Old age, not falling within any other category registration, with number (30) of places Lands House Care Home DS0000060872.V337841.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 3rd July 2006 Brief Description of the Service: Lands House is registered to provide nursing and personal care for up to 30 older people. The establishment, a spacious detached property, is situated on New Hey Road in Rastrick with easy access to the town centres of Halifax, Brighouse and Huddersfield. Local community facilities are nearby. The establishment is generally well maintained throughout and provides accommodation in single and double rooms. Safe and accessible garden areas with seating are available for the service users to enjoy, especially in the summer months. The weekly charges at the home range from £336 to £448, with additional charges made for personal toiletries, newspapers, hairdressing and podiatry. Lands House Care Home DS0000060872.V337841.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report brings together evidence gathered during a key inspection of Lands House. This included an unannounced visit I made to the home on 27th April 2007. A total of 5 hours was spent on the visit. During this time I looked round the home, examined some of the records and spoke with management, staff and the people living at the home. In addition to this visit, comment cards were sent out to give people an opportunity to share their views of the service with us. A total of twenty three comment cards were returned from people living at the home. Eight relatives/visitors responded and two health care professionals replied. The response was generally positive with people expressing satisfaction with the services and facilities provided in the home. The last inspection of Lands House was on 3rd July 2006, no additional visits have been made. A pre-inspection questionnaire was sent to the home which was returned promptly and gave useful information. What the service does well: The home has a relaxed and welcoming atmosphere, people living at the home and visiting relatives and friends confirmed this is always the case. Some form of activity takes place most afternoons with a wide choice available for the people using the service to participate in if they choose to do so. The activities are recorded and recent activities have included gentle exercises, ball games, reminiscence, video afternoons, arts and crafts, bingo, baking, table games, and songs of praise. In addition to activities provided within the home, regular outings take place. The staff appeared to be working together as a team and meeting the needs of the people living at the home in a sensitive and caring manner. People consulted expressed satisfaction with the standard of care and facilities provided within the home. The standard of the meals provided in the home were described as “first class” by the people living at the home, and the meals seen being served during the visit appeared appetising and well presented. Lands House Care Home DS0000060872.V337841.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Lands House Care Home DS0000060872.V337841.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 Lands House Care Home DS0000060872.V337841.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): 1,2,3,5,6 People who use the service experience good outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. People’s needs are assessed before moving into the home and they are provided with written information about the services and facilities provided. EVIDENCE: The home has updated the Statement of Purpose which now contains up to date information about the services and facilities provided by the home. This means that people have sufficient information about the home before making a decision to move in. All people are assessed before moving into the home to ensure that their needs can be met. People are encouraged to visit the home before making a decision to move in, to meet the staff and other people living in the home. Lands House Care Home DS0000060872.V337841.R01.S.doc Version 5.2 Page 9 The manager stated that all people have a contract which states the terms and conditions. This could not be confirmed during the visit as only the provider has access to these documents and she was not available at the time of the visit to the home. All people living at the home, however, who returned a comment card said that they have a contract. Intermediate care is not provided in the home. Lands House Care Home DS0000060872.V337841.R01.S.doc Version 5.2 Page 10 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): 7,8,9,10,11 People who use the service experience good outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. People’s health and personal care needs are met and care plans clearly show how their support is to be given. EVIDENCE: All people living at the home have an individual care plan. The care plans have recently been revised following concerns raised by the local authority contracts monitoring team. The care plans now contain up to date assessment of needs and how the care is to be delivered. The assessments now include details of nutritional requirements, falls risk assessments, tissue viability and skin care and medical information. The revised care planning documentation is now acceptable to the Local Authority contracts monitoring officer. A daily record is kept which clearly shows how people have spent their time and any significant events. Lands House Care Home DS0000060872.V337841.R01.S.doc Version 5.2 Page 11 People living at the home spoken to during the visit confirmed that their personal and health care needs are met. The comment cards received supported this. One GP who returned a survey made the following comments: “Staff are caring and sympathetic to individual health care needs for patients”. “Lands House responds appropriately to health needs, seeking appropriate advice and managing appropriate care”. “Lands House cares well for patients who are terminally or potentially terminally ill. They are well nursed and cared for and this enables a GP to keep a patient in familiar circumstances and surroundings rather than sending them into hospital”. The home uses a Monitored Dose System (MDS) supplied by a local pharmacy for the administration of medication. The medication is securely and appropriately stored. The qualified nursing staff are responsible for administering the medication. Medication Administration Records were accurately completed and stocks of medication reconciled with records held. The medication systems ensure that people using the service are given their medication safely. Lands House Care Home DS0000060872.V337841.R01.S.doc Version 5.2 Page 12 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 People who use the service experience good outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. People choose how to spend their time and join in activities provided in the home. The quality of the meals provided are good and mealtimes are a relaxed social occasion. EVIDENCE: Some form of activity takes place daily with the activities calendar posted in the entrance hall. The current activities advertised include reminiscence therapy, ball games, gentle exercise, videos, arts and crafts, bingo, baking, songs of praise and board games. In addition to activities provided within the home, regular outings take place. People living at the home who returned a comment card said they there was always or usually activities available in the home for them to take part in. Lands House Care Home DS0000060872.V337841.R01.S.doc Version 5.2 Page 13 One relative who returned a comment card said “We do not get proper letters about trips or extra activities carried out, just asked for the money. Would appreciate more information”. People living in the home confirmed that they can choose when to go to bed and when to get up and where and with whom to spend their time. Visitors spoken to at the time of the visit said they were always made welcome when they visit the home, and are kept informed of any issues concerning their relative. Relatives who returned a survey said that the care home always helps their friend or relative to keep in touch with them. The following additional comments were received: “The staff are friendly and helpful when in contact with people”. “They will ring me if I need to sort something out”. “We visit on a regular basis so they do not need to contact us often, but they do ring if anything is wrong or she requires anything”. Menus showed that the people living at the home receive varied and nutritionally balanced meals. The main meal of the day is served at lunchtime and, on the day of the visit, the lunch was fish, chips and peas followed by rice pudding. People said they enjoyed their meals and one person said “the fish and chips here are the best”. The people living at the home who returned a comment card all said that they enjoyed the meals served at the home and one made the additional comment “mealtimes are managed very well”. Lands House Care Home DS0000060872.V337841.R01.S.doc Version 5.2 Page 14 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): 16,17 People who use the service experience good outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. People are protected by the policies, procedures and practices in the home. EVIDENCE: The home has a complaints procedure and a complaints log is held which details all complaints received and the outcome of the investigation. Seven of the relatives who returned a survey said that they knew how to make a complaint about the care provided by the home. One did not but made the following comment “but I would find out if I felt that neglect was taking place”. All of the people living at the home who returned a survey said that they knew who to speak to if they were unhappy about anything in the home. Five said “The Matron”. All staff have received training in the Protection of Vulnerable Adults (POVA). Staff spoken to were aware of the procedure to follow if they suspected that abuse or neglect was taking place. Lands House Care Home DS0000060872.V337841.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): 19,20,21,23,24,25,26 People who use the service experience adequate outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. The home is maintained to an acceptable standard but people’s private living space is in a poor state of decoration. EVIDENCE: A full tour of the building was undertaken during the visit. The property is generally maintained to an acceptable and safe standard. A passenger lift is provided to ensure that people living at the home have access to all areas of the building. Some communal areas have been redecorated and are bright and welcoming. The majority of the bedrooms, however, are rather dated and would benefit from refurbishment. Lands House Care Home DS0000060872.V337841.R01.S.doc Version 5.2 Page 16 In two of the shared bedrooms equipped with en-suite facilities, there was no door to the toilet area, only a curtain, which does not promote the privacy and dignity of the service users. In another bedroom with an en-suite, there was no screening at all to the toilet facilities. Pull cords to the light switches in some of the bedrooms were tied up and out of reach, which means that the people cannot switch on the light whilst in bed. Bedrooms are not fitted with locks to enable the people living at the home to keep their possessions safe. In one of the shared rooms, there were three wheelchairs stored in the ensuite, which meant the people sharing the room could not use the facilities provided. People living at the home are encouraged to personalise their rooms and there was evidence of personal possessions in the majority of the bedrooms. Some of the bathrooms have been redecorated and appear fresher and cleaner. Comments made by relatives who returned a survey included: “The bedrooms are all different shapes and sizes and some residents get a better environment than others. My mother’s room is rather small (shared) and she does not have enough cupboard space for her belongings owing to access being needed for wheelchairs”. “It would be good to have areas to store extra equipment, like room separators out of double rooms as this in mum’s room is pushed in front of a mirror on the wall, which could otherwise be used. Storage space for photo’s etc., (shelves maybe) could be installed to make the room homely. Plants could be watered to keep them alive longer”. “The decoration needs updating”. “I think the décor needs updating”. The home was seen to be clean and hygienic throughout. People using the service who returned a comment card confirmed that the home was always fresh and clean. There are well maintained, safe and attractive garden areas which are enjoyed by the people living at the home in the warm weather. Lands House Care Home DS0000060872.V337841.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 People who use the service experience adequate outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. People living at the home are supported by adequate numbers of staff and are protected by the home’s recruitment practices. Staff rotas are not completed accurately and do not record who is on duty at any given time. EVIDENCE: There is always a Registered Nurse on duty supported by a team of carers. The staff rotas seen were not completed accurately and did not reflect who was actually on duty at any given time. The duty rota stated that one particular carer was on duty on Friday night followed by 8am until 8pm on the Saturday, which obviously is impossible. This was an error on the rota, not actual working time. The nursing staff rota had also been changed at short notice which resulted in the nurse in charge, at the time of the visit, spending a lot of time ringing round colleagues to cover shifts, instead of spending time with the people living at the home. Lands House Care Home DS0000060872.V337841.R01.S.doc Version 5.2 Page 18 As the rotas were not completed accurately, it was not possible to assess the actual numbers of staff on duty at any time. There did, however, appear to be sufficient staff to meet the needs of the people during the visit. The staff were meeting the needs of the people living at the home in a sensitive manner and promoting dignity and independence. People spoken to confirmed that this was always the case. People living at the home who returned a survey said that staff are always available when they need them. Additional comments made included: “There is always someone available in the home”. “There is always someone to talk to”. “All staff are always there to listen, I am happy living in the home”. “There is always somebody to hand”. “Well satisfied with the staff”. “The staff try to help the best they can”. Relatives who returned a survey said that they felt the staff always or usually have the right skills and experience to look after people properly. The following additional comments were made: “I feel the care home tries it’s best sometimes under difficult circumstances, to meet the needs of the residents”. “The staff make sure all residents are cared for properly. Give their time to residents ensuring they are comfortable in their surroundings”. “Things are talked about on review days re changes my mum requires. Some fall by the wayside in time, probably due to staff changes and shifts. Maybe an appraisal could be done from time to time to check these changes by internal management”. “They create a homely environment with good care and support”. “We feel the standard of care provided is good and the staff are approachable”. “If anything I feel there is too much emphasis on new initiatives and training to the detriment of staff being seen to be around”. Lands House Care Home DS0000060872.V337841.R01.S.doc Version 5.2 Page 19 “When I get old and in need of a care home I would have no hesitation but to come to Lands House. I can’t praise the staff enough. What they do always puts the residents first”. One GP who returned a health care professional survey card made the following comments: “Staff are pleasant and friendly with residents and respond appropriately to their needs. Staff are reliable, experienced and of a high calibre”. There is a programme of National Vocational Qualifications (NVQ) in the home with all staff being required to undertake their level 2 award. The home is working towards meeting the requirement that 50 of the care staff are qualified to NVQ level 2 which will ensure that a high standard and consistent quality of care is given to the people living at the home. In addition to the NVQ and mandatory health and safety training, additional training by staff has included understanding MRSA, tissue viability and skin care, catheter care, dementia care in elderly clients and falls risk. The home operates a safe recruitment procedure and staff files seen showed that an application form is completed, two written references received and a Criminal Records Bureau (CRB) and Protection of Vulnerable Adults (POVA) disclosure are required prior to commencing employment. Lands House Care Home DS0000060872.V337841.R01.S.doc Version 5.2 Page 20 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): 31,32,33,35,38 People who use the service experience adequate outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. People live in a well run and adequately managed service. People’s health and welfare are protected by the home’s health and safety practices. EVIDENCE: The acting manager of the home is experienced and competent to run the home. She is a Registered General Nurse and has been in post for over twelve months. She has not as yet registered to obtain the NVQ level 4 Registered Managers Award and must do so. Lands House Care Home DS0000060872.V337841.R01.S.doc Version 5.2 Page 21 The manager has applied for registration with the CSCI but the process has been delayed and the manager was advised to pursue this with the registration team. The manager and the proprietor work together as a team and provide strong leadership. There are clear policies and procedures for handling finances which means that people’s personal finances are held safely. There are detailed health and safety policies and procedures in place. All staff receive mandatory training in health and safety and safe working practices. Risk assessments are in place which ensure the health and safety of the people living at the home is protected. Lands House Care Home DS0000060872.V337841.R01.S.doc Version 5.2 Page 22 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 3 3 3 x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 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 2 1 x 3 2 2 3 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 3 3 x 3 x x 3 Lands House Care Home DS0000060872.V337841.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? Yes 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 OP28 Regulation 18 Requirement To make sure that consistent care is given to people, progress must be made to ensure that a minimum of 50 of care staff are qualified to NVQ II or equivalent. Timescale for action 31/08/07 2. OP21 23 This remains outstanding from the last inspection. Timescale of 31/01/07 has not been met). All toilet facilities must be fitted 30/06/07 with doors, to protect the privacy and dignity of the people using the service. This remains outstanding from the last inspection. Timescale of 30/09/06 has not been met). The manager must ensure that the duty rota is completed accurately. This is to ensure that a record is kept of which staff were on duty at any one time. The manager must register for and undertake a recognised NVQ level 4 management DS0000060872.V337841.R01.S.doc 3 OP27 17(2) Schedule 4 08/05/07 4 OP31 9 30/06/07 Lands House Care Home Version 5.2 Page 24 5 OP20 23 qualification. This is to ensure that the home is managed effectively. All people living at the home must be able to control the lighting in their own rooms. Pull cords that are out of reach must be replaced to enable people to switch the light on and off from their beds. 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. 2. 3. Refer to Standard OP24 OP24 Good Practice Recommendations People using the service should live in comfortable surroundings. Redecoration and refurbishment should be carried out to ensure this. People using the service should be able to lock their bedroom doors to ensure privacy and security. Lands House Care Home DS0000060872.V337841.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Brighouse Area Team First Floor St Pauls House 23 Park Square Leeds LS1 2ND 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 Lands House Care Home DS0000060872.V337841.R01.S.doc Version 5.2 Page 26 - 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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