Inspection on 03/07/06 for Lands House Care Home

This inspection was carried out on 3rd July 2006.

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 27/04/07

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 Lands House New Hey Road Rastrick Brighouse West Yorkshire HD6 3QG Lead Inspector Cheryl Stovin Key Unannounced Inspection 3rd July 2006 10:00 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.V293647.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.V293647.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Lands House Care Home Address Lands House 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 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.V293647.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 17th March 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 en joy, especially in the summer months. The weekly charges at the home range from £323 to £448, with additional charges made for personal toiletries, newspapers, hairdressing and podiatry. Lands House Care Home DS0000060872.V293647.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report refers to a Key Inspection of Lands House which was undertaken on 3rd and 4th of July 2006 by an inspector from the Commission for Social Care Inspection. A total of 14 hours was spent on the site visit. In addition to the site visit to the home, when service users were consulted, relatives/visitors were invited as to their opinions of the services and facilities provided within the home by the completion of a comment card. Seven replies were received. A pre-inspection questionnaire was sent to the home which was returned accurately completed. In April 2006 the Commission for Social Care Inspection (CSCI) made some changes to the way in which care services are inspected. Care services are now judged against outcome groups. The inspection report is divided into separate sections for each outcome group for example Choice of Home. An overall judgement is made for each outcome group based on the findings of the inspection. The judgements reflect how well the service delivers outcomes to the people using the service. The judgements categories are “excellent”, “good”, “adequate” and “poor”. The judgements are recorded within the main body of this report. More detailed information about these changes is available on our website – www.csci.org.uk What the service does well: Some form of activity takes place most afternoons with a wide choice available for the service users to participate in if they choose to do so. The activities are recorded and recent activities have included: gentle exercises, old time music hall, reminiscence, video afternoons, arts and crafts, bingo, baking, table games, and church services. In addition to activities provided within the home regular outings take place. The home has a relaxed and welcoming atmosphere, service users’ and visiting relatives and friends confirmed this is always the case. The staff appeared to be working together as a team and meeting the needs of the service users’ in a sensitive and caring manner. Residents 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 “excellent” by the service users’ and the meals observed being served during the inspection appeared appetising and well presented. Lands House Care Home DS0000060872.V293647.R01.S.doc Version 5.2 Page 6 All seven of the respondents to the relatives/visitors comment cards indicated that they were satisfied with the overall care provided within the home. 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. Lands House Care Home DS0000060872.V293647.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.V293647.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3,6 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The Statement of Purpose and Service User Guide requires revising as it does not reflect the current situation within the home, therefore service users do not have the full information they need to make an informed choice about moving in. EVIDENCE: Records seen indicate that all prospective service users’ are subject to a detailed pre-admission assessment to ensure that the home can meet their needs. An admission checklist is in place to ensure that all aspects of life within the home are explained to the new service user upon admission. The Statement of Purpose and Service User Guide requires revising as it does not reflect the current situation within the home, therefore service users do not have the full information they need to make an informed choice about moving in. Intermediate care is not provided within the establishment. Lands House Care Home DS0000060872.V293647.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 at least once during a 12 month period. 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. Service users’ health and personal care needs are thoroughly assessed and care is given in accordance with the plan of care. EVIDENCE: Each service user has an individual plan of care. The documents are detailed and cover all aspects of health and personal care and activities of daily living. The care plans contain manual handling risk assessments, falls risk assessments, tissue viability assessments and nutritional assessments. The care plans are reviewed on a monthly basis. A daily record is made in respect of each resident. The daily recording system has improved since the last inspection and the daily records are now more detailed giving a clear indication of how the person has spent their day. The establishment uses a Monitored Dose System 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 in accordance with NMC guidelines. Medication Lands House Care Home DS0000060872.V293647.R01.S.doc Version 5.2 Page 10 Administration Records were accurately completed and stocks of medication reconciled with records held. Service users, with whom the inspector consulted, confirmed that they are treated with dignity at all times. Lands House Care Home DS0000060872.V293647.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 at least once during a 12 month period. 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. Routines within the home are flexible and service users’ have opportunities to participate in activities if they choose to do so. Nutritious meals are served to the service users’. EVIDENCE: Some form of activity takes place daily with the activities calendar posted in the entrance hall. In addition to activities provided within the home regular outings take place, recent outings have included a theatre visit and meals out. Service users’ 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 inspection said they were always make welcome when they visit the home, and are kept informed of any issues concerning their relative. The service users’ receive a varied and nutritious diet. The main meal of the day is served at lunchtime, and the luncheon being served on the first day of the inspection consisted of: chicken and leek pie, creamed potatoes and fresh vegetables, followed by chocolate sponge and white sauce. An alternative is Lands House Care Home DS0000060872.V293647.R01.S.doc Version 5.2 Page 12 always available. Hot and cold drinks were seen to be freely available. Service users confirmed that they enjoyed the meals served Lands House Care Home DS0000060872.V293647.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and relatives concerns are listened to and acted upon. Residents are protected from abuse. EVIDENCE: The establishment holds a complaints procedure which is freely available to service users’ and visitors. Only two of the respondents to the relatives/visitors comment cards, however, indicated that they were aware of the home’s complaints procedure. A complaints log is held which indicated that two complaints have been received since the last inspection. Both of the complaints had been acted upon and resolved to the complainants’ satisfaction. Staff were familiar with the adult protection procedures and have received training on abuse and the protection of vulnerable adults. Staff were aware of the different types of abuse and how to report any concerns. Lands House Care Home DS0000060872.V293647.R01.S.doc Version 5.2 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,23,24,26 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 well maintained and provides a safe and predominantly clean environment. The majority of the bedrooms would benefit from redecoration and refurbishment. Doors must be fitted to toilet areas where they are not provided. EVIDENCE: A full tour of the building was undertaken during the inspection. The property, a stone built detached period residence, is generally well maintained throughout. Communal areas have been redecorated and are bright and welcoming. The majority of the bedrooms, however, are rather dated and would benefit from refurbishment. 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. With the exception of the recently installed shower room, the Lands House Care Home DS0000060872.V293647.R01.S.doc Version 5.2 Page 15 bathrooms appeared stark and unwelcoming. One bedroom carpet was noted to be exceptionally stained. Service users’ have been encouraged to personalise their bedrooms to reflect their occupants ‘interests and tastes. Service users confirmed that they were satisfied with their private accommodation. The bedroom doors are not fitted with locks suited to service users’ capabilities. Laundry facilities are provided which meet with all the required regulations with infection control measures in place. The fire door to the laundry was noted to be wedged open which is not acceptable. Externally, there are well maintained and safe and accessible gardens and grounds, and an enclosed patio area equipped with garden furniture. The service users’ were enjoying sitting outside during the inspection. Lands House Care Home DS0000060872.V293647.R01.S.doc Version 5.2 Page 16 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 at least once during a 12 month period. 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. There are adequate levels of staff to meet the needs of the service users. There is a programme of NVQ training within the home, however, only 20 of the staff team hold the award. Service users’ are protected by the home’s recruitment practices. EVIDENCE: Staff rotas examined indicated that there is always a Registered Nurse on duty, supported by a team of carers. Five carers are on duty between the hours of 8am until 8pm, and two carers and a nurse between 8pm until 8am. In addition to the nursing and care staff catering, domestic and laundry staff are employed in sufficient numbers. Four of the respondents to the relatives/visitors comment cards felt that, in their opinion, there are not always sufficient staff on duty, with a comment made that “shortage of staff at night makes night time very difficult for the residents”. Three respondents felt that there are always sufficient staff on duty with a comment made that “staff I have dealt with are friendly and courteous”. The staff team were observed to be meeting the needs of the service users’ in a sensitive manner with appropriate use of informality and humour. Service Lands House Care Home DS0000060872.V293647.R01.S.doc Version 5.2 Page 17 users’ expressed satisfaction with the staff team as a whole, and made the following comments: “they can’t do enough for you”, “they are all very kind”, and “tip top staff”. There is a programme of NVQ training in place and all staff are expected to undertake their NVQ II award. At the time of the inspection only 20 of staff had completed the award. In addition to the NVQ training, other recent training opportunities have included: continence care, moving and handling, nutrition and health, safe handling of medicines, catheter care, first aid, dementia care, abuse in the care home and social care and activities. Staff consulted were enthusiastic about the training provided. The home operates a safe recruitment procedure and staff files examined indicated that an application form is completed, two written references received and a CRB and POVA disclosure are required prior to commencing employment. Lands House Care Home DS0000060872.V293647.R01.S.doc Version 5.2 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,35,38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed; the interests of the residents are seen as important to the manager and staff. Staff are appropriately supervised. Residents’ financial interests are safeguarded. Health, safety and welfare are promoted. EVIDENCE: The acting manager of the home, a registered nurse, is experienced and competent and is committed to ensuring an open and positive atmosphere is prevalent within the home. She has applied to be registered as manager by the CSCI and will shortly be attending for a ‘fit person’ interview. There are Lands House Care Home DS0000060872.V293647.R01.S.doc Version 5.2 Page 19 clear lines of accountability between the owner and the manager and they work together as a strong management team dictating clear leadership. Staff supervision systems are in place and staff meetings are held on a six weekly basis Any money held on behalf of service users’ is securely held in individual pockets with a record kept of all financial transactions. Cash held reconciled with records kept. The home promotes the health and safety and welfare of the service users’ and staff. Certificates were seen indicating compliance with gas and electricity regulations, and the lift is regularly serviced. A current service certificate for the hoist was not available at the time of the inspection. The fire door to the laundry must be kept closed at all times. Lands House Care Home DS0000060872.V293647.R01.S.doc Version 5.2 Page 20 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 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 2 17 x 18 3 3 3 1 x 3 2 x 1 STAFFING Standard No Score 27 3 28 1 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 x 3 x x 2 Lands House Care Home DS0000060872.V293647.R01.S.doc Version 5.2 Page 21 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 A minimum of 50 of care staff must be qualified to NVQ II or equivalent. This remains outstanding from the last inspection. The Statement of Purpose and Service User Guide must be revised to reflect the current situation within the home. The fire door to the laundry must be kept closed at all times. The bedroom carpet identified as being dirty must be cleaned. Doors must be fitted to toilet facilities where there are none. The hoist must be serviced and a certificate held indicating date of the service. Timescale for action 31/01/07 2 OP1 4 31/08/06 3 4 5 6 OP38 OP24 OP21 OP38 23 23 23 13 04/07/06 31/07/06 30/09/06 31/08/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Good Practice Recommendations DS0000060872.V293647.R01.S.doc Version 5.2 Page 22 Lands House Care Home 1. 2 3 Standard OP16 OP24 OP24 All relatives/visitors should be made aware of the home complaints procedure. Areas identified as in need to redecoration to be carried out as part of a routine programme of refurbishment. Suitable locks should be fitted to bedroom doors. Lands House Care Home DS0000060872.V293647.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Brighouse Area Office Park View House Woodvale Office Park Woodvale Road Brighouse HD6 4AB National Enquiry Line: 0845 015 0120 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. 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