Inspection on 18/01/07 for Landscore House

This inspection was carried out on 18th 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

Landscore House 21/03/06

Landscore House 27/09/05

Landscore House 12/01/05

Landscore House 21/09/04

Similar services:

Fairfields Country Rest Home

Queensmount

Poldhu

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Landscore House 3 Landscore Road Teignmouth Devon TQ14 9JU Lead Inspector Stella Lindsay Key Inspection (unannounced) 18th January 2007 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 Landscore House DS0000046736.V321018.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. Landscore House DS0000046736.V321018.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Landscore House Address 3 Landscore Road Teignmouth Devon TQ14 9JU 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) 01626 770340 Nicholas Alan Webb Penelope Webb Penelope Webb Care Home 14 Category(ies) of Old age, not falling within any other category registration, with number (14) of places Landscore House DS0000046736.V321018.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21st March 2006 Brief Description of the Service: Landscore House is situated on a hill about half a mile from Teignmouth town centre. The home is registered to care for up to fourteen people aged sixty-five and over. Two of the residents bedrooms are large enough to be double, but all bedrooms are currently in single occupation. They all have an en suite WC. There are good views from some of the windows. There is a stair lift, but no shaft lift. There is one assisted bathroom, which is upstairs. There is a lounge and adjoining sun lounge. There is a dining room, which is also used for some office duties. There is a south facing terrace and garden, and a sizeable car parking area. The registered providers live on the premises. Fees range from £287 to £396. Landscore House DS0000046736.V321018.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out on a Thursday in January 2007. It involved a partial tour of the premises, and examination of care records, staff files, and the medication procedure. The inspector met with the home owners, Mr & Mrs Webb, nine of the twelve residents and two staff on duty. Surveys and comment cards were received from staff and relatives, and their views are represented in the report. All core standards were inspected. What the service does well: What has improved since the last inspection? The fire doors had been upgraded, according to advice from the Fire Safety Officer, to have surrounding strips that keep out smoke as well as heat. Improved door closers were also fitted to assure residents’ safety in an emergency. Mobility aid equipment had been purchased, and training for staff in its safe use, to give residents safer and more dignified transfers. A professional carpet cleaner had been recently purchased to maintain standards of cleanliness in the bedrooms. Landscore House DS0000046736.V321018.R01.S.doc Version 5.2 Page 6 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. Landscore House DS0000046736.V321018.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 Landscore House DS0000046736.V321018.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Careful assessment and good judgement are used when offering a service to a new resident. 3 EVIDENCE: The care records of two recently admitted residents were examined. These showed that full assessment of their needs had been carried out, and the service had been offered appropriately. One had visited, and moved in the following week, having also made a visit to another home. The other had met the home owner before moving in, though had entrusted inspection of the home to a relative. In both cases, health professionals were involved. Residents had up to date information in their rooms, in red-bound folders. This included the week’s menus as well as the Residents’ Guide, and a summary of the responses to the quality assurance questionnaire. Landscore House DS0000046736.V321018.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff demonstrate a good understanding of the residents’ care and support needs. Medication is well managed, though the storage temperature must be monitored. 7,8,9 EVIDENCE: All residents had care plans clearly written. Particular risk factors such as diabetes or epilepsy were highlighted. The plans are written in the form of identifying the problem, then spelling out the action to be taken. Medical histories are recorded, and weight charts are kept. The home owner designs charts as appropriate, for example, for blood pressure and pulse where this recording is necessary. Records showed that pressure areas are monitored when necessary, and care given. Spiritual and social needs were also recorded. Care plans and risk assessments had been reviewed, with alterations typed in blue so that staff would easily spot any changes. There were signatures of relatives, showing that they had been consulted. The home has a good record of working to keep residents whose health is deteriorating, seeking reviews by health professionals and providing mobility Landscore House DS0000046736.V321018.R01.S.doc Version 5.2 Page 10 equipment. However, any resident who occupies a ground floor room and is unable to use the stair lift cannot get to the bathroom. Such residents were happy with staff’s help to wash. All residents who spoke to the inspector were very satisfied with their care. A diary is used for passing messages to staff coming on duty. Care is taken to keep personal information from this joint record. Information sharing is very good, as the home-owners live on the premises and are fully involved in all aspects of the life and work of the home. A better method for recording daily personal details might be considered for the longer term, for example, a page per person which could be added to their care records when full. No residents were assessed as being competent to manage their own medication. The Manager manages the system of administration of medication, and keeps a list of the staff who have received training and can administer medication. No homely remedies are in use. Controlled drugs are properly and accurately recorded. Medications are stored in a location which may not be ideal with regard to temperature, so a weekly record of the temperature within the storage area should be kept, in order that action may be taken if 25 degrees centigrade is reached. Landscore House DS0000046736.V321018.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident’s views are heard, and routines, activities and meals arranged to please them. 12,13,14,15 EVIDENCE: Most residents choose to stay in their room, and this is respected. One of these particularly appreciated the view from their window, as they can see the boats coming and going from the River Teign to the sea. A musical entertainer is engaged six-weekly, and his visits are most popular as he plays songs that residents like to join in. One resident is collected weekly by her fellow Church members. Several residents talked about having enjoyed going out into the garden during the summer months. Two residents completing the home’s own quality assurance questionnaire said that they would like to be offered more trips out. Relatives who met with the inspector or who returned comment cards were very satisfied with the quality and consistency of the service at Landscore House. ‘I am fully involved in any decision’; ‘staff and owners are always cheerful and receptive of Mum’s needs’; ‘(the owners) provide an outstanding level of care’; ‘their splendid staff reflect ...their caring attitude’. One relative comes for lunch every Sunday. Landscore House DS0000046736.V321018.R01.S.doc Version 5.2 Page 12 On the day of the inspection gammon and parsley sauce were served for lunch, with cabbage, runner beans, cauliflower, carrots and mashed potato. Five vegetables are normally served at Landscore House, for the good nutrition of the residents, and to provide choice for any resident who may not like all of them. This is good provision. The home owner stated that they are serving more fish and cutting down on red meat in the interests of healthy eating. Most residents chose to eat in their room. A few choose to eat at individual tables in the lounge. Residents said that staff ask them what they would like for tea, and offer suggestions. Residents were pleased with the quality, choice and variety of their food. Landscore House DS0000046736.V321018.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 good. This judgement has been made using available evidence including a visit to this service. Residents are protected from potential harm by procedures in place as well as by staff attitudes and training. 16,18 EVIDENCE: A copy of the home’s “Complaints, Comments, Suggestions” procedure is given to each resident as part of the information folder, and the complaints procedure is also displayed on the ground floor. None of the residents spoken with expressed any complaint about the home, and no complaint has been received by the Commission for Social Care Inspection since the last inspection. The home has a procedure for recognising and dealing with abuse, which includes the arrangements for reporting any allegation of abuse as recommended. Staff have had abuse awareness training, and have seen the No Secrets video. Residents told the inspector they would be confident to speak to either of the home owners if they had any concerns. Landscore House DS0000046736.V321018.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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is comfortable and attractive, and kept warm and clean throughout. 19,22,26 EVIDENCE: The home owners live on site, and deal immediately with any maintenance issue that arises. All parts of the home seen were warm, bright and welcoming. There is an attractive and well kept garden. The patio had been re-laid, to ensure safe access to fresh air. Easy access is not available around the entire house. There are four bedrooms on the ground floor. The assisted bathroom is upstairs. Two flights of stairs each with its stair-lift give access to the upper floor. Three of the bedrooms are up three steps from the middle landing. Landscore House DS0000046736.V321018.R01.S.doc Version 5.2 Page 15 Equipment had been obtained in order to help people who have mobility problems to move safely. A motion detector had been installed in a bedroom in order to alert staff when a vulnerable resident rises, as they are unable to use the call bell. The home was clean and sweet-smelling throughout. Protective gloves and aprons were available, and paper towels and liquid soap were provided in toilets. A professional carpet cleaner had been recently purchased to maintain standards. Landscore House DS0000046736.V321018.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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Caring, well-motivated and well-informed staff were providing residents with very good care. 27,28,29,30 EVIDENCE: From observation it was clear that the number of staff on duty was sufficient to meet the current residents’ needs. The residents spoken with said that they felt enough staff are available and that, for example, their call bells are responded to quickly. There is one carer awake at night, with the owners providing sleeping-in cover. The staff spoken with enjoy working at this home and staff morale appears to be high. The home owners work alongside their staff. The current staff group ranges in age from 22 to 63 years, showing an equal opportunity approach by the home owners, as well as providing choice and variety of carer for the residents. Good progress had been made with NVQ training. Of the nine care staff, one had achieved NVQ3 in care, and four had almost completed their NVQ2. Other training provided during the year included Food Hygiene, Infection Control, Death and Dying, Understanding Dementia, Pressure Ulcer prevention, and Abuse. Certificated training on Dealing with Medication and Moving and Handling was provided. Information on diabetes and stroke was available to staff. Landscore House DS0000046736.V321018.R01.S.doc Version 5.2 Page 17 No staff had been recruited since the last inspection. Documents required to assure that residents are protected from potential harm had been gathered by the homeowners when recruiting staff, but had not all been retained as required by the regulations. Landscore House DS0000046736.V321018.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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home owners consult with residents to ensure that their service suits them, and lead their team with care and dedication to ensure the consistency and safe delivery of the service. 31,32,33,35,36,38 EVIDENCE: Mrs Webb, one of the Registered Providers, is also the registered manager of the home. She has worked at Landscore House for over thirteen years, and is accordingly experienced and knowledgeable about this client group. She has continued to undertake training, and has completed the Registered Managers’ Award and NVQ4 in care. Mr Webb is also working towards the Registered Managers’ Award. Staff who returned surveys to the CSCI all said that they consider they receive enough support to do their job well. They appreciate working in a small home Landscore House DS0000046736.V321018.R01.S.doc Version 5.2 Page 19 where the home owners work together with them. A typical view was, ‘Because we are such a small home we have a lot more time to get to know our service users, so we find out what they would like from us and how they would like us to help them…this is great for everyone who lives and works there.’ New residents are given a questionnaire three months after moving in, to give them an opportunity of giving feedback on the service as a whole. This is good practice. Residents’ views have been systematically gathered and summarised annually. The summary of findings for 2006 had been produced, and each resident had a copy in their room. This demonstrated general satisfaction with the service, and responses were given to suggestions. The home owners do not administer the personal money of any residents, but they are aware of their responsibilities were they to do so. A secure facility (a safe) is available for the safe-keeping of residents’ money and other valuables if requested. The home’s Manager carries out appraisals with all staff. Six per year had been documented. These covered assessment of performance, and any plans for progress. The home owner has installed call bells at suitable places according to individual need, considering where each person likes to sit, and their level of vulnerability. Moving and handling training had been provided, and when new equipment had been provided, the suppliers had trained staff in its safe use. The fire doors had been upgraded, according to advice from the Fire Safety Officer, to have surrounding strips that keep out smoke as well as heat. Improved door closers were also fitted, and the home-owner checks regularly to ensure that fire doors close satisfactorily. There is a qualified First Aider on the premises at all times. Landscore House DS0000046736.V321018.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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X 3 X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 4 3 X 3 3 X 3 Landscore House DS0000046736.V321018.R01.S.doc Version 5.2 Page 21 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 OP9 OP29 Good Practice Recommendations The temperature inside the medication cupboard should be monitored, so that remedial action can be taken if it gets to 25 degrees centigrade. The registered Person should ensure that the documents required by schedule 4 of the regulations are retained in the home. Landscore House DS0000046736.V321018.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 Landscore House DS0000046736.V321018.R01.S.doc Version 5.2 Page 23 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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