CARE HOMES FOR OLDER PEOPLE
Landscore House 3 Landscore Road Teignmouth Devon TQ14 9JU Lead Inspector
Mark Sharman Unannounced Inspection 21st March 2006 13:30 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 Landscore House DS0000046736.V271536.R01.S.doc Version 5.1 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.V271536.R01.S.doc Version 5.1 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.V271536.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 27/09/05 Brief Description of the Service: Landscore House is situated on a hill about half a mile from Teignmouth town centre. 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 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. There are good views from some of the windows. The registered providers live on the premises. The home is registered to care for people aged sixty five and over. Landscore House DS0000046736.V271536.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection and a little over three hours were spent at the home. Some time was spent with the owners, and six of the residents and three staff were also spoken with. A small sample of care records was examined. All of the communal areas of the home were seen, as well as several of the bedrooms. What the service does well: What has improved since the last inspection?
One requirement was made at the last inspection that an amendment was to be made to the home’s adult protection procedure, and this has now been dealt with. This clarifies action to be taken by the management if an allegation of abuse at the home were to be made. The kitchen has recently been refurbished, including new storage units, work surfaces and new flooring. Three more staff plus Mr Webb are now registered for NVQ level 2 in care, which will help to promote a qualified workforce.
Landscore House DS0000046736.V271536.R01.S.doc Version 5.1 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. Landscore House DS0000046736.V271536.R01.S.doc Version 5.1 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.V271536.R01.S.doc Version 5.1 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): None of these Standards was considered. (Standard 6 is inapplicable). EVIDENCE: Landscore House DS0000046736.V271536.R01.S.doc Version 5.1 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): 9 and 10. There is a satisfactory system for administering medication. It is clear that residents’ privacy is respected and dignity maintained. EVIDENCE: All aspects of the home’s medication system which were considered were being dealt with satisfactorily. None of the current residents self-medicates. Medication was stored securely in two metal drugs cupboards, and a sample of the medication administration recording sheets was inspected. The separate controlled drugs register was also inspected. A list of the staff who are authorised to administer medication to the residents has been compiled as recommended. The manager (Mrs Webb) said that she is arranging for external medication training to take place in the home so that additional staff can be competent to administer medication. All of the residents spoken with were very complimentary about the attitude of the staff and the owners, and said they are treated with respect by all. They confirmed that they are treated with dignity with regard to their personal care. A chiropodist attended to several of them during the inspection, and gave them their treatment in their own bedrooms. Although there are two double bedrooms in the home these are used for single occupation. Several residents
Landscore House DS0000046736.V271536.R01.S.doc Version 5.1 Page 10 have their own telephone in their bedroom (some were seen), and a cordless telephone is available for use in private by other residents who do not have their own. Landscore House DS0000046736.V271536.R01.S.doc Version 5.1 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): 13 and 15. Residents are fully able to maintain contact with their relatives and friends. The catering arrangements are of a commendable standard. EVIDENCE: Residents said they may have visitors at any reasonable time and most of those spoken with said they do have regular visitors. Indeed some visitors were seen in the home during the afternoon (but not spoken with by the inspector on this occasion). Residents may use a cordless telephone in the privacy of their own rooms in order to keep in touch with relatives and friends. All of the residents spoken with said they were very satisfied with the meals and catering arrangements in general. A typical comment made was “the food is wonderful”. Each resident has a leather folder (seen) containing important information about the home’s services, including printed menus for the next four weeks. The menus were examined and demonstrated a wide variety of nourishing meals. There are always at least four different vegetables served with main meals, and a very large choice of sandwiches or hot snacks at tea time. The lunch on the day of the inspection was roast lamb and lots of vegetables followed by apple strudel. Landscore House DS0000046736.V271536.R01.S.doc Version 5.1 Page 12 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 and 18. Residents are fully confident that any complaint made would be taken seriously. There are satisfactory arrangements to protect residents from abuse. 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 now includes the arrangements for reporting any allegation of abuse as recommended. Staff have had abuse awareness training, and have seen the No Secrets video (of which the home has a copy). Landscore House DS0000046736.V271536.R01.S.doc Version 5.1 Page 13 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, 24 and 26. The home offers comfortable, attractive accommodation and was warm, clean and tidy. EVIDENCE: All parts of the home seen were warm, bright and welcoming. This included the residents’ bedrooms, most of which have been personalised and made homely by the residents (with help from Mr Webb). There was a high standard of cleanliness, including bathroom and toilets, which residents said is normal. The kitchen has recently been refurbished, including new storage units, work surfaces and new flooring. The laundry room was inspected. It has readily cleanable floor and walls, and the equipment includes two commercial washing machines and a commercial dryer. There was no unpleasant odour in any of the rooms visited. Landscore House DS0000046736.V271536.R01.S.doc Version 5.1 Page 14 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 and 28. The current staffing arrangements are sufficient to meet the residents’ needs, and progress is being made to create a qualified workforce. EVIDENCE: From observation it was clear that the number of staff on duty was adequate to meet the current residents’ needs. Mr and Mrs Webb are very much “hands on” owners and provide a lot of the staff cover themselves. The residents spoken with said that they felt enough staff are deployed 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. Currently one of the care staff has achieved NVQ level 3 in care, and another is working towards NVQ level 2. Mrs Webb said that three more of the care staff plus Mr Webb are now registered for NVQ level 2. Accordingly progress is being made towards the 50 NVQ target, and the Standard should be fully met when that has been reached. Landscore House DS0000046736.V271536.R01.S.doc Version 5.1 Page 15 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): 35. Residents can be confident that their financial interests are protected. EVIDENCE: In fact 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. Landscore House DS0000046736.V271536.R01.S.doc Version 5.1 Page 16 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 x x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 x 8 x 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 x 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 x x x x 3 x 3 STAFFING Standard No Score 27 3 28 2 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x x x x 3 x x x Landscore House DS0000046736.V271536.R01.S.doc Version 5.1 Page 17 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. Refer to Standard Good Practice Recommendations Landscore House DS0000046736.V271536.R01.S.doc Version 5.1 Page 18 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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