Inspection on 27/09/05 for Landscore House

This inspection was carried out on 27th September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 18/01/07

Landscore House 21/03/06

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 Announced 27 September 2005 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 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 D54-D07 S46736 Landscore House V239594 270905 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Landscore House Address 3 Landscore Road, Teignmouth, Devon, TQ14 9JU Telephone number Fax number Email 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 Care Home 14 Category(ies) of Old age, not falling within any other category registration, with number (14) of places Landscore House D54-D07 S46736 Landscore House V239594 270905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 12/01/05 Brief Description of the Service: Landscore House is situated on a hill about half a mile from Teignmouth town centre. Two residents bedrooms are large enough to be double, but all are currently in single occupation, and all have an en suite WC. There is a stair lift, but no shaft lift. There is one 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 D54-D07 S46736 Landscore House V239594 270905 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place over a Tuesday and Wednesday in September 2005. It involved a tour of the premises, and examination of care records, staff files, and health and safety records. As well as discussion with the Home owners, the inspector met with staff and residents, and thanks all for their time. What the service does well: Landscore House is a small and homely care home, where staff and residents know each other well, but privacy and independence are respected. Care is taken to make sure that new entrants will be suited by the home. The Home owners visit, and have collected prospective residents and brought them to visit. Care plans are drawn up carefully in consultation with the resident, and a relative if that is appropriate. Risk assessments updated regularly, with alterations printed in blue for staff awareness, and action is taken to reduce or remove hazards. Staff are well motivated, and have a good caring attitude to their work. They are encouraged to spend time talking with residents, and outings and activities are arranged to suit individuals. Residents said that they can get up when they like, and go to bed, or have a bath, when they want. Some choose to have their meals in their room, while some like to come downstairs for company. The house is attractive and the Home owners deal with any environmental problem promptly. A good standard of decoration and furnishing is maintained, to provide a comfortable and attractive home. Eight bedrooms had been redecorated and recarpeted this year, and carpets in all communal areas had been renewed in the past two years. The gardens and flower tubs were full of colour. Residents and staff commented on the energy and commitment of the Home owner – ‘anything that needs doing is done instantly’. Comments received from relatives were entirely positive – ‘all the staff are friendly, helpful and dedicated’, this is a ‘professionally run and genuinely caring home’, ‘all staff are very helpful and cheerful and the owners in particular go out of their way to make sure Mum and I are happy’ – are representative. Landscore House D54-D07 S46736 Landscore House V239594 270905 Stage 4.doc Version 1.40 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. Landscore House D54-D07 S46736 Landscore House V239594 270905 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Landscore House D54-D07 S46736 Landscore House V239594 270905 Stage 4.doc Version 1.40 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 standard(s) 1,3,5 There is a good range of written information for prospective residents and their representatives to understand what support and care the Home offers. Care is taken to assess a person’s needs before offering accommodation. EVIDENCE: There is good information for prospective residents, which has been recently updated. A pack is kept by the front door to offer visitors. The Home owners visit applicants, to assess their needs and ensure that the home is suitable before offering accommodation. They have produced their own format to ensure that all aspects of care are considered. Nursing referrals and Social Service care plan summaries were also seen on files of new entrants. The Home owner brought a patient from a local hospital to visit before they decided to move in. Another resident had been for a convalescent stay a year before she needed to move in on a long term basis, and was keen to return to Landscore House. Landscore House D54-D07 S46736 Landscore House V239594 270905 Stage 4.doc Version 1.40 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 standard(s) 7,8,9,10,11 Personal care and health needs are met with close attention to detail, and excellent recording. There is a sound system for administering medication. Residents’ privacy is respected. EVIDENCE: All residents have care plans, which the Manager reviews monthly with the resident or their relative. They include a policy statement on care planning. Social worker, GP and hospital visits are recorded separately, and includes the name of the professional who attended. Health records were kept so well that the progress of recovery could be read from residents’ care records. The home has 7 propad mattresses and two airwave mattresses for the people who are most vulnerable to pressure areas. Risks associated with cot sides had been assessed, and a different method of achieving safety was found – ie obtaining a lower bed. On another occasion the doctor’s agreement had been recorded, which is good practice. Following an accident, a resident needed regular blood pressure and pulse checks. This was done, and the Home owner had produced a chart to meet these specific recording needs clearly. Landscore House D54-D07 S46736 Landscore House V239594 270905 Stage 4.doc Version 1.40 Page 10 Residents said they were very pleased with the staff, and that they come quickly when wanted. There is a clear policy on Medication. There were two medicine cupboards fixed to the wall, and suitable storage facility for Controlled drugs, and a register for recording their administration. No homely remedies were kept. At the time of the inspection only three staff were competent to administer medication, but training had been arranged for others. A list of competent staff should be kept with the Medication Administration Record (MAR)sheets, with an example of the initial normally used. Residents’ MAR sheets had been completed accurately, and their photo was attached (to help staff avoid making mistakes). Old or unwanted medicines had been reclaimed by the pharmacist, who had signed for them. All the residents who returned comment cards to the Commission for Social Care Inspection said that they felt well cared for, and that their privacy was respected. Although there are two rooms large enough to be double, all are in single occupation, and residents said they were happy with their rooms. Suitable locks are fitted to bedroom doors. The hairdresser comes to peoples’ private accommodation. The Manager is trying to gather information regarding residents’ wishes about their own care in their final illness and after death. Residents have been given a fact-finding form to discuss with their family if they wish. When there was a difference of opinion between the resident and their family on future arrangements, the Home Owners had kept written records in order that the residents’ wishes may be carried out. Landscore House D54-D07 S46736 Landscore House V239594 270905 Stage 4.doc Version 1.40 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 standard(s) 12,14,15 The Home owners and staff promote choice and give individual consideration, in the routines of daily life, social activities, and meals. EVIDENCE: Residents said that they can get up when they like, and go to bed, or have a bath, when they want. One said they had been out till 11.30pm for a family celebration recently. Residents may be limited by their disabilities or medical condition but not by the home’s routines. Staff are encouraged to spend time talking with residents, ‘talk first, clean later’. They may have a game of Scrabble. Outings and activities are arranged to suit individuals. One resident told the inspector that the Home owner heard her say that she had not been out for a while, and then took her for a two hour drive, then brought tea on a tray. Another said that the Home owner takes her to the library and waits while she chooses her books. An entertainer is regularly booked to lead the residents in ‘Old time Singing’. Some residents choose to have their meals in their room. One who needs to be careful with their diet for health reasons said that staff come to her room to ask what alternative she would like. Residents have all been given smart red leather bound books containing the menus for the month ahead. One said they can ‘choose from the menu for breakfast’ and staff come and ask ‘what do Landscore House D54-D07 S46736 Landscore House V239594 270905 Stage 4.doc Version 1.40 Page 12 you want for your tea’. A staff member said that one resident had wished for prawns – and the Home owner bought some in for tea. Plenty of vegetables are served with every meal to give choice as well as a healthy diet. On the day of the inspection four different vegetables were served as well as potatoes, Yorkshire puddings, beef and gravy. Landscore House D54-D07 S46736 Landscore House V239594 270905 Stage 4.doc Version 1.40 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 standard(s) 16,18 The ‘Complaints, Comments, and Suggestions’ procedure is given to each resident, and residents are confident that their suggestions are heard and acted upon. The Adult Protection policy did not include the local reporting arrangements, which are to afford best protection for residents. EVIDENCE: Residents had all been given copies of the complaints procedure, which they had in their rooms. No complaints have been received, but if any were, they would be recorded, a response made, and records kept in the confidential office in the basement. The Home had a procedure for recognising and dealing with abuse, but it did not include the local arrangements for reporting any allegation of abuse. Staff have had abuse awareness training, and have seen the No Secrets video (of which the home has a copy). Landscore House D54-D07 S46736 Landscore House V239594 270905 Stage 4.doc Version 1.40 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 standard(s) 19,20,21,24,26 The house is attractive and the Home owners deal with any environmental problem promptly, in order to provide a safe and comfortable home for the residents. EVIDENCE: Landscore House is set on the hillside above Teignmouth. The Home owners have renewed and improved floor coverings to encourage mobility, and there is a stair lift to the bedrooms and the bathroom on the upper floor. The Home owner does not keep a maintenance book, because he deals with any problem as soon as it comes to his attention. This was observed during the inspection, with the immediate adjusting of a faulty thermostat and adjusting a fire door so that it closed effectively. The kitchen refurbishment is almost complete, with new units, good work surfaces and a non-slip floor. Eight bedrooms have been redecorated and recarpeted this year. Planning permission is awaited to renew windows in the conservatory. Landscore House won a Teignmouth in Bloom Award in 2004, and hopes to again this year. The floral displays around the front drive and in the garden Landscore House D54-D07 S46736 Landscore House V239594 270905 Stage 4.doc Version 1.40 Page 15 were still colourful in the September sunshine. The Home owner has laid attractive non-slip brick paving to make the garden paths safe and accessible, and built a pergola, which will give pleasant shade next summer. The lounge is so comfortable that residents have chosen to have their meals served there, at individual tables. It has recently been redecorated, and carpet tiles were brought for residents to make their choice. The lounge is brightly lit with a new chandelier. It has no direct daylight but leads straight into the conservatory, which is bright and looks across the garden and the Teign estuary. The dining room has a choice of tables, one looking on to a patio garden. It is not currently used for dining, but has many other uses. A combination Standaid/hoist has been purchased by the home, for the use of any resident who may benefit or need to be lifted after a fall. Grab rails and toilet frames have been provided according to individual need. Lighting has been improved, with chandeliers newly fitted in the lounge, entrance hall and top landing. In bedrooms there were central and bedside lights. Residents said that they liked their bedrooms. Those visited by the inspector were attractively decorated and furnished. One resident said how happy they were with their room, which has its own conservatory. Suitable locks had been fitted to bedroom doors. Furniture had been provided to meet the needs of the residents, and height of chairs to enable independent movement, and solidity of furniture to help avoid falls had all been considered. One said that the Home owner had brought furniture from home for her, and her own bedding – and a Chinese pagoda for the garden. The home was sweet smelling throughout, and residents said that the laundry is done well. The laundry has readily cleanable floor and walls, and there is an effective system in place to ensure that soiled linen is not allowed to contaminate clean laundry. Landscore House D54-D07 S46736 Landscore House V239594 270905 Stage 4.doc Version 1.40 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28,29,30 Staff are well motivated and work positively with residents, adding to their quality of life. EVIDENCE: There is a written rota which shows that there are three care staff on duty between 8am and 8pm. This is in addition to the Home owners who are fully involved in the personal, health and social care of the residents. At night there is a waking Care Assistant, as well as both Home owners, who live on the premises. It is clearly sufficient to meet residents’ needs, as they said that they get ‘almost immediate attention’. All relatives who returned comment cards to the Commission for Social Care Inspection gave the opinion that there are always sufficient staff on duty. The Home owners said that they look for a caring attitude when appointing staff, which is good practice but they also should promote a qualified workforce. Currently of the nine care staff, one has achieved NVQ3 in care, and another is working towards NVQ2. The Registered Manager stated that three staff are considering embarking on NVQ training, and that a pay increase is offered on achievement of the qualification. The files of the recently appointed staff were examined. Two written references and CRB clearances had been obtained, in order to protect residents. The two Home owners interview candidates together, and use the same set of questions, in the interests of Equal Opportunities. A contract of employment had been given. Landscore House D54-D07 S46736 Landscore House V239594 270905 Stage 4.doc Version 1.40 Page 17 The Manager had worked through a TOPSS affiliated induction programme with new staff, in order to properly prepare them for work with the residents. This included Fire drills, Moving and Handling, Infection Control, Food Hygiene, Abuse in the Care Home, Effective Communication, Death, Dying and Bereavement, understanding dementia, Pressure ulcer prevention, and Care Needs and the Role of the Care Worker. Eye awareness training is also planned. Landscore House D54-D07 S46736 Landscore House V239594 270905 Stage 4.doc Version 1.40 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,33,36,37,38 The Home owners have a clear vision for the home, for the care to be delivered now, and the direction for the future, and they communicate this effectively with their staff team. Safe systems of work are maintained, with records kept to demonstrate consistency. EVIDENCE: Mrs Webb, one of the Registered Providers, is also the registered manager of the home. She has worked at Landscore House for over twelve years, and is accordingly experienced with this client group. She has continued to undertake training, and expects to complete the Registered Managers’ Award and NVQ4 in care by September 2006. Staff said that although formal staff meetings are not held, informal communication and teamwork are very good. 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 Landscore House D54-D07 S46736 Landscore House V239594 270905 Stage 4.doc Version 1.40 Page 19 annually. This covers levels of care, meals, cleanliness and décor, facilities, activities, and the use of the visitors’ book and complaints book. Residents had all been given copies of the summarised results of the questionnaire. There is a business plan which recognises the changes in the care sector, and states the managements’ aims to maintain their high occupancy by keeping their skilled and motivated workforce, and keeping the home appealing and presentable. Improvement of facilities are planned, with appropriate financial planning. The Manager records probationary reviews, and includes comments from residents on how helpful they find the new carer, also records their flexibility and teamwork. She follows this with two monthly ‘Staff Continual Assessment Reviews’, which is good practice. Staff confirmed that they have individual meetings with the Registered Manager for their supervision, feedback, and development. Record keeping was found to be very good at Landscore House, with charts produced by the Home owner to meet specific recording needs, and all records written clearly and promptly. The Home owners maintain good practice with health and safety issues. There is a written statement of the policy, organisation and arrangements for maintaining safe working practices. Risk assessments of rooms in the building have been done. The Fire Safety policy was reviewed on 02/09/05. Fire risk assessments have been completed. The fire precaution system was checked professionally on 04/04/05, and the Home owner checks the emergency lighting and the holdopen devices on fire doors. Staff training includes a fire training video. All staff had signed to say they had attended fire drills. These had been held quarterly, and charts were kept showing attendance. The house has been assessed for risk of Legionella, and action taken to avoid any risk. The Home owner is booked to train as a Moving and Handling trainer. Inhouse up-dates have been held, using a video training resource. There is a qualified first aider on duty at all times. Five staff members had achieved their Food Hygiene certificates recently. Further training was booked for First Aid and Food Hygiene. Accidents are recorded. Any serious accident must be reported to the Commission for Social Care Inspection, in accordance with regulation 37(1)©. Landscore House D54-D07 S46736 Landscore House V239594 270905 Stage 4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 x 4 N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 3 10 3 11 4 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 x 14 4 15 4 COMPLAINTS AND PROTECTION 3 3 3 x x 3 x 3 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 2 3 x 4 3 x 3 3 3 Landscore House D54-D07 S46736 Landscore House V239594 270905 Stage 4.doc Version 1.40 Page 21 Are there any outstanding requirements from the last inspection? 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 OP18 Regulation 13(6) Requirement The Adult Protection procedure must include the local reporting arrangements. Timescale for action 31/10/05 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. Refer to Standard Good Practice Recommendations Landscore House D54-D07 S46736 Landscore House V239594 270905 Stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection Unit D1 Linhay Business Park Ashburton Devon, TQ13 7UP 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. Extracts may not be used or reproduced without the express permission of CSCI Landscore House D54-D07 S46736 Landscore House V239594 270905 Stage 4.doc Version 1.40 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. 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