Inspection on 14/03/08 for Lane End House

This inspection was carried out on 14th March 2008.

CSCI found this care home to be providing an Good service.

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

Lane End House 29/11/06

Lane End House 17/11/05

Lane End House 02/06/05

Lane End House 26/01/05

Lane End House 18/10/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE Lane End House Lane End Drive Emsworth Hampshire PO10 7JH Lead Inspector Michelle Presdee Unannounced Inspection 14th March 2008 09:50 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 Lane End House DS0000061009.V359373.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. Lane End House DS0000061009.V359373.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Lane End House Address Lane End Drive Emsworth Hampshire PO10 7JH 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) 01243 373046 01243 378562 laneendhouse@yahoo.co.uk Caromar Care Limited Mr Balkrishna Ramaya-Untiah Care Home 22 Category(ies) of Old age, not falling within any other category registration, with number (22), Physical disability over 65 years of age (8) of places Lane End House DS0000061009.V359373.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 29th November 2006 Brief Description of the Service: Lane End House is a 22-bedded residential care home, which is situated in secluded grounds in a quiet residential area of Emsworth. The service is registered for twenty-two people over 65 years old, eight of whom may have physical disabilities. There is purpose built accommodation on the ground floor with en suite toilet facilities, which are suitable for wheelchair users. Lane End House has a shaft lift to the first floor accommodation and assisted bathing facilities. Mr and Mrs Ramaya-Untiah, trading as Caromar Care Limited, with Mr Ramaya-Untiah as the registered manager, privately own the service. On 21 October 2005 the home’s registration increased from sixteen service users accommodated to twenty-two, following the completion of an extension providing five bedrooms downstairs and one upstairs. Lane End House’s aim of philosophy of care is to provide its residents with a secure, relaxed and homely environment in which their care, well being and comfort are of prime importance. Carers will strive to preserve and maintain the dignity, individuality and privacy of all residents within a warm and caring atmosphere and in so doing will be sensitive to the resident’s ever changing needs. The current fees are £450 to £600 per week. This information was obtained on the day of the inspection. There are additional charges for hairdressing, chiropody, tapes, books, magazines and newspapers. Lane End House DS0000061009.V359373.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. During this inspection The Commission (we) were assisted by Mr RamayaUntiah the manager of the home and the deputy manager. We were able to speak to a lot of people living in the home, some in more depth than other. Members of staff on duty were also spoken with, as were visitors to the home. All feedback was of a very positive nature. Surveys were received from staff, residents, health professionals and relatives. The home sent us their Annual Quality Assurance Assessment (AQAA) back on time, which had detailed information. A tour of the home including all communal areas, the kitchen, the laundry and most of the bedrooms was taken on the day. Paperwork including assessments, service user plans, menus, staffing records and health and safety checks were seen. All this information has helped form the judgements included in this report What the service does well: What has improved since the last inspection? What they could do better: The controlled drugs cupboard needs to meet the required standard. A risk assessment on the garden needs to be competed and any areas identified as needing action need to be addressed. Lane End House DS0000061009.V359373.R01.S.doc Version 5.2 Page 6 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. Lane End House DS0000061009.V359373.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 Lane End House DS0000061009.V359373.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): 3, 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People have accurate assessments of their needs and are confident the home can support them. EVIDENCE: We were told in the AQAA a full assessment is carried out at the potential residents home or at hospital and if an emergency admission the assessment will be carried out when the resident comes to the home. If a care manager is involved with the person an assessment from them will be sought. All residents are given a copy of the up to date Service Users Guide and Statement of Purpose. The assessments of three people living in the home were seen. These gave a very clear picture of the persons needs prior to admission and stated what the aims of the care were. The person concerned had signed the assessments and there was evidence of family involvement in the assessment process. Lane End House DS0000061009.V359373.R01.S.doc Version 5.2 Page 9 Whilst talking to residents in their rooms we were shown copies of the Statement of Purpose and Service User guide, which all people had a copy of in their room. All surveys received from residents stated they had enough information on the h0me before moving in. The home does not provide intermediate care. Lane End House DS0000061009.V359373.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a plan of care to meet each person’s health, personal and social care needs. Medication is managed in a safe way. People’s right to privacy is respected and support is given in a way that maintains dignity. EVIDENCE: The AQAA told us a comprehensive plan of care is developed for each resident, looking at emotional, psychological and physical needs. The three care plans seen detailed information on memory, co-operation, independence, relationships, communication, social interests and hobbies, skin and foot care, orientation, sleep patterns, medication mobility, nutrition. A moving and handling plan was also available. Risk assessments had been completed. It was noted changes had been recorded on care plans as they had been reviewed monthly. We were advised residents are usually involved in the care plans and reviews and evidence was seen that this takes place on a regular basis. Plans also included details of resident’s religion and how they wished to carry on practicing their faith. All surveys received from residents had ticked staff are always available and staff act and listen to what they say. One person stated, Lane End House DS0000061009.V359373.R01.S.doc Version 5.2 Page 11 “The staff are very kind and helpful”. One relative stated “The support often goes beyond expectations from the staff and owners”. Care plans included information on a persons health needs. Evidence was seen on care plans that a range of health professional visit the service including, dentist, optician, chiropodist, district nurse and doctor. Surveys from health professional revealed they felt the home offered god care and they were contacted appropriately. One stated, “staff have been very supportative in assisting my client and have liaised closely with the mental health team. It was noted in one care plan it detailed the person suffered from diabetes, clear instruction were on the care plan as to how this should be managed and a chart was maintained. One relative stated, “When mum has been unwell the Doctor has always been called and we are always informed”. The home had a clear medication policy and procedure. Staff spoken to confirmed only staff that have undertaken training are involved with the administration of medication. The home uses a monitored dosage system. We were advised the home manages the medication for all residents. Medication and records held for three residents were checked and it was noted these were being stored appropriately and accurate records were maintained. Controlled medication was being dispensed and recorded appropriately. It was noted for one person the medication held did not match the records held; we were advised this is because the person had been in hospital. The way controlled medication is being stored in the home does not meet with the required standard. All unused medication is returned to the pharmacist, the book was seen, which has been signed regularly by the pharmacist. It was clear from observations and from discussions with staff, that they have a respect for all residents and resident’s privacy. Staff were observed to knock on residents door and waited for a verbal response from the occupant before going in. All doors had appropriate locks. In discussion with one resident he stated how pleased he was with the staff and felt some were like “good friends”. Lane End House DS0000061009.V359373.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Each person is treated as an individual and can join in activities. People keep in touch with family and friends. People have nutritious meals at a time and place to suit them. EVIDENCE: The service user plan details information on each person’s hobbies, interests and social contacts. The home organises daily activities, which are displayed on a notice board in the home. People have the choice to join in events or not. Events include singing and music, birthday parties, crafts, exercises and a range of games and puzzles. On the day people were enjoying a game of ‘Hoopla’, which was causing much enjoyment and merriment. A range of musical instruments had been purchased; with money a family had donated in memory of their relative. One person told us how he had enjoyed going on a ferry trip to the Isle of Wight with a member of staff. Another resident enjoys going shopping with the manager. Four residents are able to access the community on their own. Staff will weather permitting take residents for a walk to the local millpond and car trips to the local beach are arranged. All surveys from residents had ticked there is always activities they can take part in. One Lane End House DS0000061009.V359373.R01.S.doc Version 5.2 Page 13 person stated, “I enjoy the activities exercise and entertainment”. Religious services are offered in the home and people if they want will be helped to the local church. Visitor are encouraged and made welcome at the home. Visitors spoken to stated they could visit at any time and were always made welcome. They confirmed they could see their relative in private or in any of the communal areas. It was clear from discussions with residents and visitor’s residents have choices and control over their lives. Residents are asked to join in social events but their choice is respected if they do not want to join in. Care plans record how a person wishes to be addressed. Details are also recorded on how each resident can manage part of their own personal care. The home usually does a weekly menu; which is done with residents. The cook confirmed resident’s wishes have been taken into account when the menus are planned. Cheese and biscuits with a range of pickles had recently been added to the menu at the request of a resident. Residents have the choice of having their meals in the dining room or in their own rooms. Residents who needed assistance with meals were observed and it was noted this was done in a dignified manner. All residents spoken stated they enjoyed their meals and a choice was available. One person stated, “the fish meals were marvellous” and another commentated “there is too much to eat, but it is all very tasty”. All residents in the surveys received had ticked always for liking the meals in the home. One health professional survey received stated their client had felt there was not enough choice at breakfast and did not receive a large enough evening meal. Lane End House DS0000061009.V359373.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People know how to complain and know their concerns will be looked into. The home safeguards people from abuse and neglect. EVIDENCE: The AQAA states all residents are issued with a copy of the complaints procedure, which is incorporated into the service user guide. All residents spoken to stated they would have no concerns complaining to the manger whom they all felt would sort out any problem. Visitors and staff spoken to stated if they had any concerns they would discuss it with the manager who all had confidence it would be sorted out. The home had copies of a safeguarding adults procedure and prevention of abuse procedure. All policies and procedures are available to staff. Members of staff spoken to were aware of the whistle blowing procedure and what action to take if abuse was suspected but were unsure what agency should be contacted. The home has a training session booked on Adult Protection. Lane End House DS0000061009.V359373.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. EVIDENCE: The home is well maintained and all areas seen on the day were clean and no offensive odours were detected. The home has twenty- single bedrooms. Four residents were spoken to in their bedrooms, who were full of praise for the home. All stated their rooms and laundry are kept very clean. Resident surveys received stated they all felt the home was always clean and fresh. One resident stated, “The home is very clean and frequently dusted, swept and vacuumed”. The home has a very large conservatory, with access from both the dining room and lounge. Some residents enjoy sitting out in the conservatory, which was comfortably furnished. Residents can access the garden from the conservatory. Lane End House DS0000061009.V359373.R01.S.doc Version 5.2 Page 16 The garden was well furnished, and recently had a new lawn laid. In parts the pathway had steps and uneven pavements. We were advised the steps were going to be clearly marked and a risk assessment would be completed on the garden. The home has a separate laundry room, which was clean and tidy. There was evidence of COSHH [control of substances hazardous to health] policies and procedures in place and staff were observed to be complying with infection control procedures and practices. Lane End House DS0000061009.V359373.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People have appropriate and safe support by competent, experienced and trained staff. They have confidence in the staff as the home makes appropriate checks on staff to ensure they are suitable to care for them. EVIDENCE: Some staff have worked in the home for some considerable years, but recently three new staff members have been recruited. Six out of ten care staff have achieved a National Vocational Qualification (NVQ) Level 2. The deputy manager is currently studying for a N.V.Q level 4 and registered Managers Award. The home also employs a cook and a domestic. Staff spoken to stated, they enjoyed working in the home and always felt there was enough staff on duty to meet the needs of the people in the home. An extra member of staff has started working in the afternoons to ensure there is always an activity taking place. We were advised two members of staff work a night duty, one working a sleep in duty and the other an awake duty. Discussions were held on whether this was adequate to meet the needs of residents. When looking at night time notes it was noted at some times in the night in a one hour period five residents needed assistance with going to the toilet. The manager agreed to keep this under review and discuss with nighttime staff. Staff meetings are held and staff reported when a new resident comes into the home, meetings are always held to ensure all their needs are being met and any concerns can be discussed. Staff felt they worked well together and were supportative of each other. Resident’s and visitors all praised the staff. Resident’s staff and Lane End House DS0000061009.V359373.R01.S.doc Version 5.2 Page 18 visitors all praised the manager stating he was always available and was very supportative. The staffing records of the two newest members of staff were seen. It was noted these were very well organised and contained the correct checks and documentation. Files included staff handbooks, code of conduct and a job description. Staff spoken to confirmed they were aware they were not allowed to start work in the home until all necessary checks and references had been obtained. The manager confirmed he is going to start using the Common Skills Induction pack. It was noted new staff had undertaken an induction, which had been signed by the manager and the member of staff. Staff spoken to felt the training offered was adequate for them to do their jobs. They stated if there was an area of training they felt they needed the manager would try and organise this. The training records were very well maintained and there was a clear system for recording when training needed renewing. A range of training methods and companies were used. All staff had in-date training in all the key areas. Lane End House DS0000061009.V359373.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People have confidence in the care home because it is well managed. The environment is safe for people and appropriate health and safety practices are carried out. EVIDENCE: The manager is suitably qualified to run Lane End House, having obtained a nursing diploma in higher education, the registered managers award for NVQ level 4 in management and care. All persons spoken to including residents, visitors and staff were full of praise for the manager. All stated he had an open door policy and could be contacted at any time. Lane End House DS0000061009.V359373.R01.S.doc Version 5.2 Page 20 It was clear the home is run in the best interests of the people who live there. The home has a friendly open atmosphere and residents are consulted on decisions affecting the home. Quality audits are carried out annually and areas identified by the residents will be acted on. The audit at the end of 2007 showed residents were 100 happy with the food. All surveys received from residents, staff and relatives praised the home and the management of the home. Relatives confirmed they were always kept in touch with developments regarding their relative and the home. We were advised the home does not become involved in any of the resident’s money. The manager explained if he has to pay any money out on the behalf of residents’ for example a hairdressing bill he puts this itemised on the monthly bill. The AQAA advised us regular checks are made on the equipment in the home and professionals service these. The fire logbook was seen, which demonstrated all the necessary checks were being carried out within the agreed timescales. The accident book was being filled out appropriately. Staff reported they all have the equipment and training they need and there is always a supply of appropriate gloves and aprons. The laundry was well maintained. All windows had restrictors fitted. Lane End House DS0000061009.V359373.R01.S.doc Version 5.2 Page 21 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 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X 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 3 X 3 X 3 X X 3 Lane End House DS0000061009.V359373.R01.S.doc Version 5.2 Page 22 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. 1 Standard OP9 Regulation 13 Requirement Controlled Drugs, including Diazepam, must be stored in a Controlled Drugs cupboard complying with the Misuse of Drugs (Safe Custody) Regulations 1973 Timescale for action 02/07/08 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 Lane End House DS0000061009.V359373.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Lane End House DS0000061009.V359373.R01.S.doc Version 5.2 Page 24 - 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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