Inspection on 02/06/05 for Lane End House

This inspection was carried out on 2nd June 2005.

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

Lane End House 14/03/08

Lane End House 29/11/06

Lane End House 17/11/05

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 Rodney Martin Unannounced 2nd June 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. Lane End House H54 S61009 Lane End House V230510 020605.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Lane End House Address Lane End Drive Emsworth Hampshire PO10 7JH 020 89091110 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) Caromar Care Ltd Mr Balkrishna Ramaya-Untiah CRH 16 Category(ies) of OP Old age - 16 registration, with number PD(E) Physical dis - over 65 - 4 of places Lane End House H54 S61009 Lane End House V230510 020605.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Only 4 service users may be accommodated in the PD(E) category. Date of last inspection 26th January 2005 Brief Description of the Service: Lane End House is a 16-bedded residential care home, which is situated in secluded grounds in a quiet residential area of Emsworth. The home is registered with the Commission for Social Care Inspection and provides support and accommodation for older persons. The service is registered for sixteen people over 65 years old, four of whom may have physical disabilities. There is purpose build 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. The service is privately owned by Mr and Mrs Ramaya-Untiah, trading as Caromar Care Limited, with Lane End House H54 S61009 Lane End House V230510 020605.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. There were no requirements or recommendations in the previous inspection report. The unannounced inspection took place between 9.350am and 1.0pm and during the visit Mr Balkrishna Ramaya-Untiah, the registered person and registered manager, was available to assist the inspector in the inspection process. The inspector was able to tour the building as well as speak to all the staff members on duty as well as ten service users. The inspector had a meal with service users at lunchtime. 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 home is meeting its stated aims and objectives. On the day of the visit the home was accommodating sixteen service users, whose ages ranged from 78 to 100 years old. Lane End House has a four male and twelve female service users. On the day of the inspection workmen were working in the home as part of the first phase of an improvement to Lane End House, by building a very large conservatory. Plans have been approved for a two-storey building, which will give the home a single bedroom on the ground floor and five additional bedrooms on the first floor. All new bedrooms will be provided with en suite toilet facilities. There will also be the provision of a new bathroom on the first floor and a separate laundry room. What the service does well: Residents, spoken to, were quick to praise the staff team, who do their utmost to provide a friendly environment, with a caring attitude, providing support and encouragement. One resident commented that one particular staff member was “ a gem” and quick to respond to their needs. The home provides a happy environment for residents. Residents are supported and encouraged in all aspects of individual health care and personal needs. They are able to participate in appropriate age related activities. Residents are settled in Lane End House and were appreciative of the care they received and had no complaints. Lane End House H54 S61009 Lane End House V230510 020605.doc Version 1.30 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. Lane End House H54 S61009 Lane End House V230510 020605.doc Version 1.30 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 Lane End House H54 S61009 Lane End House V230510 020605.doc Version 1.30 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) 3,4,5 and 6 Prospective residents have their needs assessed and are able to visit prior to admission to make an informed choice about whether or not the home is able to meet their particular needs. EVIDENCE: Since the last inspection there have been three admissions, one in February and two in March 2005. The home has an admission policy, which ensures that service users are assessed before accepting a place at Lane End House. When a vacancy occurs, if there are prospective service users on the waiting list they are contacted first, to see if they still require the room. Relatives usually visit first. The prospective service user is then invited to come and spend some time in the home; which includes a complimentary meal and is the preferred way; otherwise, the manager would visit the prospective service user in their own home or in hospital. If the home and prospective service user agrees to an admission, the service user comes on a month’s trial basis. The home is regularly full and when a vacancy occurs it is filled very quickly. The home does not have emergency admissions for this reason. Lane End House H54 S61009 Lane End House V230510 020605.doc Version 1.30 Page 9 The inspector was able to view the files of all sixteen residents. Residents’ case notes are kept together in one file, which contains personal data, various assessments, including risk assessments and activities of daily living assessment. The home has produced a food satisfaction questionnaire as well as a family satisfaction survey. The manager reported that these are due to go out shortly. The inspector spoke with several of the new residents. They were happy with the care they were receiving and evidence gained from their individual file, were appropriately placed in Lane End House. Other residents were full of praise for the staff, in especially one staff member, whom they said “is a real gem and there is nothing they will not do for them, in particular coming when they request it and not saying, “I’ll come in a minute”. The majority of staff have worked in Lane End House for some time and consequently there is a balance of experience and skills within the staff team. This is reflected in the care given to service users. There was evidence that links are made with other specialist services to assist the home in meeting the needs of service users. Lane End House does not provide intermediate care, although prospective service users can come for a short respite stay, if there is a vacancy. Short stay service users are assessed in the same way as permanent service users. Lane End House H54 S61009 Lane End House V230510 020605.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8 and 9 The arrangements for planning care are good, ensuring residents’ physical and emotional health needs are met with evidence of good multidisciplinary working. Working practices in the home ensure the promotion of privacy and independence for service users. EVIDENCE: Care plans are contained in one folder and detail the need/difficulty, with the aim of the care and the course of action required to meet this, along with a review of the care plan. Since the last inspection the home has revised and up dated the various assessments, which lead into the care plan. These are comprehensive and the twenty-three headings detail various risk assessments, activities of daily living, memory, spiritual needs and nutrition. Care plans are reviewed monthly. One service user is permanently confined to a wheelchair, although several service users use one for transferring. The personal and oral hygiene of each service user is maintained and this is recorded in their individual file. An individual record is kept of all health professional visits. Service users are registered with various GP’s in the Emsworth surgery. There is good support from the district nurses. There are Lane End House H54 S61009 Lane End House V230510 020605.doc Version 1.30 Page 11 also domiciliary visits by the dentist and chiropodist. Service users have a choice of attending surgery or other medical services, with staff support, but the majority, because of frailty, have domiciliary visits to the home. Service users have access to all other health professionals on an as needs basis. There was evidence from individual service users’ files of appointments with the dentist, optician, chiropodist and other health professionals. The home has a relevant medication policy, which satisfactorily details the receipt, recording, storage, handling, administration and disposal of medicines. The policy and procedure also included over the counter medication. Residents are able to self medicate within the home’s risk management framework. Currently one resident is self-medicating and a self-medication risk assessment was included in their care plan file. Lockable storage is available in the service user’s room. The home operates a ‘Nomad’ system for administering medication. This is kept in a locked drugs’ cupboard. Controlled drugs, including Temazepam are stored in an inner locked container within the locked cupboard and are recorded in a controlled drugs’ book. The drug administration sheets were found to satisfactorily recorded, with no omissions. The drugs’ cupboard was found to be clean, tidy and safe. The home has a copy of the Royal Pharmaceutical Society of Great Britain’s document ‘the administration and control of medicines in care homes’, to ensure consistency when staff give out medication. Staff have received in-house training from the manager in medication administration. Lane End House H54 S61009 Lane End House V230510 020605.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13 and 15 Social activities, social contacts and meals are well managed and reflect variation and interest for residents. EVIDENCE: The home provides various activities for residents to participate in, including chair aerobics. The home has used a questionnaire to find out what service users would prefer to do. The home has a good selection of games, puzzles et cetera. Three residents go out regularly with their family and three residents go regularly to church. A Church of England cleryman takes a monthly service in the home. Four residents go out for a drink, locally to a pub. There was a good atmosphere in the home. Service users greeted each other when coming to the dining room for lunch and asked after their welfare. The inspector noted a good rapport between the residents and staff, with a lot of friendly banter. Several residents said they enjoyed sitting outside during the summer months. Visitors can visit at any reasonable time and there is a notice up in the foyer regarding this. Residents can see their visitors in the privacy of their bedroom or in the communal areas in the home. Residents are not offered a choice for the midday meal unless they do not like what is on the menu. However, for the tea time meal, staff go round and Lane End House H54 S61009 Lane End House V230510 020605.doc Version 1.30 Page 13 advise residents what is on the menu and record their preference. The inspector had lunch with the residents. The meal was plated and residents had sausages in gravy, mashed potato, carrots, broccoli and cauliflower with strawberry cheesecake for dessert. Three residents had wine with their meal. Residents were due to have spaghetti or bake beans on toast for tea, with a Swiss roll. The manager reported that a nutritional assessment is to be completed on each resident. On the day of the inspection, Mrs Ramaya-Untiah was cooking the midday meal. The inspector discussed the menu with Mr and Mrs Ramaya-Untiah, as there appeared to be a repetition of various meals and the use of frozen vegetables vis-à-vis fresh fruit and vegetables. It is recommended that prior to the nutritional assessment being completed that the advice of a dietician is sought. Lane End House H54 S61009 Lane End House V230510 020605.doc Version 1.30 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16, 17 and 18 The home has a satisfactory complaints procedure, which residents feel able to use and an adult protection procedure, to safeguard residents from abuse. EVIDENCE: The home has a detailed and relevant complaints procedure. Residents, spoken to, were aware of whom to complain should they have a need to. The Commission has not received any complaints and there were none recorded in the home. All the residents are on the electoral roll, enabling them to vote, the home having completed and returned the form to the Electoral Registration office. The home is aware that new service users can be put on the list for Lane End House. The manager took four residents in his car to the polling station on 5 May 2005 to enable them to vote in the general election. The other residents had postal votes. The majority of service users previously lived in the Emsworth and Havant area and all have family and/or friends visiting them. Lane End House has an adult protection policy. Staff receive training in preventing and dealing with suspected abuse. There have been no incidents of abuse recorded in the home. Lane End House H54 S61009 Lane End House V230510 020605.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 21, 23, 24 and 25 A very good standard of accommodation is provided ensuring that residents live in a homely, comfortable and safe environment. EVIDENCE: The inspector was able to tour the building. The home is well maintained and provides a safe environment for service users. Lane End House is situated at the end of a cul-de-sac and has ample car parking space. There are attractive grounds for service users to enjoy. Lane End House is a non-smoking home and none of the service users smoke. There is easy access around the home. On the day of the inspection workman were in the home as part of the first phase of an improvement to Lane End House, by building a very large conservatory. The outer structure was complete and the dining room and lounge windows were covered up as the workmen were ‘breaking through’ to provide patio doors, replacing a window in both the lounge and dining room. The manager discussed with the inspector when to send in the application for Lane End House H54 S61009 Lane End House V230510 020605.doc Version 1.30 Page 16 an increase in the number of residents accommodated in Lane End House. Plans have been approved for a two-storey building, which will give the home a single bedroom on the ground floor and five additional bedrooms on the first floor. All new bedrooms will be provided with en suite toilet facilities. There will also be the provision of a new bathroom on the first floor and a separate laundry room. There is sufficient space within the home for the current sixteen residents. The lounge and separate dining room are well lit with natural sunlight and over look the garden. These two rooms will be further enhanced once the conservatory is available for residents to use. All bedrooms are bright and in a good decorative state and there was evidence of service users’ personal possessions and furniture. The rooms are naturally ventilated. Window restrictors are provided on first floor windows. The home is centrally heated and double glazed throughout. Radiators are thermostatically controlled and have attractive covers fitted. Emergency lighting is provided throughout the home. Lane End House H54 S61009 Lane End House V230510 020605.doc Version 1.30 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 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 and 30 Residents are supported by sufficient staff to ensure their needs are met. The home’s recruitment procedure and staff development plan ensures residents are protected. EVIDENCE: Since the last inspection one staff member retired and the home has recruited a replacement carer. The inspector was able to view their file, which included an application form, their photograph, two references, a CRB returned certificate and a registration form from the Home Office, confirming their right to work in this country. The home currently employs six care staff and two domestic staff members. The manager is aware that following an increase in numbers the home will need to recruit more staff. Two prospective staff members have completed an application form and the necessary checks are in place. They have agreed to commence employment nearer the time. The manager works three days ‘on the floor’ and is supernumerary the rest of the time. Residents spoke highly of the staff and said they were always attentive to their needs. Since the last inspection one carer has commenced National Vocational Qualification [NVQ] level 2 and another carer, NVQ level 3. The inspector spoke to a carer, on the day of the inspection, who is due to start an NVQ level 3 course on 8 June 2005. The manager has a City & Guilds certificate D32 and Lane End House H54 S61009 Lane End House V230510 020605.doc Version 1.30 Page 18 D33 as an internal assessor for NVQ training. He is hoping to complete the new award of A1 and A2, which has superseded the D32 and D33 course. The inspector was able to view the files of all the staff members. Each carer had copies of certificates obtained for a variety of current training courses, including health and safety for the workplace, manual handling, emergency first aid, food hygiene, infection control, first aid, and fire training. Lane End House H54 S61009 Lane End House V230510 020605.doc Version 1.30 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 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, 32 36 and 38 The manager provides good leadership, which ensures staff are supported and residents’ health, safety and welfare are promoted and protected through the home’s practices. EVIDENCE: The manager is suitably qualified to run Lane End House and has a background in nursing. He communicates a clear sense of direction and leadership within the home. He has been able to cascade relevant training to the staff. There is an open, friendly and transparent atmosphere within the home. Residents spoke warmly of staff and the way the home is run. The home is using questionnaires to further ensure a quality control within Lane End House. A system of supervision is in place. Staff have received supervision and there was evidence of this. Lane End House H54 S61009 Lane End House V230510 020605.doc Version 1.30 Page 20 The fire logbook was inspected and the records indicated that the fire safety equipment had been tested and serviced in accordance with previous laid down standards. All staff attended a fire training session on 26 January 2005, with a fire services company, which also included a fire drill. The home updated a fire risk assessment on 9 April 2005. The manager ensures the safe working practices by planning courses on health and safety within Lane End House, including first aid, manual handling, food hygiene, fire and medication. Risk assessments are in place. There are current and up to date contracts on electrical equipment as well as kitchen and domestic appliances et cetera. COSHH policies and procedures are in place. Window restrictors are in place on the windows above ground level, to ensure safety for residents. From an investigation of the records and practices observed in the home during the inspection, the health and safety measures taken in the home ensure the welfare and safety of the residents. Lane End House H54 S61009 Lane End House V230510 020605.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 3 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 3 x 3 3 3 x 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 Standard No 16 17 18 Score 3 3 3 3 3 x x x 3 x 3 Lane End House H54 S61009 Lane End House V230510 020605.doc Version 1.30 Page 22 No 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 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. Refer to Standard Good Practice Recommendations Lane End House H54 S61009 Lane End House V230510 020605.doc Version 1.30 Page 23 Commission for Social Care Inspection 4th Floor, Overline House Blechynden Terrace Southampton Hampshire, SO15 1GW 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 Lane End House H54 S61009 Lane End House V230510 020605.doc Version 1.30 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. 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!