Inspection on 24/10/06 for Lanrick House

This inspection was carried out on 24th October 2006.

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

Lanrick House 11/05/09

Lanrick House 25/06/08

Lanrick House 23/01/06

Lanrick House 17/09/05

Lanrick House 27/01/05

Lanrick House 04/06/04

Lanrick House 15/10/03

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

CARE HOMES FOR OLDER PEOPLE Lanrick House 11 Wolseley Road Rugeley Staffordshire WS15 2QJ Lead Inspector Mrs Kathryn Marks Key Unannounced Inspection 24 October 2006 08:45 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 Lanrick House DS0000004970.V316316.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. Lanrick House DS0000004970.V316316.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Lanrick House Address 11 Wolseley Road Rugeley Staffordshire WS15 2QJ 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) 01889 577505 01889 577505 Mr Barry Price Mr Richard Charles Britten, Mrs Diane Isobel Britten, Mrs Hazel Mary Elizabeth Price Mrs Geraldine Mary Reid Care Home 32 Category(ies) of Dementia - over 65 years of age (18), Old age, registration, with number not falling within any other category (32), of places Physical disability (1), Physical disability over 65 years of age (6) Lanrick House DS0000004970.V316316.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. One Physical Disability (PD) - Minimum age 62 years on admission. Date of last inspection 23 January 2006 Brief Description of the Service: Lanrick House is a care home that can accommodate thirty-two older people with needs associated with old age and dementia related conditions. The home is located in a residential area of Rugeley, is close to amenities and served by public transport. The premises a large Victorian house which has been extended, is pleasantly situated with lawns and external sitting areas. Adequate car parking is provided. Accommodation is provided on three levels, the first and second floors are served with stairs and a shaft lift. There are 12 single occupancy bedrooms and 10 doubles, and no bedrooms have an en-suite facility. There are adequate bathroom and toilet facilities on each floor of the home. There are two separate lounges, and two separate dining rooms, located on the ground floor. Services and facilities including laundry, catering and hotel services are adequate with ongoing upgrading work taking place. There is an area used as a service user smoking area when food is not being served. The two service users who use this area are happy with this arrangement. The registered care manager, her deputy, and teams of care assistants provide care. Health service professionals such as district nurse, community psychiatric nurse, and physiotherapist are accessed when required, and local GP’s and a pharmacist service the home. Activities, hobbies and entertainment all take place and transport is provided when required. Families and friends are encouraged to take part, and have an involvement in the home. Information gained from the Care Manager identified that the current fees charged are £327 to £425 per week. Lanrick House DS0000004970.V316316.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced key inspection was carried out on the 24/10/06 between the hours of 08:45 am to 1.30 pm. The inspection was undertaken using the National Minimum Standards for Older People as a reference. The Registered Care Manager was in charge of the home, accompanied by the deputy care manager and three care assistants. These staffing levels were adequate to meet the needs of the current service users in the home. As at the previous inspection aspects of care had been addressed well, with service users able to choose the home following an assessment and invitation to visit Lanrick House. Service users plans had been well written, based on the community care plans completed by social workers. Health, personal and social care needs had been met and well documented. Privacy, dignity and choice aspects for service users were being upheld. Six feedback cards were received from service users, six from relatives, one from team manager, one from General Practitioner, all made positive comments about the home. The home appeared to be managed well by a competent care manager. General management aspects were good with quality assurance taking place although the area of quality assurance is to be further developed. One complaint has been received since the last inspection relating to care issues. This complaint has been investigated and was found not upheld. There was also one in house complaint relating to the wrong clothing being delivered to a service users bedroom, this was dealt with by the home. Both were recorded in the complaints book. What the service does well: The home provides a good standard of care for its service users in a relaxed atmosphere where staff were observed to be interacting with individuals in a respectful and jovial manner. Service users the inspector talked to said they were happy at the home and that staff cared for them appropriately. The following are a sample of comments made. “I love it here” “I came fifteen years ago for a week and I am Lanrick House DS0000004970.V316316.R01.S.doc Version 5.2 Page 6 still here. Relatives visiting the home said that they were made welcome and that they were satisfied with the care observed at Lanrick House. 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. The summary of this inspection report can be made available in other formats on request. Lanrick House DS0000004970.V316316.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 Lanrick House DS0000004970.V316316.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This means the home was able to meet the needs of service users. The homes Statement of Purpose and Service Users Guide provides prospective service users with up to date details of the services the home has to offer enabling an informed decision about admission to Lanrick House to be made. Standards 1, 3, were reviewed at this visit. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The homes admission procedures for service users choosing Lanrick House remains as at previous visits. The documentation seen, evidenced that service users had been assessed prior to admission and they had been enabled to make a choice about the home. All involved had visited the home prior to choosing to stay, had a meal spent the day at Lanrick House and this formed part of the assessment process. A full assessment of each service users needs had taken place and this was documented. Lanrick House DS0000004970.V316316.R01.S.doc Version 5.2 Page 9 The community care plans provided by the social worker, as part of the individual needs assessment process, were seen within the service user plans. Observations of staff and discussions with individuals identified staff had the necessary experience and skills to meet the assessed needs of the current service users. The home informs service users in writing of the outcome of assessments. The inspector saw a service user guide and the homes statement of purpose both were comprehensive. Lanrick House DS0000004970.V316316.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Health, personal and social care needs of service users is well met. The systems for the administration of medication were observed by the inspector to be good with clear arrangements being in place to ensure service users medication needs are met. Standards 7,8,9,10 were reviewed. EVIDENCE: All service users have in place an individual plan of care with a photograph identifying the service user. Care Plans are detailed and include a Life Map, risk assessments, plan of care, health care needs. The Care Plans of three service users were reviewed along with documentation relating to them. Visiting district nurses have separate records when visiting service users. Lanrick House DS0000004970.V316316.R01.S.doc Version 5.2 Page 11 There were no service users currently choosing to self medicate. Medication is stored in a locked trolley secured to the wall and administered by senior staff trained to do so. Policies and procedures are in place to inform staff of procedures. Observations of staff were that they treated service users with respect and their approach to individuals was sensitive and calm. Lanrick House DS0000004970.V316316.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Standards 12,13,14,15 have been reviewed. The systems in place for consultation with service users are good with a variety of evidence that indicates that resident’s views are sought and acted upon. EVIDENCE: The home has a weekly sheet identifying social activities available for service users to choose from if they wish to be involved and a record is kept of who does become involved. However there is a need to individually identify activities for diverse groups of service users to evidence that all receive social stimulation as identified in standard 12.3 of National Minimum Standards. The majority of service users go out to Rugeley tennis club for lunch once a week paid for by the home. All service users with the exception of one have visitors on a regular basis and visitors were moving freely in and out of the home today. One resident has an advocate from assist to act on their behalf. Lanrick House DS0000004970.V316316.R01.S.doc Version 5.2 Page 13 Observations were made throughout this visit of service users making choices about their chosen daily routines. The homes menu for the next four weeks was seen and offered a varied traditional choice of food with alternatives available at all mealtimes. Inspector had lunch at the home today this was nicely presented and tasteful. Teas consisted of a choice of sandwiches fruit jelly cakes salads and a light cooked choice. Lanrick House DS0000004970.V316316.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Standards 16,18 have been reviewed. The home has a satisfactory complaints system with some evidence that service users views are listened to. EVIDENCE: There has been one complaint received about Lanrick House since the last inspection regarding care issues. This complaint has been fully investigated and was not upheld. The home has a complaints procedure in place this is displayed in the hallway for service users/relatives and is contained in the service users guide. The home has in place a book to record any complaints and how they are dealt with. Discussions with service users identified that they were aware of the complaints procedure. The service users feel able to raise issues with staff the most recent was an in house complaint relating to clothing this is recorded and was dealt with by the home. Lanrick House DS0000004970.V316316.R01.S.doc Version 5.2 Page 15 Service users are protected from abuse by staff awareness, discussions during supervision and staff meetings, observations, and training. Policies and procedures are in place at the home. Staff regularly has discussions about abuse and read the homes policies signing to say they have read and understood. Lanrick House DS0000004970.V316316.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Standards 19,21,26 were reviewed. Lanrick House has been subject to ongoing refurbishment and areas that have been upgraded have been done to a good standard. EVIDENCE: The home generally is well maintained and suitable for its stated purpose. Communal areas include two lounges, and two dining areas both have been attractively refurbished. A number of original features of the house have been retained including the fireplace alcove in the dining room. Lanrick House DS0000004970.V316316.R01.S.doc Version 5.2 Page 17 Bathrooms and toilets are satisfactory in number and appropriately sited around the home. The inspector was told at the last inspection that plans are in hand to refurbish ground floor bathroom in 2006. This refurbishment has not commenced due to vacancies in the home. Externally there are attractive gardens with level walkways and seating for service users. Observations of the inspector were that areas of the home visited was clean and free from offensive odour. On arrival at the home observations were made of a glass bowl propping open the sash window of bedroom 6 on the second floor. This window and frame appear to be rotten. To ensure the safety of staff and service users an audit must be carried out of windows in the old part of the house and prioritise the repair/replacement of any windows in a poor state. This will be a requirement of this report. Lanrick House DS0000004970.V316316.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Standards 27,28,29,30 were reviewed at this visit. Staff on duty at Lanrick House was observed to be competent and satisfactory in number to meet the needs of individuals in their care. Staff morale was observed to be good with the staff team working well together assisting individuals where needed to make choices to improve their quality of life. Appropriate procedures are in place for the recruitment of staff. EVIDENCE: Observations of staff on duty at this unannounced inspection were that staff were as the rota and satisfactory in number to meet the observed needs of service users in their care. The home has in place a training matrix that clearly identifies who needs to attend which training. Infection control, food hygiene, and medication are all booked for ongoing or refresher training. Lanrick House DS0000004970.V316316.R01.S.doc Version 5.2 Page 19 Robust recruitment procedures are in place to employ staff Criminal Records Bureau checks are carried out along with POVA checks prior to permanent employment being offered. To ensure compliance with Regulation 19, schedule 2 paragraph 7 (a) records of CRB and POVA must be retained at Lanrick House. Lanrick House DS0000004970.V316316.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Standards 31, 33, 35, 38, were reviewed at this visit. The Manager is well supported by the proprietors in providing clear leadership throughout the home with all staff demonstrating an awareness of their roles and responsibilities. EVIDENCE: As at the previous inspection the Care Manager is competent and experienced to care for older people and manage the staff. The Care Manager has the Registered Managers Award and attends all staff training to update her knowledge. Systems and procedures have been reviewed by her and updated to meet the stated aims and objectives of the home. Lanrick House DS0000004970.V316316.R01.S.doc Version 5.2 Page 21 Records are kept of transactions entered into by the home and those records observed were up to date. The home has in place a quality audit programme along with resident/relatives surveys and questionnaires that are continually reviewed. The home is not involved in the management of service users finances. The registered proprietors and care manager ensures so far as is reasonably practicable the health safety and welfare of service users and staff. Lanrick House DS0000004970.V316316.R01.S.doc Version 5.2 Page 22 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 4 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 4 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X 3 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 4 X 4 X 3 X X 3 Lanrick House DS0000004970.V316316.R01.S.doc Version 5.2 Page 23 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 OP19 Standard Regulation 23 (2) (b) Requirement The premises to be used as a care home are of sound construction and kept in a good state of repair externally and internally. Timescale for action 31/01/07 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 OP12 Good Practice Recommendations Ensure that individual records are maintained for socialisation of service users with diverse needs including individuals with dementia. 12.3 To ensure compliance with Regulation 19, schedule 2 paragraphs 7 (a) records of CRB and POVA must be retained at Lanrick House for inspection purposes. 2 OP29 Lanrick House DS0000004970.V316316.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Stafford Office Dyson Court Staffordshire Technology Park Beaconside Stafford ST18 0ES 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. 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