Inspection on 25/06/08 for Lanrick House

This inspection was carried out on 25th June 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

Lanrick House 11/05/09

Lanrick House 24/10/06

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 28/09/2008.

CARE HOMES FOR OLDER PEOPLE Lanrick House 11 Wolseley Road Rugeley Staffordshire WS15 2QJ Lead Inspector Peter Dawson Key Unannounced Inspection 25th June 2008 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.V366686.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.V366686.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.V366686.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 24th October 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. 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 £368 - £380 per week. Lanrick House DS0000004970.V366686.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 stars. This means the people who use this service experience good quality outcomes. This inspection was carried out on one day by one inspector from 8.45 a.m. – 5.00pm. The inspection was undertaken using the National Minimum Standards for Older People as the basis for assessment. 30 People were in residence and around half reported to have dementia care needs. The service provided an Annual Quality Assurance Assessment (AQAA) which was received prior to the inspection and some information from that assessment is include in this report. Eight feedback forms were received by us directly from residents prior to the inspection. Positive comments were made about the care provided at Lanrick House, although one comment about the cleanliness of the toilets was investigated during the inspection but all toilets throughout the day were clean and hygienic. Positive comments were made about the “excellent” food although in written feedback it was stated that very little fresh fruit was available. This is delivered twice weekly by suppliers and the Manager will ensure this is more readily available to residents. A resident who has lived at the home for 17 years and leads an active social life said that he was very happy with all aspects of care and took part in all social activities inside and outside the home. His chosen lifestyle is known and supported. He has “no complaints at all about any aspect of the home”. There was an inspection of the physical environment which is well maintained and a sample of bedrooms seen showed comfortable rooms with good personalisation. Two regular weekly visitors were spoken with and spoke highly of the care and commitment of staff to residents needs. A visiting District Nurse with knowledge of the home said that relationships between care staff and the District Nursing service were good. She confirmed that staff have a pro-active approach to healthcare needs and were helpful and cooperative in the treatment of residents. Lanrick House DS0000004970.V366686.R01.S.doc Version 5.2 Page 6 Records relating to the inspection process were seen including a sample of care plans and related documents. Records were generally to a high standard although some records require updating as stated in this report. What the service does well: What has improved since the last inspection? The main reception/corridor areas on the ground and part of the first floor have been re-carpeted and redecorated improving the presentation of the home giving a more luxurious feel to those areas. Some bedrooms have been reccarpeted and new toilets, wash-hand basins and a new bath hoist have been provided. Personalised activities and related daily life plans have been introduced for each person, ensuring the social and recreational needs of all residents are known and met. Recording of activities provides evidence of the involvement of residents. Lanrick House DS0000004970.V366686.R01.S.doc Version 5.2 Page 7 The laundry has been redecorated following a recommendation of the last report and improves presentation and infection control in that area. There has been some replacement/repair of some sash windows as recommended in the last report and agreed with the provider. What they could do better: All residents should be weighed monthly (or weekly if there are concerns about weight loss). This will ensure that healthcare needs can be monitored. Recording in this area could be improved. Some care plans require updating of information to give a current account of the actions required by staff to meet current needs. This will further improve the service to residents. Monthly reviews of care plans should avoid stock phrases such as “no changes” which has happened when there have in fact been changes in the level of support needed. Risk assessments should be reviewed and updated monthly to identify the current level of risk and ensure safety of the person. Work must be completed to comply with the requirements of the Fire Officer in his letter dated 13/02/08. The Fire Officer should then approve the changes to ensure compliance and safety of residents. Review the preferred rising (and retiring) times of residents to ensure their individual preferences and choices are being met in this area. Whilst a good private chiropody service is reported to be provided for all residents, it is important that pressure is applied to the NHS chiropody service to provide a free service for those who prefer it. There is an individual right to this service, any shortfalls in the service should be reported to the Primary Care Trust. Review the arrangements for laundry/sorting of clothing to ensure that all residents wear their own clothes. Consider the possibility of installing a shower facility to give alternative bathing choice to residents. Please contact the provider for advice of actions taken in response to this Lanrick House DS0000004970.V366686.R01.S.doc Version 5.2 Page 8 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.V366686.R01.S.doc Version 5.2 Page 9 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.V366686.R01.S.doc Version 5.2 Page 10 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): Standards 1 – 5 were inspected on this visit. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Good information and pre admission assessments ensure the needs of people using the service will be met. EVIDENCE: There is a Statement of Purpose/Service Users Guide available for prospective residents/relatives. This is reviewed regularly and provides adequate information about the home. The weekly fees charged should be added to the Statement of Purpose. Lanrick House DS0000004970.V366686.R01.S.doc Version 5.2 Page 11 All residents have contracts, those who are self funding have a contract directly with the home, a sample was seen and was satisfactory. All residents are assessed prior to moving into the home. Pre-admission assessments carried out by the homes staff were seen on the 2 records of recently admitted residents and provided adequate detailed information. The home ensures that all prospective residents are invited to spend the day in the home prior to admission (even if in hospital), there has only been one exception to this in the past 6 months. This procedure ensures the person is able to make a judgement about the suitability of the home prior to admission and it also provides the home with a better opportunity to assess the needs of the person, rather than a brief meeting, for instance in hospital. Relatives are always involved in the pre-admission assessments and visits. Care Management Assessments (multi-agency) were provided by Social Work staff prior to admission in the records of the 2 people seen. This home does not provide an intermediate care service. Lanrick House DS0000004970.V366686.R01.S.doc Version 5.2 Page 12 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): Standards 7 – 10 were inspected on this visit. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health and personal care needs of residents are met. Improvements in recording of information would ensure needs are known and can be met at all times. EVIDENCE: A sample of 4 care plans were inspected. All had detailed infromation. Two were of recently admitted residents for respite care/short stay and contained all required information that was good and accurate. Care plans for longerterm residents were equally detailed but some information had not been updated or accurately reviewed, examples were a resident whose physical needs had changed due to deterioration, from walking independently to requiring 2 staff to assist with personal care – the care plan did not reflect this. Lanrick House DS0000004970.V366686.R01.S.doc Version 5.2 Page 13 Monthly reviews had stated “no changes”. Another person had a care plan regularly reviewed for dementia care needs, but in fact did not have dementia. There was some good recording of information. All care plans included a Map of Life (social history) completed by/with relatives giving important information about past life, helpful in meeting present/future needs. Healthcare information was good with clear information about diagnosed conditions and monitoring changes. A visiting District Nurse was spoken with during the inspection and said that there was a good rapport/relationship between the home and the nursing service. She had visited following an early referral by staff of a pressure area skin break swiftly identified, now being treated and pressure relieving equipment being put into place by the nursing service. Risk assessments were in place relating to daily activity including moving and handling needs, one seen had not been reviewed accurately although there had been a physical deterioration and 2 staff needed to support the person the risk assessment remained as “moves independently”. Others seen were still accurate and been appropriately reviewed. Care plans included weight charts. A shortfall was identified in relation to a person who had lost 2 stones in weight in the previous year with clear nutritional deficits. The last recorded weight was 5 months ago. This could be inadequate recording but it is important that all residents are weighed regularly as a means of monitoring healthcare and any concerns referred to the GP. All residents have a private chiropody service arranged by the home at a special rate. This arose from the poor service provided by the NHS Chiropody service. All residents pay for this service (a good service). The Manager agreed to review this to ensure that a free NHS service was provided where possible for those who would prefer a free service. A good service is reported from the 3 local GP practices visiting the home. On the day of the inspection a GP was called to assess a person with severe cellulites who had been due to return home that day but clearly not well and unable to do so safely. Further medication was prescribed and respite care extended. Staff have good awareness of health care issues, there were several examples which included a serious condition identified whilst bathing a person. An early referral to GP/Consultant resulted in ongoing treatment for a serious condition. The medication system is provided by Boots Chemists and was inspected. It was found that the receipt, storage, administration and disposal of medication is to a high standard with no deficiencies or inaccuracies. Two people selfmedicate, including one who self-administers insulin that is overseen by staff who have had training in the management of diabetes and are monitoring blood glucose levels with the person. Lanrick House DS0000004970.V366686.R01.S.doc Version 5.2 Page 14 There is a safe and accurate medication system in place. A visiting relative found that her relative was not wearing her own clothes. This has happened previously. All clothes are purchased and labelled by the visitor. The Manager agreed this was not acceptable and will take steps to ensure this does not happen in future. Lanrick House DS0000004970.V366686.R01.S.doc Version 5.2 Page 15 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): Standards 12 – 15 were inspected on this visit. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A wide range of activities ensure the social, recreational and religious needs of all residents are met. Food provision is good. EVIDENCE: Many residents were spoken with in the communal and bedroom areas throughout the day and observations of routines and interactions gave a picture of the lifestyles of many residents. An immediate observation upon arrival at the home at 8.45 a.m. was that both lounges were virtually full indicating that 25 people had risen, been given personal care, had breakfast and were sitting in the lounge at that time. This raised the question of rising times. It was stated that residents rise (from Lanrick House DS0000004970.V366686.R01.S.doc Version 5.2 Page 16 choice) from around 6.00 a.m. It was acknowledged that some residents do rise early, some also have unconventional sleeping patterns. The Manager said that when the day shift commenced at 7.30 a.m. around half the residents were up. Records of two preferred rising times in care plans seen were different from those in practice, but it is accepted that rising times must be flexible and can change. Some residents rise independently from around 6.0 a.m. The Manager will review rising times with day and night staff to ensure the natural waking policy continues and that choices are made by residents. There is a good activities programme in place. Daily activities are carried out by staff usually in the afternoon. Additionally there are weekly progressive mobility sessions and music to movement. Entertainment is also brought into the home. There are very positive external visits – each month the majority of residents go to the local tennis club for lunch and enjoy the social aspects of this. Taxis are provided and the costs borne by the home. Residents spoke enthusiastically about the regular outings. Twenty- two people recently went to a Show at the community centre nearby and there are trips to local places of interest. There is good recording of activities with individual daily records showing activities residents are involved in. A recommendation of the last report was made to record social stimulation provided individually for this diverse group and in particular people with dementia care needs. A sample of records showed daily input including 1:1 “chat and reminiscence”. The range of internal and external activities are good catering for the diverse needs of up to 32 people. Visitors are encouraged as an important part of care provision. Two visitors were seen, both regular weekly visitors and said that they were welcomed into the home, offered drinks, snacks or meals. They clearly felt at ease with staff and observed to discuss progress or issues relating to their relatives health and care needs. A visitor said she visits weekly, enjoys coming and “it is like home from home”. There were indications of chosen lifestyles: A resident who refuses to leave his bedroom, is resistant to personal care and has a propensity to self-neglect is dealt with extremely well by staff. He has weekly visitors who persuade him from the bedroom to have a bath, whilst the room is cleaned, bed changed etc. He is persuaded to have the chiropody service. A Community Psychiatric Nurse (CPN) is involved and a recent change in anti-depressant medication made. The home manage this situation particularly well. Friends in written feedback about this person said “He is very happy and does not wish to live anywhere else. Lanrick House DS0000004970.V366686.R01.S.doc Version 5.2 Page 17 A resident on respite care who does not sleep in a bed/bedroom has brought her reclining chair from home which she uses in the lounge area throughout the day and night. Equality and diversity training has been provided for staff. There is written information available in relation to different cultures including food and personal care provision, what should or should not be provided. The AQAA confirms that the kitchen provides a range of cultural meals. Food provision is good. The mid-day meal was discussed with residents whilst it was being taken and all spoke highly of the quality and quantity of food. Comments included “I really love the meals here, I enjoy eating and it is marvellous”. A visitor who stays for lunch said “the food is excellent”. Written feedback supported the above comments with one exception which stated that there was very little fruit available. This was discussed with the Manager who evidenced from records, regular ordering of fresh fruit delivered twice each week. The Manager said it was available to anyone who asked for it. She said that in future this would be made readily available and offered to residents, either with morning or afternoon tea or at other times. Pastoral care needs include regular visits by local clergy individually to residents who wish and a monthly religious service available to all. Lanrick House DS0000004970.V366686.R01.S.doc Version 5.2 Page 18 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): Standards 16 – 18 were inspected on this visit. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents feel safe and listened to. Complaints and protection issues are dealt with swiftly. EVIDENCE: There is a clear and concise complaints procedure posted in the home for residents and visitors information. In written feedback from residents all stated that they knew how to make a complaint. Since the last inspection one complaint was received by us and investigated by the provider. The home has received 3 complaints which have been dealt with swiftly and well. The complaints related to healthcare practice, missing clothes, absence of a hoist and a general practice issue. Most were not upheld and appropriate action taken in relation to the others. The home manages complaints well. Lanrick House DS0000004970.V366686.R01.S.doc Version 5.2 Page 19 Protection of residents from abuse is dealt with by means of staff training and awareness and discussions in supervision and staff meetings. Staff have knowledge of the various forms of abuse and the procedures for reporting them. Since the last inspection potential financial abuse has been identified by staff and referred to the Social Worker for action. There are policies/procedures relating to safeguarding that staff are required to read and sign to confirm they have read and understood them. Lanrick House DS0000004970.V366686.R01.S.doc Version 5.2 Page 20 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): Standards 19 – 26 were inspected on this visit. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from a clean, safe, well maintained environment that suits their needs. EVIDENCE: Improvements have been made the physical environment, both internally and externally since the last inspection. Lanrick House DS0000004970.V366686.R01.S.doc Version 5.2 Page 21 The majority of communal areas including corridors and stairs on the ground floor have been recarpeted and redecorated. The home presents well. A malodour in the reception areas identified upon arrival was later not present. All areas of the home were clean and hygienic. It was surprising to hear that only 28 domestic hours per week were provided – but results were good. Two written feedback comments from residents relating to the environment were received. One stated “The home is kept as clean as possible depending upon the patients incontinence” (this may relate to the odour issue mentioned above). The other comment was “The only criticism is the downstairs (and 1 upstairs) toilets are sometimes quite “soiled”. This does not often affect me personally – but is a fault that should be rectified”. Particular attention was given throughout the day to the state of the toilet areas on both floors but they were clean and well maintained. No “soiling” was evident. There are 12 single and 10 shared bedrooms - there are no en-suite facilities and many bedrooms have commodes. The large number of shared bedrooms were questioned in relation to decisions to share. A visitor did say that originally her mother did share with someone she was not compatible with and was disturbed by her. She raised this with her daughter who spoke to the Manager and an alternative room allocated immediately. She now shares with another person she is compatible with and “cares” for that person. It is important that as stated in Standard 23.7 residents who share “have made a positive choice to share with each other”. There are 4 bathrooms, only one has an assisted facility recently replaced with a new bath hoist. The bath is extremely marked/chipped and it is not possible to negotiate a wheelchair into the room - although there is registration to admit people with a physical disability. One resident did say that she would prefer a shower. There is no shower facility and discussions with staff indicated that a shower (wet room) would greatly assist in providing bathing facilities for people with high continence needs. The providers may wish to consider this option. A sample of bedrooms seen had good standards of furniture, equipment, decor and hygiene. All were well-personalised – in one room the resident had brought her own curtains, headboard and bureau from home all integrated well into the bedroom. There is a very pleasant garden area to the front and side of the building, easily accessed from the home. There is also a patio with good seating used throughout the summer months where possible. There is an enclosed garden area where residents with a propensity to wander can do so safely. Lanrick House DS0000004970.V366686.R01.S.doc Version 5.2 Page 22 Lanrick House DS0000004970.V366686.R01.S.doc Version 5.2 Page 23 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): Standards 27 – 30 were inspected on this visit. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident receive good care from an experienced, committed and well-trained workforce. EVIDENCE: There were 30 people in residence at the time of this inspection. The number of care staff on duty throughout the day (7.30 am – 8.30pm) is: 1 Senior Carer and 3 Care Assistants. At night time (8.30 – 7.30) there are 2 carers and one person on-call at home (Manager or Deputy) who live minutes from the home. The number of care staff provided during the day are adequate for the numbers and dependency levels of the current resident group. Lanrick House DS0000004970.V366686.R01.S.doc Version 5.2 Page 24 The Manager was asked if 2 carers on night duty were adequate. She felt that they were and in addition there was almost immediate back-up from those on call if needed. She would provide additional night staffing if dependency needs indicated that it was required, for example - temporary or terminal illness. Staff on duty throughout the day (including 1 shift change) were seen, observed and some spoken with. All were approachable, relaxed and open in their discussions. Their committment to residents was clear from both observations and discussions. A resident with repetitive behaviour who shouted loudly and consistently throughout the day was dealt with in a professional, caring, affectionate and very patient way by staff at all times throughout the 8 hour inspection. About half the residents have dementia care needs. All staff have had training in this area of work with comprehensive training from a college providing an in-depth course over 3 months with 4 units assessed on a basis similar to NVQ. The home has a good training record. A matrix was seen and it was clear that all statutory training had been provided and also professional/additional training to meet the needs of the resident group. A sample of staff files were seen and recruitment procedures checked. There were no staff photographs and these should be provided as required under Schedule 2 of the Regulations. References and health checks were present. Passports, birth certificates and proof of identity were not, but had been provided for CRB purposes. At the time of the last inspection a requirement was made to provide evidence of CRB and POVA checks in the home. CRB checks were present on this visit but POVA checks were not. One staff file showed a starting date with a CRB check 1 month later. It was not possible to check if a POVA check had been carried out prior to employment as required, as they were not available in the home. A further requirement is made to provide evidence of POVA checks. Induction was recorded in the records of a new employee. Training for staff appeared satisfactory from the matrix seen. NVQ training has been provided for all staff with the exception only of one. Lanrick House DS0000004970.V366686.R01.S.doc Version 5.2 Page 25 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): Standards 31 – 33 & 36 - 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Good positive management and a well-motivated workforce are meeting the needs of residents. EVIDENCE: The Registered Manger has the required experience and qualifications to run the home. She is fully aware of her responsibilities. Lanrick House DS0000004970.V366686.R01.S.doc Version 5.2 Page 26 She takes a positive lead in the home and works on the staff rota hands-on alongside other care staff giving her a first hand knowledge of the needs of residents and standards of care being provided. She also works weekends on the rota giving a wider view of care. She has one day supernumerary when she is able to focus upon specific management duties. There is a relaxed and open atmosphere in the home. Staff are supported with a continuous professional development programme to ensure their training and skills are constantly updated. The Manager is an approved moving and handling trainer, providing this training for all staff. An example of inappropriate moving and handling techniques were observed during the inspection. The Manager had also noted this, the two staff had had appropriate training and she would pursue the matter individually with them following the inspection. The Manager also takes the opportunity to update her training, having recently attended training relating to the Mental Capacity Act. She intends to implement aspects of the Act relevant to the care setting. Staff receive supervision on a regular basis evidenced from the staff records seen. One of the 4 providers has a daily presence in the home and always available to be contacted. This provides the necessary oversight of the home by providers in accordance with Regulation 26. Records seen met professional standards, although some records around care planning and risk assessments do need updating. The home does not handle finances on behalf of residents who are supported by relatives/others. The Manager ensures the health, safety and welfare of residents by means of direct observation, support, policies, procedures and reviews. There is a quality audit programme in place and includes resident/relatives surveys and questionnaires. Fire records were not inspected on this visit. A letter from the Fire Officer dated 13th February 2008 outlined some deficiencies in fire safety and requirements made for compliance. The majority of this work is reported to be almost complete. The person carrying out the work was present in the home during the inspection and outlined the work being done. It is anticipated that this will be completed in the next week. It is a requirement of this report that the work identified by the Fire Officer is carried out and that he is invited to inspect and approve the work when completed. Lanrick House DS0000004970.V366686.R01.S.doc Version 5.2 Page 27 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 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 3 2 2 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X X 3 3 2 Lanrick House DS0000004970.V366686.R01.S.doc Version 5.2 Page 28 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 OP7 Regulation 15 Requirement Information in some care plans must be updated & reviewed to ensure needs can be met at all times. Risk assessments shold be updated to identify current levels of risk and ensure safety of the resident. Residents must be weighed monthly as an important part of health care monitoring. Complete work to address deficiencies in fire safety, identified in the Fire Officers report of 13.2.08 to ensure safety in the event of a fire. Timescale for action 31/07/08 2. OP7 13(4) 31/07/08 3. 4. OP8 OP38 12(1) 23(4)(a) (b) 30/06/08 15/07/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2. Refer to Standard OP8 OP10 Good Practice Recommendations Give residents the option of NHS chiropody. Review arrangements to ensure that all residents wear DS0000004970.V366686.R01.S.doc Version 5.2 Page 29 Lanrick House 3. 4. 5. OP12 OP22 OP29 their own clothes at all times. Review preferred rising times to ensure individual choices and preferences are met. Consider installation of shower to provide an alternative bathing choice to residents. Ensure that POVA checks are retained at Lanrick House for inspection purposes. Lanrick House DS0000004970.V366686.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection West Midlands West Midlands Regional Contact Team 3rd Floor 77 Paradise Circus Queensway Birmingham, B1 2DT 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 Lanrick House DS0000004970.V366686.R01.S.doc Version 5.2 Page 31 - 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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