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Inspection on 23/08/05 for Lansdowne Retirement Home

Also see our care home review for Lansdowne Retirement Home for more information

This inspection was carried out on 23rd August 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

There is an open and inclusive atmosphere with a track record of achievement in terms of the built and care environment, service users, visitors and staff comment favourably on the approachability of the manager and staff in addition to the value given to their input, "we are pleased with all aspects of care" "I visit regularly and have never found anything to complain about". Training is promoted and the home is creative in ensuring it is easily accessible to staff. The environment is in good decorative order throughout.

What has improved since the last inspection?

This home has met all requirements from the previous inspection and is working towards implementing the one recommendation not yet achieved. Local authority approval for upgraded accommodation and laundry facilities has been applied for and the registered provider informed the inspector at the time of inspection that approval was reported to be imminent. Service users views are sought informally and at a formal quarterly review service users and visitors spoke favourably on being welcomed and valued "they always offer me a cup of tea and ask how I am "

What the care home could do better:

A partnership approach to care planning with the involvement of service users or their representatives should be implemented and evidenced throughout theassessment, care planning, implementation and review processes; their views and comments should be actively sought. Assessments are relevant and reviewed regularly but a broader range suitable to the service users needs is required e.g. nutrition, pressure area and weight.

CARE HOMES FOR OLDER PEOPLE Lansdowne Retirement Home 35 Liphook Road Lindford Bordon Hampshire GU35 0PT Lead Inspector Andrew Cole Unannounced 23 August 2005 10:00am rd 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. Lansdowne Retirement Home H54 S58657 Lansdowne V246569 230805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Lansdowne Retirement Home Address 35 Liphook Road Lindford Bordon Hampshire GU35 0PT 01202 824390 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) Mrs Nicola Anne Withers CRH - PC 17 Category(ies) of OP - 17 registration, with number of places Lansdowne Retirement Home H54 S58657 Lansdowne V246569 230805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: N/A Date of last inspection 14th December 2004 Brief Description of the Service: Lansdowne retirement home is a care home providing personal care and accommadation for 17 older people. The home is located in the village of Lindford, which is approximately two miles from Borden. The home is situated close to local amenities and public transport. All bedrooms are single and have en suite facilities. There is a communal lounge and communal dining room. The home has an established enclosed garden with seating that is accessible to the service user. Lansdowne Retirement Home H54 S58657 Lansdowne V246569 230805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place over 8 hours the registered provider was present throughout. A tour of the premises was undertaken and 2 staff were spoken with, as were 5 service users and 4 relatives. Records for service users and staff were inspected. What the service does well: What has improved since the last inspection? What they could do better: A partnership approach to care planning with the involvement of service users or their representatives should be implemented and evidenced throughout the Lansdowne Retirement Home H54 S58657 Lansdowne V246569 230805 Stage 4.doc Version 1.40 Page 6 assessment, care planning, implementation and review processes; their views and comments should be actively sought. Assessments are relevant and reviewed regularly but a broader range suitable to the service users needs is required e.g. nutrition, pressure area and weight. 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. Lansdowne Retirement Home H54 S58657 Lansdowne V246569 230805 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Lansdowne Retirement Home H54 S58657 Lansdowne V246569 230805 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3,4,5 Standard 6 is not applicable to this service The admission process is well managed and prospective residents are able to assess the homes suitability and to fully participate in the homes information gathering process prior to admission. Data gathered would enable the home to identify and address initial care needs. EVIDENCE: Appropriately completed pre admission forms were noted in a sample of four service users records examined. Service users and relatives spoken to confirmed they had been involved in a pre admission assessment process, they had also been invited to visit the home prior to admission and felt the home had been “warm and welcoming with no pressure to decide” A service users guide is available in the office upon request. Lansdowne Retirement Home H54 S58657 Lansdowne V246569 230805 Stage 4.doc Version 1.40 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,9,10,11 Service users healthcare needs are set out in an individual care plan. Dementia care needs are assessed, however as this does not usually generate a care plan this shortfall has a potential to place a service user at risk. To minimise the risk of unidentified needs a wider range of assessment tools are required. There is an absence of written evidence of service users participation in care planning. This is needed in order to ensure a meeting of care needs prioritised to the service users requirements and preferences. The home ensures all service users are treated with respect and dignity in well being and in the final stages of life. EVIDENCE: Individual care plans are available and are regularly reviewed together with some assessments, a mental health screening tool was found in the four records examined and was regularly reviewed but did not generate a care plan. Observations and discussions with staff, visitors and service users indicated that many psychological needs were being met despite the absence of written records. Lansdowne Retirement Home H54 S58657 Lansdowne V246569 230805 Stage 4.doc Version 1.40 Page 10 Nutritional, pressure area and weight assessments are not recorded. The home has a medication policy and a copy of the Royal Pharmaceutical College guidelines. Staff were observed dispensing medication appropriately and records and storage of medications were in line with the policy. Staff were frequently observed treating service users with respect and recognising their need for privacy and dignity. Service users and relatives alike commented on this positive approach to service users, “they speak to you not at you”, “ the staff remember you are an adult”. Relatives are able to stay overnight in the final stages of a service users life and some refreshments would be available. Contact with local healthcare providers are found in the daily notes. Lansdowne Retirement Home H54 S58657 Lansdowne V246569 230805 Stage 4.doc Version 1.40 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,14,15 Social activities and meals are both well managed and provide variety and choice. EVIDENCE: Friends and relatives are free to visit and legal or financial representatives can be seen in private, service users and visitors present confirmed this. An activities programme is displayed that included bingo and singing in addition care staff were observed to provide ad hoc games and dancing, a game of hoops was noted during the inspection. A service user commented “ we have lots of activities” and a relative had “attended the Xmas party and had a great time with prizes as well” A communion service is available once a week at the home that one service user spoken commented on favourably. Meals are home cooked from the original fresh ingredients with home baked cakes at teatime. Staff were observed discussing alternatives to the main menu with a service user. Lansdowne Retirement Home H54 S58657 Lansdowne V246569 230805 Stage 4.doc Version 1.40 Page 12 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) 16,17,18 Procedures are in place to ensure there is a positive approach to complaints and ensuring service users are protected from abuse. EVIDENCE: Service users and relatives all noted a good approach to dealing with complaints and all were aware of how to complain and felt at liberty to do so. A current complaints book is maintained and events noted, the provider sees complaints as helping her “ to provide the best quality service to the residents”. Staff have attended abuse training, records were noted as were copies of the “No Secrets” document and the Hampshire prevention of abuse policy. Staff spoken to were aware of abuse issues and believed they were at liberty to report any concerns. Lansdowne Retirement Home H54 S58657 Lansdowne V246569 230805 Stage 4.doc Version 1.40 Page 13 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) 19,20,21,22,23,24,25,26. Improvements to the décor have been made and the home is well decorated and pleasant, further planned improvements to facilities will enhance the environment even further. A garden area is accessible and has outdoor furniture suitable for the service users. EVIDENCE: Lounge and dining areas are appropriately furnished with lounge chairs and settees dining tables and chairs .The garden area is accessible by two ramps and has garden furniture that includes tables and chairs and sun protection The provision of toilet and bathing facilities is adequate and remains unchanged from previous inspections in addition to all rooms being en-suite. Bedrooms are homely and many have a variety of personal possessions and furniture. The home was clean to a good standard, it smelt fresh. Lansdowne Retirement Home H54 S58657 Lansdowne V246569 230805 Stage 4.doc Version 1.40 Page 14 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28,29,30. There are adequate staff employed and recruitment procedures are followed. Training is promoted and staff are enabled to participate, the need for continuous development to reflect service users changing needs is recognised. The current induction programme is utilised it needs some alteration to meet the induction and foundation standards of the “skills for Care” organisation. EVIDENCE: In line with the national demographics of older adults this home currently cares for a small number of persons with a dementia, the need for relevant training is acknowledged by the provider and is being sourced for this years programme. The induction programme which present in the staff records was current. Lansdowne Retirement Home H54 S58657 Lansdowne V246569 230805 Stage 4.doc Version 1.40 Page 15 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) 31,32,33,36,37,38. The manager is a recent entrant into the care sector but a commitment to further develop the service is evident in addition to developments already achieved. The manager has established a good rapport with all stakeholders. The home is well maintained to provide a safe environment. Procedures regarding the storage of foodstuffs are not fully implemented this is a potential hazard to service users well being. EVIDENCE: Service users their visitors and staff made positive comments on the management of the home and the new care ethos. The care environment was described as “warm and friendly” The manager has now achieved NVQ 4 and the registered managers award. Lansdowne Retirement Home H54 S58657 Lansdowne V246569 230805 Stage 4.doc Version 1.40 Page 16 A quality assurance approach includes quarterly service users and quarterly staff meetings that are minuted and records kept. An ad hoc feedback from visitors is available via forms kept at the front reception. All information gathered is evaluated by the manager and discussed with the senior carers to identify actions. Staff are supervised regularly records are kept and staff spoken to valued this experience. The records of fire equipment tests, fire drills and teaching are current. A maintenance book is used and signed as work is completed. There are plans to expand capacity by using previously private non-registered accommodation and this will include a new laundry facility. A number of food items stored in a fridge and in a freezer lacked appropriate labels. Lansdowne Retirement Home H54 S58657 Lansdowne V246569 230805 Stage 4.doc Version 1.40 Page 17 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 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 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 3 x x 3 3 3 Lansdowne Retirement Home H54 S58657 Lansdowne V246569 230805 Stage 4.doc Version 1.40 Page 18 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 7 Regulation 15 Requirement Timescale for action 28/10/05 2. 8 12 (1)(a) 3. 30 18(1)(i) 4. 32 16(2)(g) You must consult with and advise the service user regarding any change of care plan,this can be evidenced through the service user (or representative where this is not possible) signing an agreed care plan. You must provide and regularly 28/10/05 review adequate asessments e.g nutrition,pressure areas and weight You must provide an induction 28/10/05 and foundation programme for staff in line with that of the Skills for Care standards. You must ensure all food is 23/8/05 correctly dated and labelled when stored in the fridge and/or freezer. 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 38 Good Practice Recommendations You should ensure that night staff receive more frequent fire training to recognise the particular risk of fire at night. H54 S58657 Lansdowne V246569 230805 Stage 4.doc Version 1.40 Page 19 Lansdowne Retirement Home Lansdowne Retirement Home H54 S58657 Lansdowne V246569 230805 Stage 4.doc Version 1.40 Page 20 Commission for Social Care Inspection 4th Floor Overline House Blechynden Terrace Southampton 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. 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