Inspection on 19/05/06 for Lansglade

This inspection was carried out on 19th May 2006.

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

Lansglade 23/04/07

Lansglade 10/01/06

Lansglade 12/08/05

Lansglade 09/12/04

Lansglade 03/09/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Lansglade 14 Lansdowne Road Bedford Bedfordshire MK40 2BU Lead Inspector Leonorah Milton Unannounced Inspection 19th May 2006 06.55 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 Lansglade DS0000014925.V295588.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. Lansglade DS0000014925.V295588.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Lansglade Address 14 Lansdowne Road Bedford Bedfordshire MK40 2BU 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) 01234 356988 01234 359194 lansgladehomes@btconnect.com Lansglade Homes Limited Ms Vivien Lockwood Care Home 31 Category(ies) of Dementia - over 65 years of age (31), Old age, registration, with number not falling within any other category (31), of places Physical disability over 65 years of age (31) Lansglade DS0000014925.V295588.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 10th January 2006 Brief Description of the Service: Lansglade House was a large double fronted Victorian building that had been sympathetically converted to provide comfortable accommodation. The directors of the company had changed in 2004. Their influence had resulted an improvement in the under pinning documentation of the service. Mrs Vivian Lockwood had effectively managed the home for a number of years. The home was situated in a pleasant residential area of Bedford within close proximity to the towns amenities including local bus services and national coach and rail networks. The service was registered to provide for thirty-one older people who may also have physical disabilities and/or dementia. The condition for physical disabilities was not necessary as the home could accommodate those with the frailties associated with old age under the category for old age (OP). The accommodation was arranged over three floors with the communal sitting and dining areas on the ground floor. The bedrooms were located on each of the three floors. Bathrooms and toilet facilities were located for convenient access throughout the building. The upper floors could be accessed by a shaft lift. Twenty-five single bedrooms were provided and four double rooms. Eleven single rooms and one double room had ensuite toilet and washbasin facilities. The remaining rooms were fitted with washbasins. The home was well decorated and maintained. A well maintained garden with garden furniture was located to the rear of the property. Fees for accommodation were set out in the service user’s guide and ranged from £415 to £445 per week. Lansglade DS0000014925.V295588.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report sets out the significant evidence that has been collated by the Commission for Social Care (CSCI) since the last visit to and public report on, the home’s service provision in January 2006. Taken into account were reports submitted to the CSCI by the provider each month on the conduct of the home, reports from other statutory agencies and information gathered at the site visit to the home, which was carried out on 19th May 2006 from 06.55 to 13.15 hours. The visit to the home included a review of the case files for two service users, discussions with eight service users, three members of staff, an activity organiser and the manager. Much of the visit to the home was spent with service users in the rear lounge/diner and during breakfast to assess the lifestyle experienced by service users during the morning. Other records were also reviewed and a partial tour of the building took place. What the service does well: What has improved since the last inspection? Systems had been introduced to ensure that any valuables item including chequebooks held in safe keeping on behalf of service users were recorded properly. Lansglade DS0000014925.V295588.R01.S.doc Version 5.2 Page 6 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. Lansglade DS0000014925.V295588.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 Lansglade DS0000014925.V295588.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2,3 Quality output in this area is good. This judgement has been made using available evidence including a visit to the home. The home had ensured that it could properly care for service users by obtaining information about their care needs prior to admission. Contractual arrangements were in place to ensure that service users were aware of the conditions for their accommodation in the home. EVIDENCE: Two case files were assessed. Assessments of need covered were thorough, referred to the details identified in standard 3 of the National Minimum Standards and showed that other professionals had contributed where necessary. The inspector requested and was shown the contractual arrangements with regard to the two service users who were case tracked during the visit to the home. Details of fees were included in the contracts. The home no longer provided an intermediate care service. Lansglade DS0000014925.V295588.R01.S.doc Version 5.2 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 the following standard(s): 7,8,9,10 Quality outcome in this area is adequate. This judgement has been made using available evidence including a visit to the home. There were omissions from care plans that may have resulted in some aspect of care needs remaining unmet. Service users had been treated with dignity and respect. EVIDENCE: Whilst there were records to show that appointments had been arranged for service users to receive routine health care treatments the care plans seen at this inspection did not set out precise details. (For example the section for special medical needs did not refer to chiropody or dental care. There was no indication whether service users preferred services from private practitioners or the local health trust). The care plan for one service user referred to continence needs and actions were to “follow toilet plan”. On enquiry the manager explained that service users were to be assisted to access a toilet on a two hourly basis. She was Lansglade DS0000014925.V295588.R01.S.doc Version 5.2 Page 10 advised that continence needs must be assessed on an individual basis to determine whether any individual had a pattern of incontinence that could then be managed by timely offers of assistance. The pre-admission assessment for both service users who were case tracked during the visit showed that they had a history of falls. Neither case file contained any risk assessment about the same, although a sensor device had been installed in the bedroom of one of these service users to alert staff when their bed was vacated. Care plans seen referred to “needs at death” and detailed funeral arrangements and whether family members wished to be contacted if death were to occur during the night. There were no records of the service users’ spiritual needs in the event of terminal illness or at death. Given that there was evidence that both service users had a religious faith it is recommended that their wishes in relation to this matter be sought. Service users confirmed that they had been able to see their doctors when they were unwell and that they had received regular chiropody treatment. Records on individual case files showed that service users had been referred to their doctors and other professionals such as the continence advisor and district nursing services as required. A senior was observed as she gave out the morning medication. Her practice met safety guidelines for the administration of medicines. Medications were stored securely in lockable cupboards and a medicine trolley. Records assessed showed that medicines had been given as prescribed. Service users confirmed that they had been treated with courtesy by the staff in the home. Observation of practice showed that there were cordial relationships between service users and the members of staff on duty. Lansglade DS0000014925.V295588.R01.S.doc Version 5.2 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 the following standard(s): 12,13,14,15 Quality outcome is this area was adequate. This judgement was made using available evidence including a visit to the home. Service users had been supported to achieve a lifestyle that recognised their abilities. However the morning routines commenced rather early in the morning, which was somewhat institutional and may not have met all service users’ preferences. Service users’ nutritional needs had been met. EVIDENCE: Service users confirmed that the routines of daily living suited them. There was evidence of the provision of regular activities for recreation and stimulation. An activity organiser visited the home on the day of the inspection. The majority of service users were seen to join in the exercises to music and the following quiz. The inspector was concerned that some routines such as getting up times were in place to suit organisational schedules rather than service users’ preferences. Whilst service users did not express any concerns about the times they got up, one remarked that she had been occasionally “nudged to wake up in the morning”. The manager explained that it was necessary to bring a few service Lansglade DS0000014925.V295588.R01.S.doc Version 5.2 Page 12 users downstairs in the early morning because they were at risk if they were left alone in their bedrooms after having woken up. The inspector observed the following with regard to the morning routines; at 06.55 eleven of the thirty-one service users in residence were up, washed, dressed and were seated in the lounge. The majority of these had needed staff assistance with washing and dressing. When breakfast commenced at 08.00 twenty-one people were ready for the meal. By 09.00 hours the serving of breakfast was finished. Twenty-six service users had eaten in the lounge/diner; four breakfast trays had been taken to rooms. A member of a service user’s family had expressed concerns to the commission recently about morning routines. They stated that the time for getting up that been agreed with the service user had not suited the service user’s preferences but she had felt compelled to sign the agreement document. The service user had become accustomed to the routine because she had consequently gone to bed earlier. The manager must ensure that routines are not rushed and suit individual need and preference. Service users must not be woken up to meet the home’s routines. Service users confirmed that their visitors had been welcomed into the home. One remarked that visiting she had arranged for her visitors to call on her at her convenience. Service users confirmed that they liked the meals served to them. There were two choices for the main meal of the day and a range of choices for the lighter evening meal. Service users stated that they could always ask for and had been given alternatives to meals on offer. Menus seen showed a nutritious choice. Special diets were noted on care plans and known by staff. Lansglade DS0000014925.V295588.R01.S.doc Version 5.2 Page 13 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 the following standard(s): 16,18 Quality outcome in this area was adequate. This judgement was made using available evidence including a visit to the home. Satisfactory written arrangements were in place to enable service users’ to raise concerns and for their protection. However written agreements to care arrangements may have disempowered service users from raising concerns. EVIDENCE: Previous inspections had identified that the home’s written complaints and protection procedures were satisfactory. The manager stated that the home had not received any complaints since the previous inspection and indeed for some considerable time before that visit. Service users who contributed to the inspection stated that they felt able to raise concerns with members of staff or the manager, but none had felt the need to do so. However, given the concerns raised by a service user’s family, the home must ensure that before service users are requested to sign agreements to care arrangements, they have been given the opportunity to discuss the arrangements with their representatives. Recruitment records for two recent employees were assessed at this visit and showed that they had not been employed until statutory checks had been undertaken to verify their identify, employment records and criminal records disclosures. Training records indicated that staff had received training in protection procedures. Lansglade DS0000014925.V295588.R01.S.doc Version 5.2 Page 14 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 the following standard(s): 19,26 Quality outcome in this area is good. This judgement has been made using available evidence including a visit to the home. Service users had been provided with a comfortable, clean and safe environment that was suitable for their needs. EVIDENCE: Areas of the building seen at the visit to the home were clean and orderly. Two service users bedrooms were seen. Each room was well decorated and furnished as were the communal lounge/diner and hallways and corridors. The bedrooms contained many private items belonging to the occupant, which gave the rooms a unique and personal appearance. During the tour of the building it was noted that hoists and fire extinguishers had been tested as required. The fire officer’s last visit to the home showed that fire safety precautions were satisfactory. The manager reported that the environmental health officer had visited recently and had noted that hygiene arrangements were satisfactory. Lansglade DS0000014925.V295588.R01.S.doc Version 5.2 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Quality outcome in this area is adequate. This judgement has been made using available evidence including a visit to the home. Sufficient numbers of trained personnel had been rostered on duty to ensure that service users were well cared for. However the lack of ability of at least one member of the team to communicate fully with service users meant that there was a risk that requests for assistance or similar may not be understood. EVIDENCE: The home had a core team of personnel who had worked in the home for a considerable time. They were well acquainted with service users, the daily routines in the home and presented as competent and caring. It was evident from the observation of practice that the team worked well together. The inspector spoke to a care assistant on duty on the day of the visit to the home. Conversation was difficult because the worker clearly could not follow the conversation even though the inspector used simple phrases and basic vocabulary. The manager explained that the employee was attending language classes. There was however no indication on this employee’s personnel file that they were required to work in a supervised capacity only until they were able to communicate properly with service users. Lansglade DS0000014925.V295588.R01.S.doc Version 5.2 Page 16 The care staff rota showed that additional staff had been rostered in the early morning to provide support to service users at this busy time of the day. Rotas also indicated that sufficient ancillary personnel had been rostered on duty to carry out the catering, cleaning, laundry and administrative duties. The care staff therefore had been able to concentrate their efforts on the care of service users. The personnel records for two recent employees were reviewed. The records showed that satisfactory recruitment practices had been followed. Files contained applications, relevant references, interview notes, health declarations and evidence of disclosures from the Criminal Records Bureau. Records indicated that all but recent employees had under taken training in statutory safety techniques and procedures for the protection of vulnerable adults. The majority had received training in the needs of people with dementia. Key personnel had received training in continence care, the effects of Parkinsons disease, nutrition and swallowing. Six of the nineteen care staff had achieved National Vocational Qualifications (NVQ) in care at level 2. Four of these had also achieved the level 3 award. Ten other members of staff were working towards the award and were scheduled to complete this year. Both cooks held NVQ awards in food preparation and cooking. Lansglade DS0000014925.V295588.R01.S.doc Version 5.2 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38. Quality outcome in this area was good. This judgement has been made using available evidence including a visit to the home. The home had been effectively managed for the benefit of those who lived and worked in the home. EVIDENCE: The manager had worked in the home for a significant time. Previous inspections had identified that she was qualified and experienced to run a care home. Records seen indicated that formal systems were in place to consult with service users via service user meetings each quarter, the last having been held on 20.04.06 and an annual quality review. The next was scheduled to take place in the near future. Dates were organised in the diary for questionnaires to be distributed to service users and a corresponding meeting with them to Lansglade DS0000014925.V295588.R01.S.doc Version 5.2 Page 18 review the outcomes of the exercise. Staff meetings took place six monthly. It was reported that care staff received supervision every two months and ancillary personnel on a six monthly basis. Action had been taken since the last inspection to improve the arrangements for safe guarding monies or valuables held on behalf of service users. The manager reported at this visit that no personal monies were held in safe keeping for service users. The previous report had noted, “home had adopted comprehensive risk assessment and safety management strategies from a professional provider to ensure that safety matters were well managed and monitored in the home. The last review of risk assessments had been held in November 2005.” There were no other records to indicate any review of the health and safety aspects of the home or the quality audit systems since that date. There was however no cause to question the safety of the environment at this inspection. Lansglade DS0000014925.V295588.R01.S.doc Version 5.2 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x 3 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 x 18 3 3 x x x x x x 3 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 x x 3 Lansglade DS0000014925.V295588.R01.S.doc Version 5.2 Page 20 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 12(1)(a) 14 15(1) Requirement Timescale for action 31/08/06 2 OP7 12(1)(a) 15(1) 12(1)(a) 15(1) 3 OP7 4 OP27 12(1)(a) 18(1)(a) Care plans must show how all identified health care needs are to be met, to include details in relation to any risks of falling and toileting plans that have been based on individual assessments of continence needs. Service users must not be woken 14/06/06 up early in the mornings unless their care plan shows that it is in their best interests to do so. The registered person must 14/06/06 ensure that before service users are requested to sign agreements to care arrangements, they have been given the opportunity to discuss the arrangements with their representatives. Members of the care team who 14/06/06 are unable to fully understand spoken English must not work alone with service users. Lansglade DS0000014925.V295588.R01.S.doc Version 5.2 Page 21 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 OP11 Good Practice Recommendations It is recommended that service users be consulted about their spiritual needs in the event that they become terminally ill and at death. Lansglade DS0000014925.V295588.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Bedfordshire & Luton Area Office Clifton House 4a Goldington Road Bedford MK40 3NF 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 Lansglade DS0000014925.V295588.R01.S.doc Version 5.2 Page 23 - 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. 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