Inspection on 13/04/07 for Lapstone House

This inspection was carried out on 13th April 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Lapstone House 27/10/05

Lapstone House 20/04/05

Lapstone House 18/11/04

Lapstone House 28/06/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Lapstone House Lapstone Road Millom Cumbria LA18 4BY Lead Inspector Cath Wilson Unannounced Inspection 13th April 2007 10:00 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 Lapstone House DS0000035223.V327554.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. Lapstone House DS0000035223.V327554.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Lapstone House Address Lapstone Road Millom Cumbria LA18 4BY 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) 01229 772527 01229 775887 www.cumbriacare.org.uk Cumbria Care Miss Christine Pidduck Care Home 25 Category(ies) of Dementia - over 65 years of age (8), Old age, registration, with number not falling within any other category (25) of places Lapstone House DS0000035223.V327554.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The service must at all times employ a suitably qualified and experienced manager who is registered with the Commision for Social Care Inspection. The home is registered for a maximum of 25 service users to include: Up to 25 service users in the category of OP (Older People) Up to 8 service users in the category of DE(E) (Dementia over65 years of age) When single rooms of less than 12 sqm usable floor space become available they must not be used to accommodate wheelchair users and where existing wheelchair users in in bedrooms of less than 12 sqm they must be given the opportunity to move to a larger room when one becomes available. 27th October 2005 3. Date of last inspection Brief Description of the Service: Cumbria Care is an internal Business Unit of Cumbria County Council and they operate Lapstone House. The care and services can be provided for 25 older people of whom 8 may have special mental health needs. Lapstone House is situated in the centre of Millom a small town in the South Lake District. There are local facilities and services close to the home. There are three units and each provides individual sitting rooms, dining areas, bathing, and shower facilities. One of these units is for people with dementia. There are outside seating facilities and a small-enclosed garden and patio to the rear of the building. Car parking facilities are available at the front of the home. Charges range from £317 to £385 per week depending on care needs. Further information about the home can be obtained from the manager or from Cumbria Care. Lapstone House DS0000035223.V327554.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The lead inspector Cath Wilson sent out surveys to residents, relatives and people like doctors and social workers some weeks before she went to visit the home. She also asked the manager of the home for other information that would give her a good picture of what it is like to live in the home. She received this information promptly and a good number of completed surveys. These gave a very positive view of the experience of living in the home. She then visited the home, spoke to residents and visitors, met with the manager and the staff team and read documents and files that backed up everything that was said to her and what she saw as she went around the home. What the service does well: This home is good at making sure that they only admit new people they are sure they can care for and who will fit in with the rest of the residents. The home is good at giving residents the kind of care they want and need. They make sure that residents get the kind of health care they need. The inspector judged that medicines are used carefully and managed properly. The residents thought the staff team gave excellent levels of care. The inspector saw different kind of evidence that backed this up. She judged that the personal and health care was excellent and gave residents the best care possible. Here are some of the things that residents and their relatives had to say about how they are cared for: • ‘I am cared for by a grand bunch of lasses’ • • • • ‘I am well looked after and really cared for’. ‘I can make myself heard when anything bothers me’. ‘The staff are excellent, very caring and efficient and quick to act when needed’. ‘The staff look after my relatively excellently. They care for her needs and make sure she’s happy’. Lapstone House DS0000035223.V327554.R01.S.doc Version 5.2 Page 6 • • • • • ‘There is a welcoming atmosphere when visiting and everything is clean and well looked after.’ ‘Lapstone House is run to a very high standard. The staff are very helpful and efficient’. ‘I appreciate the good work the staff do in looking after my mother.’ ‘The staff do a good job’. ‘I think Lapstone House staff are very good at every aspect of my relative’s care’. The home is good at providing excellent, varied and changing interests and activities for residents. Everyone was happy with what was provided and a number of people said they especially enjoyed the weekly exercise class. Several people spoke about going out to church, shopping or to entertainments. Visitors are made very welcome and are encouraged to be part of the residents’ lives. Residents said they enjoyed the food and liked the way they were encouraged to try new things. The residents were confident that any concerns were taken seriously and they had no complaints about the way the home was run or about their personal safety or well being. The home is good at providing a homely, comfortable and clean environment. The residents were comfortable in their rooms and in the shared areas. They liked living in small groups and were very complimentary about the way the home was looked after. The home has a well trained and efficient staff team. There are good ratios of staff to residents. Any new starters have thorough checks to make sure they are suitable people to work with vulnerable older people. Once people start in the home they are given high levels of training and are encouraged to gain their National Vocational Qualifications in care. They also do short courses that help with the daily care tasks. As a team they have decided that they need to keep their practice up to date and appropriate to the residents needs. The home reaches excellent standards of management because they are committed to providing quality care and services that residents want. Routine things like health and safety, helping with residents finance, food hygiene and fire safety are done to a very high standards. What has improved since the last inspection? Lapstone House DS0000035223.V327554.R01.S.doc Version 5.2 Page 7 The manager has recently improved the menus after asking residents about their preferences. One resident said this was a good idea as they • ‘might miss something otherwise and this keeps us up to date with changing fads and trends’. A lot of people talked about the ‘tasting sessions’ and enjoyed trying foods from other cultures. The staff team and their manager have decided that they are going to keep on improving the way they deliver care and services to the residents. They have prepared a good plan for the next year showing how they are going to keep on improving the way they care for people. They have improved the seating outside so that residents can be more comfortable when they want to sit in the garden. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Lapstone House DS0000035223.V327554.R01.S.doc Version 5.2 Page 8 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 Lapstone House DS0000035223.V327554.R01.S.doc Version 5.2 Page 9 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): 1,3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are given lots of information before coming into the home and the manager makes sure she can give new people the care and services they want and need. EVIDENCE: The residents said that they had plenty of information when they came to the home and this helped them make up their minds. The inspector saw the ‘Service User Guide’ that describes the home. This along with a document called ‘The statement of Purpose’ give a lot of information about the aims of the home. The manager has a good system in place that makes sure these are up to date and detailed. Lapstone House DS0000035223.V327554.R01.S.doc Version 5.2 Page 10 Residents said they had visited the home before coming to live in Lapstone House. One person said her relatives had done this as she was in hospital. She did say that the manager had visited her there and answered any questions and discovered what she wanted from the home. The inspector read a number of files that showed that the manager or one of the senior staff had gone out to see any prospective new residents and made sure they could give them the kind of care they wanted. The files also showed that residents were encouraged to visit the home before they made any decisions. Lapstone House DS0000035223.V327554.R01.S.doc Version 5.2 Page 11 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): 7,8,9,10 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. This is a home where people’s needs are clearly identified and are met by a highly motivated manager and staff team that provide services and care in a sensitive, attentive and kindly manner. EVIDENCE: All the residents had up to date documents that help staff to give excellent care and services to residents. The inspector read a good number of these ‘Care Plans’ in depth. She found that they reflected the things that residents told the inspector they could do for themselves and things they needed help with. The plans included any risks involved and covered health and personal care matters. There was evidence to show that the residents or their relatives were very involved with this planning. There was evidence to show that health care is dealt with really well by the home. One person spoke about how well she had been supported by the manager and staff through a recent illness. Another person wasn’t so well and Lapstone House DS0000035223.V327554.R01.S.doc Version 5.2 Page 12 the inspector saw her and read her file. She found that this person was getting the very best care possible to make her comfortable. The files showed that the doctor or nurse is sent for as soon as anyone is unwell. The inspector checked on medicines kept on behalf of residents. These were being dealt with properly. Only the senior staff give out medicine and they had all had training in how to do this safely. The people who live in the home (and their visitors) had a lot of very positive things to say about the way the staff team treated them. They found them to be caring, respectful and polite. The inspector saw this for herself and thought that the care was nurturing and sensitive. She was impressed with staff’s understanding of every person’s individual need. She saw the residents and staff interacting in a friendly and caring way There was evidence to show that the manager checks both day and night that staff give good care Lapstone House DS0000035223.V327554.R01.S.doc Version 5.2 Page 13 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): 12,13,14,15 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents have a varied and fulfilling life and their needs and wishes are always taken into account. EVIDENCE: Residents said they got up and went to bed when they wanted, could have meals in their rooms and spend time alone, as they wanted. They said there were no rigid rules and regulations. The home has a part-time activities organiser and she and the manager make sure the activities programme takes into account what the residents want. The residents said they had a choice, if they didn’t feel like doing anything they were not put under pressure to join in. Three people said they ‘thoroughly enjoyed the exercise classes’, another said, ‘aromatherapy was good’. People said they looked forward to going to bingo in the nearby village. Clergy come into the home for services and people also attend Church in Millom. Lapstone House DS0000035223.V327554.R01.S.doc Version 5.2 Page 14 Generally people are pleased with the way they live their lives and feel that their different needs and wishes are met. The manager said that she knew people get bored so they keep checking this out with the residents and they change things like activities and choice of food. The residents said they enjoyed their meals. They had recently been asked about the menus and a number of people said they had enjoyed the ‘tasting sessions’ of new dishes. This showed the inspector that the staff team are keen to both please residents and give them opportunities to try new things. People who don’t eat very well have very good nutritional plans in place to help tempt them to eat as well as possible. Lapstone House DS0000035223.V327554.R01.S.doc Version 5.2 Page 15 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): 16,18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents in this home are listened to and protected from abuse and this makes them confident that they are safe and free from harm. EVIDENCE: The residents and relatives’ surveys showed that no one had any complaints to make about the home. When the inspector spoke to people in the home they said they knew what to do and who to talk to if they had any concerns. The inspector saw copies of the home’s documents and information about complaints in bedrooms and around the building. Residents were very aware of their rights. The staff knew how to protect older people from harm and were confident that the manager would not let this happen. They knew who to contact in Cumbria Care if there was a problem. The residents had no concerns about anything untoward happening in the home. They said they would talk to the manager if anything worried them. They said they did have contact with Cumbria Care managers and that they were easy to talk to. Everyone – residents, relatives and staff- felt confident that the home was run with the very best interests of the residents at heart. Lapstone House DS0000035223.V327554.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19,26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. This is a comfortable and relaxed home that is always clean and orderly and this gives the residents the kind of environment they want. EVIDENCE: Lapstone house is very near to all the amenities of the town. It has its own parking and is near to bus routes and to the railways station. The home has a pleasant garden and residents said they enjoyed sitting out in good weather. The home was upgraded some years ago and the manager makes sure that the home is well maintained and decorated. The home is arranged into different units where residents have bedrooms, bathroom and a lounge-dining area. Lapstone House DS0000035223.V327554.R01.S.doc Version 5.2 Page 17 The inspector walked around the home and found it to be clean, warm and comfortable. Residents in the unit for people with dementia were relaxed and safe in their own special area. She spoke to one resident who was pleased that her daughter had been able to go into the home to make her bedroom as she would like it and had great help from the staff in the home in doing this. All of the residents’ bedrooms were personalised and people enjoyed spending time in private in their rooms. They also felt relaxed and comfortable in the lounge-dining areas. These areas are large enough for all the residents have bedrooms on the unit but small enough to feel like a normal domestic living area. The residents said that staff make sure that the home is clean and tidy. Several people spoke about how clean and tidy the house is. Residents were happy with the way the staff helped them to look after their clothes. Bed linens were fresh and clean. There were good arrangements in place for preventing infection and there were no bad odours anywhere in the house. Lapstone House DS0000035223.V327554.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. This home has a well-trained, competent staff team who are committed to improvement so that they can give of their best to residents. EVIDENCE: The manager sent the inspector six weeks worth of rosters before the visit to the home. These showed that the home is properly staffed at all time with care assistants and housekeeping and catering staff. Staff are trained to a very good level. The manager has a good training programme in place and staff were enthusiastic about their job and about improving their skills and knowledge at every opportunity. A good percentage of staff had gained National Vocational Qualifications in care. Staff spoke about how they had looked at their strengths as a team and had also looked at the areas where they needed to have ‘refresher’ training or where they wanted to improve how they put training into practice. This staff development programme is part of the manager’s ongoing quality improvement plan and the inspector thought that this showed that the manager was committed to having a really well trained and capable team. All the surveys said they were happy with the way the staff cared for the residents and several people said how ‘efficient’ and ‘well-organised’ the team was. Lapstone House DS0000035223.V327554.R01.S.doc Version 5.2 Page 19 The inspector checked on all the recent recruitments to the staff team. She found that the manager made sure that any new member of staff had good references and that they had not been sacked from any other care setting. She had also made sure that new staff didn’t have a criminal record and were the right kind of people to work with older, vulnerable residents. Lapstone House DS0000035223.V327554.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. This is a very well managed home and residents feel they have no need to feel concerned about how things are arranged. EVIDENCE: This home is a County Council home run by Cumbria Care. A manager from Cumbria Care visits on a regular basis and supports the manager. Christine Pidduck has been the registered manager for a number of years. She is well trained in both care and management. She has skills and experienced that makes her a suitable person to manage the home. More importantly the staff and residents trust and respect her. There was plenty of evidence to show that she is committed to keeping standards at the highest level in the home. Lapstone House DS0000035223.V327554.R01.S.doc Version 5.2 Page 21 The home has recently won an award from the County Council for the excellent standards in the home. The manager sent the inspector details of how she makes sure that care and services are of the highest standard. The residents are asked both formally and informally about their needs and preferences. The inspector judged that asking about things like the menus and the activities programme, and being consulted about care plans were very important as this allowed residents to be in control of their lives. A new care planning system was discussed with the inspector and she felt that this would improve the care provided to an even higher standard than before. The manager had also introduced a new system whereby the staff looked at their strengths and weaknesses and she has built in a yearly programme that would build on these things the staff want to improve on. All of these things mean that the home is excellent at reaching quality standards that the residents and staff set for themselves. The inspector checked on money kept on behalf of residents and she found this to be in order. She also looked at the checks on things like food hygiene, fire safety, health and safety and maintenance. All of these things were being done to a high standard. There were no hazards seen during the visit and everything looked to be well organised for the benefit of the residents. . Lapstone House DS0000035223.V327554.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X X x HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 3 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 4 14 4 15 x COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X x 3 STAFFING Standard No Score 27 4 28 4 29 4 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 4 X 3 X X 4 Lapstone House DS0000035223.V327554.R01.S.doc Version 5.2 Page 23 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Lapstone House DS0000035223.V327554.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith Cumbria CA11 9BP 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 Lapstone House DS0000035223.V327554.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!