CARE HOMES FOR OLDER PEOPLE
Lapstone House Lapstone Road Millom Cumbria LA18 4BY Lead Inspector
Cath Wilson Unannounced Inspection 27 October 2005 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.V248938.R01.S.doc Version 5.0 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.V248938.R01.S.doc Version 5.0 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 770516 Cumbria Care Miss Christine Pidduck Care Home 25 Category(ies) of Dementia - over 65 years of age (7), Old age, registration, with number not falling within any other category (25) of places Lapstone House DS0000035223.V248938.R01.S.doc Version 5.0 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 7 service users in the category of DE(E) (Dementia over65 years of age) The staffing levels for the home must meet the Residential Forum Care Staffing Formula for Older Adults. 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. 20th April 2005 3. 4. 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 7 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 their own sitting room, 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. Lapstone House DS0000035223.V248938.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection that took place over the morning and early afternoon periods. During the inspection people in the home were met throughout the day, as were the registered manager and staff. A number of records were assessed and the inspector looked around all areas of the home. What the service does well: What has improved since the last inspection? The home continues to upgrade the furnishings and decorations and service user’s family have been included in this. The seating arrangements for the outside areas have been upgraded and there are plans in place for further developments in this area. The outcome of service user surveys organised by the home have been well documented. Lapstone House DS0000035223.V248938.R01.S.doc Version 5.0 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. Lapstone House DS0000035223.V248938.R01.S.doc Version 5.0 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 Lapstone House DS0000035223.V248938.R01.S.doc Version 5.0 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): These standards were all assessed at the previous inspection and the intended outcomes were met. EVIDENCE: Lapstone House DS0000035223.V248938.R01.S.doc Version 5.0 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 and 10 The personal, health and social care needs of people in the home are recorded in a detailed manner and greatly limited any possible or potential risk to people in the home. EVIDENCE: The manager and staff provide the support and care that people require in a nurturing, sensitive and dignified manner. People in the home are comfortable with their care and the manner that it is provided. They spoke of the manager and staff’s ‘kindness’ and ‘attention to the little things that matter’. People felt able to give their views and opinions and found the manager and staff always approachable. The care planning in the home comprehensively details people’s holistic needs and the manager and staff are very informed about people’s care needs and wishes. Care documents are kept up-to-date and are regularly monitored by the manager. Medication is securely stored and administered and staff are following the home’s policy and procedure for this. Staff are trained in these matters. The manner in which people’s health and personal care is provided shows that people in the home continue to be protected and safeguarded.
Lapstone House DS0000035223.V248938.R01.S.doc Version 5.0 Page 10 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 and 14 People can involve themselves in social interests and pastimes and observe their cultural and religious wishes. EVIDENCE: People continue to choose how they spend there day and their family and friends visit the home regularly. Activities and interests are available in the home and the manager continues to develop the range of interests to meet people’s wishes. Lapstone House DS0000035223.V248938.R01.S.doc Version 5.0 Page 11 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 and 18 The home follows the vulnerable adults procedure to ensure that the people living in the home are protected from abuse. There is a satisfactory complaints procedure available to people and their relatives. EVIDENCE: The home has a detailed complaints procedure and response system in place. There have been no complaints made since the previous inspection to either the home or the Commission for Social Care Inspection. The manager and staff know the adult protection procedures to follow and the practices needed. Staff spoken to are very clear about the responses required. Lapstone House DS0000035223.V248938.R01.S.doc Version 5.0 Page 12 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, 20, 21, 22, 23, 24, 25 and 26 People are provided with safe, comfortable and relaxing surroundings that include specialist facilities and adaptations. EVIDENCE: People are comfortable within their home and pleased with the personal way they have their own rooms and ‘love having my own things around me’. There is a programme in place to maintain the furnishings and fittings in both the private and communal rooms. Family members are also involved in this. Contact is appropriately maintained with other professional personnel regarding the environment. This makes sure people have appropriate support and assistance with the provision of specialist aids and adaptations. The outside garden and patio areas are well maintained and new seating arrangements have been provided. There are plans for further developments in these areas. The home is maintained in a clean, safe and pleasant manner. Lapstone House DS0000035223.V248938.R01.S.doc Version 5.0 Page 13 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): 27, 28 29 and 30 People benefit from an experienced and trained staff group who are fully informed of people’s needs and wishes. The home follows the Cumbria Care procedure for the recruitment of staff. EVIDENCE: Staff are very clear about their roles and responsibilities and committed to providing very positive experiences for people in the home. People in the home felt very comfortable with the manager and staff and found them to be very approachable. Staff had received regular supervision and felt they were supported in their work. Staff are provided with an individual training and development programme and records of these are kept up-to-date. Lapstone House DS0000035223.V248938.R01.S.doc Version 5.0 Page 14 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, 32, 33, 36, 37 and 38 The registered manager has a very positive vision and commitment to make sure that residents receive an appropriate consistent quality of care. These will promote and safeguard the health, safety and welfare of people in the home. EVIDENCE: The manager and staff are very clear about their roles and balance their work so that individual and communal needs of people are met. People’s records are kept up-to-date and regularly monitored by the manager. This ensures that people’s needs are appropriately met. The records assessed during the inspection ensure that people’s rights and best interests are safeguarded. The registered manager is highly qualified and experienced in a managerial position. Records indicated that all health and safety matters are kept up-todate.
Lapstone House DS0000035223.V248938.R01.S.doc Version 5.0 Page 15 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 X X 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 3 3 3 3 3 3 X 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 4 4 X X 4 4 4 Lapstone House DS0000035223.V248938.R01.S.doc Version 5.0 Page 16 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.V248938.R01.S.doc Version 5.0 Page 17 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith Cumbria CA11 9BP National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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