Inspection on 28/04/05 for Larchwood Care Home

This inspection was carried out on 28th April 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Larchwood Care Home 18/04/07

Larchwood Care Home 05/05/06

Larchwood Care Home 06/09/05

Larchwood Care Home 30/09/04

Larchwood Care Home 02/06/04

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

CARE HOMES FOR OLDER PEOPLE Larchwood Care Home 108 Broad Road Braintree Essex CM7 9RX Lead Inspector Brian Bailey Final Report Unannounced 28th April 2005 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. Larchwood Care Home I56 I05 S17864 Larchwood V222696 UI 030505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Larchwood Care Home Address 108 Broad Road, Braintree, Essex CM7 9RX. 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) 01376 347777 01376 345556 Highfield Care Homes No. 3 Ltd Mrs Sharon Thompson Care Home 64 Category(ies) of Dementia - over 65 years of age (64) registration, with number of places Larchwood Care Home I56 I05 S17864 Larchwood V222696 UI 030505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Persons of either sex, aged 65 years and over, who require care by reason of dementia (not to exceed 64 persons) Date of last inspection 30/9/04 Brief Description of the Service: Larchwood is a large purpose built two-storey care home for older people. The residents’ accommodation is arranged within three self-contained group living units each with its own group of bedrooms, lounge/dining area, bathrooms/WC’s and kitchenette. The owners of Larchwood, Highfield Care Homes, merged with Southern Cross Healthcare in February 2005. The registered manager is Sharon Thompson. The home is set back from the main road in a residential area on the outskirts of Braintree. There are ample car parking facilities and access to public transport is good. The home is divided into three units, “Acorn” and “Chestnut” on the ground and first floor in one building, and “Rowan”, which is a larger unit on the ground floor in an adjoining building. All bedrooms are for single occupancy with en-suite WC facilities. There is a passenger lift available. The grounds adjacent to each unit are enclosed and there is a secure central courtyard area. Access to the building and all areas is good. Larchwood specialises in the care of older people with dementia and also frail elderly people. Larchwood Care Home I56 I05 S17864 Larchwood V222696 UI 030505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on 28th April 2005 from 9.45am until 4.15pm. This was the first inspection of Larchwood in the inspection year 2005/6. During the inspection, the manager, staff, residents and visitors and a volunteer gave their views about the home. The majority of residents were seen during the inspection. The inspection included a tour of the building to check some bedrooms in each unit, the bathrooms, lounges and dining rooms and the activities/hairdressers room. Residents’ care records and finances, staffing levels and staff recruitment records were checked and the midday meal was observed. Eighteen standards were assessed, of which, fourteen were met and four partly met. What the service does well: What has improved since the last inspection? A new manager has been appointed and registered by CSCI. The manager has had a difficult few months with the absence of the deputy manager, but has managed to be both supportive to staff and introduce change. A revised assessment form for prospective residents has been introduced. All staff have received training in the protection of vulnerable adults from abuse. Carpets in three bedrooms had been replaced and the hairdressing facilities improved. The refurbishment of the units during the past year has included new carpets and the redecoration of lounges and bedrooms, which has improved the overall appearance of the home. The internal courtyard has been redesigned and made safe for residents to use. Larchwood Care Home I56 I05 S17864 Larchwood V222696 UI 030505 Stage 4.doc Version 1.30 Page 6 Odour control throughout the building has improved. The main entrance area is brighter and more welcoming. A wide range of information is available to visitors together with a display of photographs and the current newsletter and list of activities. 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. Larchwood Care Home I56 I05 S17864 Larchwood V222696 UI 030505 Stage 4.doc Version 1.30 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 Larchwood Care Home I56 I05 S17864 Larchwood V222696 UI 030505 Stage 4.doc Version 1.30 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) 1 and 3 The admission process is well managed and residents and relatives are given clear information regarding the service. EVIDENCE: The home’s statement of purpose and residents’ guide are up to date, informative and provide a good account of the services available. The new owners are currently operating the home based on the existing statement of purpose but plan to review this in the near future. Full assessments were available on residents’ files together with information gathered by the home prior to admission. A new pre-admission form to be used by the home had been introduced. Assessment information was minimal on some files of residents who have lived at the home for more than one year. The manager was confident that the new procedures would ensure adequate information was obtained, which was demonstrated in the care files checked. Larchwood Care Home I56 I05 S17864 Larchwood V222696 UI 030505 Stage 4.doc Version 1.30 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. Progress has been made on improving care plans and the content of daily records. The frequency of reviews being carried out is variable, which may result in some residents’ needs not being met. EVIDENCE: Residents’ care records were checked on Chestnut and Rowan Units. These contained detailed care plans and these were being reviewed but not always on a monthly basis. The daily care records were in general sufficiently detailed. Good records were being maintained for one resident who did not wish to be cared for. Evidence was available however of the manager working closely with relatives and health care professionals. Larchwood Care Home I56 I05 S17864 Larchwood V222696 UI 030505 Stage 4.doc Version 1.30 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 standard(s) 15 Residents have a balanced varied and enjoyable diet. EVIDENCE: During the inspection, residents were served with a choice of meal. The food was well-presented and appetising in appearance and the residents were not rushed. The main choice was a roast dinner or pasta. Records showed that where possible, residents’ likes and dislikes were recorded. Residents spoken with were unable to comment about the quality of food provided, although a volunteer gave a positive view about the food and choice available. Larchwood Care Home I56 I05 S17864 Larchwood V222696 UI 030505 Stage 4.doc Version 1.30 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 standard(s) 16 &18 A Policy and procedures are in place and the staff team trained to ensure residents are protected from abuse. EVIDENCE: The home had a complaints procedure that was available in the entrance hall and is included in the statement of purpose and resident guide. One complaint was received by CSCI. The issues raised included poor odour control, which on investigation was substantiated and staffing levels, which was not substantiated. The home has a policy and a procedure on the protection of vulnerable adults from abuse and all staff, apart from the most recent appointments, have been provided with training on the understanding and recognition of abuse. Training certificates were available on staff files. Larchwood Care Home I56 I05 S17864 Larchwood V222696 UI 030505 Stage 4.doc Version 1.30 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 standard(s) 19, 20, 24, 25 & 26. Substantial improvements to the decoration and general refurbishment have been made. A comfortable and safe standard of accommodation is provided for residents. EVIDENCE: During the past year the home have continued to redecorate and up-grade the building internally and externally. New carpets have still not been fitted in the corridors of Acorn and Chestnut Units. Three bedrooms that were the source of poor odour control have been fitted with new floor covering. Access for residents from Chestnut Unit to the ground floor and the garden is limited to the passenger lift and the availability of staff. New hair washing facilities have been fitted. A large central courtyard is a safe area for service users to access. There are security measures on all external doors to safeguard residents. Residents’ bedrooms were clean and well decorated but varied as to how homely they looked according to the wishes and abilities of residents. Larchwood Care Home I56 I05 S17864 Larchwood V222696 UI 030505 Stage 4.doc Version 1.30 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 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. Staff at the home are trained and supported and employed in sufficient numbers to meet the needs of residents. Residents benefit from effective staff recruitment procedures. EVIDENCE: Staff rosters showed that appropriate staffing levels were being maintained. Training records showed that fourteen staff have obtained a National Vocational Qualification at level 2 and other training courses are provided on a rolling programme. Staff spoken with commented on how they felt they were supported by the senior staff. The three staff files looked at during the inspection showed that the new manager was following procedures and carrying out all the necessary recruitment checks for new staff. The files were well maintained and kept secure. Ten staff Criminal Records Bureau disclosure checks were examined. Larchwood Care Home I56 I05 S17864 Larchwood V222696 UI 030505 Stage 4.doc Version 1.30 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 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 & 35. The home is managed efficiently but attention needs to be given to obtaining feedback from all people with an interest in the home. Attention also needs to be given to ensuring all staff receive health and safety training. EVIDENCE: A new manager has been appointed and registered by CSCI. The provider had not informed CSCI of the person who is to be the Responsible Person to represent the organisation. Staff and visitors gave positive comments about the home. Three relatives commented on how well the staff care for residents and that they had no regrets about their relatives living at the home. They felt they were made welcome at the home and were able to visit at anytime. One relative said that communication with the home was good. Minutes of relatives meetings were available in the entrance hall. Records of residents’ cash held for safekeeping were up to date, accurate and well maintained. The home has an accumulation of valuables where the home Larchwood Care Home I56 I05 S17864 Larchwood V222696 UI 030505 Stage 4.doc Version 1.30 Page 15 has, despite numerous efforts, been unable to find the rightful owner. There was no procedure for their appropriate disposal. A Quality Assurance system was in place but the manager had not implemented a system for obtaining feedback from relatives, residents and external people such as district nurses and doctors. The manager’s training log showed that the majority of staff had received various health and safety training although a few staff require basic food hygiene and moving and handling training. Larchwood Care Home I56 I05 S17864 Larchwood V222696 UI 030505 Stage 4.doc Version 1.30 Page 16 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 3 x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 x 9 x 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 3 COMPLAINTS AND PROTECTION 2 3 x x x 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 3 2 x 3 x x 2 Larchwood Care Home I56 I05 S17864 Larchwood V222696 UI 030505 Stage 4.doc Version 1.30 Page 17 yes 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. 2. Standard 7 19 Regulation 15 23 Requirement Care plans must be reviewed at least monthly and on any significant change. The stained carpets in the corridors of Acorn and Chestnut Units must be replaced. (Timescale of 1/1/05 not met) The Quality Assurance system must be extended to include obtaining feedback from residents, relatives and all people with an interest in the home. (Timescale of 1/1/05 not met.) Health and safety training must be provided to all staff. Timescale for action 1/7/05 31/7/05 3. 33 24 1/8/05 4. 38 13 1/9/05 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 33 Good Practice Recommendations A written policy should be drawn up to provide the manager with instrcutions on how to dispose of valuables not claimed by residents and/or relatives. Larchwood Care Home I56 I05 S17864 Larchwood V222696 UI 030505 Stage 4.doc Version 1.30 Page 18 Commission for Social Care Inspection Fairfax House Causton Road Colchester CO1 1RJ 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 Larchwood Care Home I56 I05 S17864 Larchwood V222696 UI 030505 Stage 4.doc Version 1.30 Page 19 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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