Inspection on 02/05/06 for Larchwood Nursing & Residential Home
Also see our care home review for Larchwood Nursing & Residential Home for more information
This inspection was carried out on 2nd May 2006.
CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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
What follows are excerpts from this inspection report. For more information read the full report on the next tab.
What the care home does well
The home has a core group of staff who care for the residents well being. Able bodied residents are allowed to maintain an independent lifestyle. The manager assesses prospective residents before admission using a basic format to record the findings.
What has improved since the last inspection?
The manager has undertaken a survey with residents looking at the quality of the service provided. A deputy manager has been appointed and although is being rostered as one of the nurses in charge she has begun updating and improving the care plans. The Commission has received fewer complaints about the service, however, this has not completely ceased. The home has recently appointed a second maintenance person who has redecorated some bedrooms and one of the lounges. The manager has produced a list of training the care staff have had, which included some training sessions in basic care practice.
What the care home could do better:
The homes service user guide is out of date and too brief to provide residents with enough information for them to make a choice about living in the home. Although the deputy manager has been updating the care plans, not all residents have a care plan and not all care plans have been updated. Staff and residents are not involved with the care plans and staff do not refer to them to ensure they are providing the right care to the residents. Care plans fail to address the residents social and emotional needs and residents were not being properly assessed for the safe use of bedrails. Residents had mixed views about staff treating them with dignity and respect. Medication practices remain poor and have not significantly improved since the previous CSCI medication inspection in November 2005. The Pharmacist Inspector has written a separate report, which is available from the Commission on request. There are not enough staff on duty to provide residents with stimulation, interaction and meaningful occupation. Not much interaction was observed during the inspection and the homes culture is one where residents spend a lot of time in their rooms. There was evidence to suggest that staff had been too busy that morning to assist residents with their drinks. The home has a designated activities co-ordinator who works part time and usually sees selected residents on a group basis. The food is not very good, the Inspectors sampled the lunch on the day of the inspection and found it to be badly cooked and poorly presented. The residents did not enjoy it and some expressed their dissatisfaction with the quality of food provided.Residents are not given enough choice about the food provided. The menu does not offer a choice of main meal. The homes complaints procedure was out of date and not all residents were aware of its existence. Staff expressed difficulties reporting concerns to the manager and regional manager saying they were not listened to and their concerns were not acted upon. The premises were dirty and poorly maintained throughout with bad odours in some areas. Despite the manager saying at the previous inspection that he was to audit the premises, the standard of cleanliness has not improved. Furniture was tatty and in need of replacement. The enamel on one bath had worn to such an extent that a strip of rust was visible. There is no planned maintenance programme for replacement of worn items, repair or redecoration of the home. The call bell remains noisy and intrusive and staff took a long time to answer calls. Staff have not been given opportunities to undertake NVQ training therefore none of the staff have achieved this qualification. New staff have not received induction training and there was no evidence on their files to suggest this had been arranged or had taken place. The home is failing to follow safe recruitment practices and is allowing staff to start working in the home without having completed proper checks. The manager has not yet set up systems for supervising and appraising care staff, induction training is not in place and he has only just completed a quality survey. Residents said they see very little of the manager and one resident had not seen him at all during his stay in the home. The manager had knowingly admitted a resident outside the homes category of registration. The responsibilities of the deputy manager need to be made clear as it is not possible for her to undertake nursing duties in conjunction with the duties expected of her as deputy manager.