Inspection on 12/11/07 for Larks Leas

This inspection was carried out on 12th November 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

Larks Leas 31/10/06

Larks Leas 29/09/05

Larks Leas 20/04/05

Larks Leas 26/11/04

Larks Leas 03/08/04

Larks Leas 05/03/04

Similar services:

Fairfields Country Rest Home

Queensmount

Poldhu

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Larks Leas Milldown Road Blandford Dorset DT11 7DE Lead Inspector Gloria Ashwell Key Unannounced Inspection 12th November 2007 11:00 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 Larks Leas DS0000055591.V354151.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. Larks Leas DS0000055591.V354151.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Larks Leas Address Milldown Road Blandford Dorset DT11 7DE 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) 01258 452777 admin@larksleas.co.uk www.larksleas.co.uk Castle Farm Care Limited Mrs Andrea Jain Falconer Care Home 24 Category(ies) of Old age, not falling within any other category registration, with number (24) of places Larks Leas DS0000055591.V354151.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 24 in 20 single and 2 double bedrooms. The rooms acceptable for double occupancy are 14, 18 or 19. 31st October 2006 Date of last inspection Brief Description of the Service: Larks Leas is a detached property on a main road approximately half a mile from the centre of Blandford where there are shops, a post office and churches. Larks Leas is close to the local hospital and a GP surgery. The home is on two floors and there are two passenger lifts. There are a variety of aids and adaptations around the building to allow residents to move about more independently. All 22 rooms are used as single rooms although the home is registered to accommodate a maximum of 24 people in twenty single and two double rooms. Some bedrooms have direct access to the rear terrace and patio areas. With one exception all bedrooms have en suite toilet facilities. There is an additional communal bathroom and toilet facilities on the ground and first floors. Laundering of clothing and household linen is carried out at the home and arrangements can be made for chiropodists, opticians and other health and social care professionals to visit individual residents. The home has a fully enclosed rear garden, and car parking at the front of the home. The fee range quoted in the service user guide at the time of inspection was £350 to £525 per person per week. Up to date fee information may be obtained from the service. Information regarding the subjects Value for Money and Fair Terms in Contracts can be obtained from the web link: www.oft.gov.uk A report entitled Care Homes in the UK - A Market Study is available on web link http:/www.oft.gov.uk/NR/rdonlyres/5362CA9D-764D-4636-A4B1A65A7AFD347B/0/oft780.pdf Larks Leas DS0000055591.V354151.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was a statutory inspection required in accordance with the Care Standards Act 2000. The inspection was unannounced; the inspector arrived at 11.00 on 12 November 2007, toured the premises and spoke to residents and staff. By arrangement with registered manager Mrs Falconer she arranged the next visit which took place at 10.00 on 19 November 2007 when documentation relating to care provision and the premises was discussed and examined. The duration of the inspection (both days combined) was 4 ½ hours. The inspector spoke to Mrs Falconer and the deputy manager, care and household staff and most of the residents accommodated at the time. The inspector observed staff interaction with residents and the carrying out of routine tasks. During the inspection, particular residents were ‘case tracked’; for example, for evidence regarding Standards 3, 7 and 8, records relating to the same resident were examined and the resident spoken with. The care records of four people who live at the home were examined in detail. The inspector was able to meet and speak with most of the residents both individually and in small groups in the communal areas. Additional information used to inform the inspection process included the Annual Quality Assurance Assessment completed in advance of the inspection by Mrs Falconer and ‘Have Your Say’ questionnaires completed and sent to the Commission by 9 residents, 6 representatives (e.g. relatives, friends) of residents and 2 social care professionals. During this inspection compliance with all key standards of the National Minimum Standards was assessed. What the service does well: People considering moving into Larks Leas receive a full assessment and are provided with the opportunity to visit and spend time at the home to make sure that it is able to meet their needs. Discussion with service users indicated they are very satisfied with the home; comments included “Excellent! They’re caring people who run it, and all the staff…I don’t think they could do better…there are different activities put on…I’m never bored” and “…the staff are very good, the food’s excellent and the care is especially good…”. Larks Leas DS0000055591.V354151.R01.S.doc Version 5.2 Page 6 ‘Have Your Say’ questionnaires stated that Larks Leas is an “excellent care home…everything possible done to meet residents physical and emotional needs” and provides “a supportive environment” with staff possessing “the right skills and experience…to meet the residents needs”. On the days of inspection the home was clean, comfortably warm and adequately staffed. It is well equipped, attractively decorated and suitably furnished. The standard of health and social care is excellent and each resident has a documented plan of care. Food is well-presented, varied and nutritious. Staff are enthusiastic and competent, and receive training. What has improved since the last inspection? 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. Larks Leas DS0000055591.V354151.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 Larks Leas DS0000055591.V354151.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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 & 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service user guide contains relevant information about the home providing prospective residents and their representatives with an accurate understanding of the people for whom the service is intended although the format of the information may not be suitable for service users who have specific needs, for example those with impaired sight. Prior to admission, the needs of each proposed resident are assessed to ensure the home will be properly able to meet them. EVIDENCE: The service user guide is made available to all residents and prospective residents. Larks Leas DS0000055591.V354151.R01.S.doc Version 5.2 Page 9 The Statement of Purpose and service user guide are available in a standard format; it is recommended that this information be made available in alternative formats, appropriate to the needs and capacity of individual prospective residents or their representatives who might find the standard format difficult to read and fully understand. The records of two recently admitted residents included details of preadmission assessments which had been carried out by the deputy manager when she visited the prospective residents at the previous addresses. In advance of making the decision to enter the home one of the prospective residents and the closest relatives of the other prospective resident visited Larks Leas to view the premises and meet residents and staff. Following pre-admission assessment of the persons needs and circumstances the home writes to them confirming agreement and ability to accommodate and care for them. Larks Leas DS0000055591.V354151.R01.S.doc Version 5.2 Page 10 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 & 11 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The health and social care needs of residents are fully met by suitably trained staff; doctors and other professionals visit as necessary and the home employs care workers who properly respect and promote the privacy and dignity of the residents. EVIDENCE: Residents representatives believe they are properly cared for; comments received in advance of the inspection included “all the carers look after X as well or even better than I could at home…all X’s needs are met and given in a loving manner” and during the inspection a resident said “I couldn’t ask for more…the staff are very proficient and what’s more they are kind; you’re never rushed…”. Larks Leas DS0000055591.V354151.R01.S.doc Version 5.2 Page 11 Care provision is in accordance with a written plan of care for each resident thereby ensuring that staff have sufficient information upon which to base their care practice. Whenever possible, residents are actively involved in planning their own care and are encouraged to sign records to confirm their agreement. Care records of four residents were examined and contained risk assessments forming the basis for care plans and daily records describing the care of each resident. To ensure correct identification of residents, records contain a recent photograph of each resident. Medicines prescribed by doctors are safely stored and carefully administered to residents by staff trained in this work, thereby protecting residents from medicine errors. Medication administration records were properly kept indicating that residents receive prescribed medicines at the correct times and in correct amounts those wishing to do so can manage their own medicines in accord with a risk assessment process; one of the currently accommodated residents manages their own medicines. In the presence of staff residents appeared relaxed, confident and at ease; staff interactions with residents were of a friendly and considerate manner and the atmosphere throughout the home was calm and unhurried. Residents are treated with respect and their privacy and dignity is protected at all times. Larks Leas DS0000055591.V354151.R01.S.doc Version 5.2 Page 12 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 good. This judgement has been made using available evidence including a visit to this service. Residents are encouraged and assisted to maintain as much independence as possible. Social and leisure activities are varied and suited to the preference and ability of each resident. Residents are encouraged to maintain contact with the local community and visits by their friends and relatives are welcomed by the home. Meals are appetising and of good quantity and quality. EVIDENCE: The inspector spoke to a number of residents; all expressed satisfaction with all aspects of the home, including the range of activities, meal provision, staff and premises. Larks Leas DS0000055591.V354151.R01.S.doc Version 5.2 Page 13 The provider organisation employs an Activities Organiser who arranges occasional local excursions, one-to-one and small group social and recreational activities throughout the 3 homes, and thereby visits Larks Leas on a part-time basis. ‘Have Your Say’ questionnaires completed and sent to the Commission in advance of the inspection stated that food provided by Larks Leas “is very good; quite a good variety and choice” and ”since being in the home X is eating better and socialising with other residents”. Visitors are welcome at any time and those the inspector spoke to said they are always made to feel welcome and placed at ease by the staff. Residents said they were very satisfied with the quality, choice and quantity of food provided, variously describing it as “excellent” and “very good”. One resident said that overall Larks Leas is “Excellent…the staff are very good, the food’s excellent and the care is especially good…” and another described the many recent and planned activities which are to include a Christmas shopping trip to Poole. Larks Leas DS0000055591.V354151.R01.S.doc Version 5.2 Page 14 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. The complaints procedure provides information on the procedure to follow to persons wishing to make a complaint; all complaints are recorded and investigated and the home has implemented an adult protection procedure. EVIDENCE: To ensure residents and their representatives have access to the complaints procedure it is included in the service user guide to the home which is displayed at the entrance and a copy is provided to each resident’s relative/representative. Residents know how to complain and feel confident that if they had concerns or complaints they will be listened to and taken seriously. The home keeps records of all complaints received and investigated. Since the last inspection no complaints against the home have been received or investigated. The home has developed and implemented written policies and procedures for the protection of residents from abuse or neglect and provides all staff with training in the understanding of abuse and their role in protecting residents Larks Leas DS0000055591.V354151.R01.S.doc Version 5.2 Page 15 from abuse in its many forms, including neglect. Care staff spoken with during the inspection said they think the standard of training available to them is very good and they are encouraged to undertake training in subjects that interest them. Larks Leas DS0000055591.V354151.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 excellent. This judgement has been made using available evidence including a visit to this service. The premises are comfortable, clean, suitably equipped and subject to a continuous programme of updating and refurbishment to ensure the standard is routinely maintained. EVIDENCE: The home has a warm and homely atmosphere; it is comfortably furnished and well decorated. Residents can enjoy walks around the garden and plenty of seating is provided. The garden has been ramped making it fully accessible from the lounge by wheelchair users and other people with mobility difficulties. Some residents have doors providing direct access to the garden from their ground floor rooms. Larks Leas DS0000055591.V354151.R01.S.doc Version 5.2 Page 17 Flower beds have been raised so residents can become involved in the gardening. The home encourages staff and residents to bring maintenance and housekeeping issues to their attention; in each bedroom there are simple forms for the residents to complete describing any items needing attention, e.g. a dripping tap, a cardigan needing a button to be sewn on. The lounge and dining area are comfortably furnished. In the newest part of the home there is a ‘quiet area’ where residents can entertain their visitors if they wish. With one exception all bedrooms have en suite toilet and wash hand basin. Some residents who use wheelchairs have larger en suite areas which are better for their needs and thereby promote greater independence, privacy and dignity. Aids and adaptations are available throughout the home e.g. grab rails, raised toilet seats. Residents with particular needs have their own personal equipment to assist with their independence. Adjustable beds are in place for those who need them. Residents are encouraged to personalise their rooms with furniture and general belongings as they wish and in agreement with the home; one resident was pleased to show the inspector the shelves installed by her relatives. There are two passenger lifts in the home providing easy access to both floors. There are emergency alarm bells throughout the home. Residents who are identified as being at high risk of falling are provided with pendant call units which can be worn at all times including in the garden allowing them to summon help as necessary. On the days of this inspection the home was clean and there were no unpleasant odours. The laundry was clean and tidy and properly equipped; all laundry is carried out at the home. Larks Leas DS0000055591.V354151.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 adequate. This judgement has been made using available evidence including a visit to this service. The home employs enough staff to meet the needs of residents and to ensure their safety and comfort and maintenance of the good condition of the premises. The home must ensure that recruitment practices designed to protect residents from potentially unsuitable staff are rigidly followed. The home provides to staff the training they need to be able to properly care for residents. EVIDENCE: At all times the home is in the overall charge of an experienced care worker. Staffing levels are provided in accordance with the assessed needs of residents to ensure that at all times sufficient staff are available to properly meet their needs. Staff are enthusiastic about their work and feel they provide a good standard of care to residents and are properly supported by the management and training provision. Larks Leas DS0000055591.V354151.R01.S.doc Version 5.2 Page 19 The records of 2 recently employed staff members were examined and found to contain most essential information including an interview assessment, health details, evidence of identity and of induction training. For one of the two new staff only one written reference had been obtained in advance of the person commencing employment in the home; the folder contained a record stating that the second reference was to be chased up but it is nonetheless recommended that no staff commence employment in the home before two written references have been obtained. At present fewer than 50 of the care staff currently employed by the home hold a National Vocational Qualification in care; this report contains an associated recommendation. The provider organisation and registered manager share an enthusiastic approach to staff training; recent topics have included the Mental Capacity Act and dementia. Larks Leas DS0000055591.V354151.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 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed, suitably staffed and much liked by residents. The quality assurance system ensures maintenance of standards and involvement of service users. Policies and practices promote the health, welfare and safety of residents and staff of Larks Leas. EVIDENCE: Larks Leas DS0000055591.V354151.R01.S.doc Version 5.2 Page 21 Registered manager Mrs Falconer is supported by a deputy manager and together they maintain a regular presence in the home; both are well respected and liked by staff and service users. The home has ongoing systems for quality assurance; satisfaction surveys are periodically issued and occasional meetings for residents and their relatives take place. There is a selection of clear and appropriate policy and procedure documents, including those for care provision, management and the premises. Records of fire alarm tests, staff training and drills were in order. The home does not manage the personal finances of any resident; there are facilities for the temporary storage of monies and valuables which residents may no longer wish to personally hold. Staff trained in First Aid and health care are on duty in the home at all times. All staff are supervised and each has a personal profile containing records of appraisal. Records are kept of all accidents and there is subsequent investigation, review of the care plan and periodic audit to identify any trends e.g. time, place, person, activity. Details of equipment servicing and maintenance were provided to the Commission in advance of the inspection in a questionnaire. The inspector examined some records to verify this information including the records of regular checks/tests of fire safety equipment and the passenger lifts. The home has recorded a fire safety assessment complemented by a detailed escape plan including reference to the currently accommodated residents. There is a written assessment of the ‘Health & Safety’ of the premises and working practices designed to ensure the continued safety of all who live in, work and visit the home. Larks Leas DS0000055591.V354151.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 2 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Larks Leas DS0000055591.V354151.R01.S.doc Version 5.2 Page 23 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. 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. 1. Refer to Standard OP1 Good Practice Recommendations The service user guide should be made available in alternatives to the standard format and should fully describe the conditions of registration with particular regard to the categories of persons who may be accommodated. At least 50 of care staff should be trained to NVQ level 2 or equivalent. To ensure that recruitment practices protect residents from potentially unsuitable staff at least 2 written references must be obtained before any new staff member is employed. 2. 3. OP28 OP29 Larks Leas DS0000055591.V354151.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF 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 Larks Leas DS0000055591.V354151.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!