CARE HOMES FOR OLDER PEOPLE
Larkswood 3 St Botolphs Road Worthing West Sussex BN11 4JN Lead Inspector
Jennifer Wright Announced 9 August 2005, 10:00 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. Larkswood H60-H11 S14601 Larkswood V235115 090805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service Larkswood Address 3 Botolphs Road, Worthing, West Sussex, BN11 4JN 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) 01903 202650 Sound Homes Limited Miss Marilyn Jones Care Home (CRH) only (PC) 18 Category(ies) of Old age, not falling within any other category registration, with number (OP), (18) of places Larkswood H60-H11 S14601 Larkswood V235115 090805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 14 January 2005 Brief Description of the Service: Larkswood is a care home registered to accommodate up to eighteen residents aged sixty-five years and over.The home is a large detached property located in a residential area of Worthing about one mile from the town centre and seafront, close to local parks and gardens. Accommodation is provided on two floors with the facility of a passenger lift. Resident’s bedrooms are for single accommodation, with twelve having en-suite facilities. A lounge/dining area and a separate small lounge is provided. In addition there is a well tendered garden. The service is privately owned by Sound Homes Ltd. and the registered manager is Miss Marilyn Jones. Larkswood H60-H11 S14601 Larkswood V235115 090805 Stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an announced inspection, the first of a minimum of two statutory visits that an inspector must make to each care home during the course of a year. A second inspection, which will be unannounced, will be undertaken later in the year. During this inspection the Inspector toured the building, visiting resident’s bedrooms, and the dining and sitting areas. The inspector spoke to the vast majority of residents, plus a visitor about what the care was like at Larkswood. The visitor spoken to on the day of inspection told the Inspector that he was satisfied with the care being provided at Larkswood. In addition to the Manager, who was present throughout the inspection, five staff members were also spoken to on the day of inspection about how they find working at Larkswood. The Inspector examined records about care being provided to residents; as well as records of any accidents, concerns or complaints, to make sure that the residents at Larkswood were being taken care of. Prior to the inspection, residents, their relatives and visitors to the home were offered the opportunity to complete a short questionnaire. Nine people responded, seven of whom were extremely complementary about the home. At this inspection Larkswood was audited against the National Minimum Standards for Older Persons. All the elements in each of the standards assessed were met. The Inspector would like to thank everyone who cooperated with her on the day of this inspection. What the service does well:
Larkswood offers the residents who live there, good care. All of the people who were spoken to, or written to, at the time of this inspection responded very favourably with regard to the care on offer at Larkswood. The Inspector received many comments from residents and relatives who said “we are very happy with the way in which my mother is looked after” and “the care is wonderful at Larkswood” and “nothing is too much trouble, this is a well run home”. The building is in good decorative order inside, and is well maintained, with the relevant records in place to ensure the safety of the people living there. The Inspector saw that staff training was ongoing at Larkswood, and it was seen that many of the staff members have worked at the home for many
Larkswood H60-H11 S14601 Larkswood V235115 090805 Stage 4.doc Version 1.40 Page 6 years. An Assistant Care Manager, who visits Larkswood, commented that she had noticed that “residents are treated with dignity and respect”. A visitor told the Inspector that in their opinion Larkswood is a “very good home” and that the person they visit “has never looked back since they came to live in the home”. The Manager informed the Inspector that Larkswood does not use agency staff, which means that the residents always know the staff member on duty. There were fresh flowers throughout the home on the day of inspection, and the Inspector was told that fresh flowers are always provided. 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. Larkswood H60-H11 S14601 Larkswood V235115 090805 Stage 4.doc Version 1.40 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 Larkswood H60-H11 S14601 Larkswood V235115 090805 Stage 4.doc Version 1.40 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, 3, 5 and 6 Prior to moving into Larkswood people are given sufficient information about what the home offers, to enable them to make a choice as to whether or not they want to live there. In addition before moving into the home, people are assessed, by a member of staff, in their own home or hospital whenever possible, to make sure they are suitable, and invited for a trial period. People know exactly what they can expect from Larkswood and what is expected from them. EVIDENCE: A resident, spoken to on the day of inspection, confirmed that they had been given information about Larkswood, prior to admission, and that they had been invited to visit the home before they came to stay. Some residents could not remember, but told the Inspector how pleased they were, with the care provided. Residents told the Inspector that they would go to the Manager if they had any queries, and felt that they would be listened to, and that they had no complaints whatsoever about the way they were being looked after. Larkswood H60-H11 S14601 Larkswood V235115 090805 Stage 4.doc Version 1.40 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) 7,8,9,10 and 11 Where possible, residents are involved with the drawing up of their care plans. All residents are informed of all services available under the National Health Service, and specialist equipment is provided where necessary. Correct medication procedures were seen to be in place, to protect the people living at Larkswood from harm, and from the comments made by many residents, a visitor, and an Assistant Care Manager, it would appear that the staff members respect the privacy and dignity of the people living at the home. EVIDENCE: Where residents are not able to be involved with the drawing up of their care plans, then the residents relative or advocate is involved. This was confirmed by many of the residents who the Inspector spoke to on the day of inspection, one of whom said, “they talk to me all the time, it couldn’t be better”. Records of drug administration are maintained, and the correct procedures, relating to medication, are being adhered to. The Manager confirmed to the Inspector that staff members administering medication had all received the appropriate training. The Inspector looked at care records of some of the residents, and found them to be satisfactory.
Larkswood H60-H11 S14601 Larkswood V235115 090805 Stage 4.doc Version 1.40 Page 10 The Inspector was informed that family or friends are offered a spare bedroom, if available, or a comfortable chair in the resident’s room, at the end of the resident’s life. Residents were spoken to and it would appear that staff treat residents who are dying, and their family and friends with respect, care and sensitivity. Larkswood H60-H11 S14601 Larkswood V235115 090805 Stage 4.doc Version 1.40 Page 11 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) 12,13,14 and 15 People living at Larkswood are able to make the day-to-day decisions about how they want to live their life. There are some activities for those who wish to participate, and residents are encouraged to maintain contact with all their old friends and family, wherever possible. The food is home cooked and offers a choice of menu, with people able to eat either with other residents in one of two dining areas, or in their own room should they prefer. EVIDENCE: Larkswood H60-H11 S14601 Larkswood V235115 090805 Stage 4.doc Version 1.40 Page 12 There were some activities on offer Larkswood, and the majority of people told the Inspector that they felt that there was enough to do, should they wish it. However the Inspector was told by some residents that they would like to go on an “outing” occasionally, and one resident said that “it would be nice to have someone to come in, perhaps once a week to play the piano”, and another resident said they would welcome the opportunity to play chess at some time. The Manager informed the Inspector that she would look into this. On the day of inspection the Inspector shared a meal with the residents, which was very tasty, attractive in appearance, plentiful, and clearly enjoyed by all. From direct observation, the Inspector noted that the mealtime appeared to be unhurried, with residents being afforded sufficient time to eat their meal. Where it was necessary staff members were seen to help residents in a sensitive and unobtrusive manner. Squash was served with the midday meal, which residents appeared to enjoy, however a visitor commented that they thought fresh juice would be preferable. On resident was practising yoga in his room when the Inspector visited, and was extremely proficient. The Inspector was told of a birthday party, held recently, for a resident who was 103, when a special cake was cooked by the home. Larkswood H60-H11 S14601 Larkswood V235115 090805 Stage 4.doc Version 1.40 Page 13 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) 16,17,18 Regular training sessions for staff, a complaints book, plus policies and procedures regarding abuse, ensure that, as far as is possible, the people who live at Larkswood are protected from bad practice. EVIDENCE: Complaints are recorded in the complaint’s book, although there were none recorded at the time of the inspection. Residents told the Inspector that should they have any concerns at all, they would have no hesitation in going to the Manager or any staff member, and know that they would be listened to. The Manager confirmed that Larkswood operates an “open door policy,” and that residents and relatives are aware that they can always come to her. Larkswood H60-H11 S14601 Larkswood V235115 090805 Stage 4.doc Version 1.40 Page 14 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, 22, 23, 24, 25 and 26 On the day of inspection Larkswood appeared clean and well maintained, and the location of the home is suitable for the residents who live there. Larkswood was seen to provide aids, ramps and assisted bathing facilities. There is a large garden for residents to sit in. EVIDENCE: During the course of the inspection all of the rooms were visited to ensure that the environment was safe and comfortable for people who live there. It was noted that many residents had brought personal possessions into the home, including small items of furniture, ornaments and photographs. Records were available to show that the home is maintained to a satisfactory standard. On the day of inspection, Larkswood was seen to be clean, and free from offensive odours. Policies and procedures were available for staff regarding control of infection, and the safe disposal of clinical waste. There were fresh flowers and plants throughout the home. A resident helps out in the garden, which was looking really nice, and residents were sitting out in the garden, enjoying a chat, on the day of inspection. There was evidence of some repair work needed to the outside of the
Larkswood H60-H11 S14601 Larkswood V235115 090805 Stage 4.doc Version 1.40 Page 15 premises. The Manager informed the Inspector that this would be addressed shortly as part of Larkswood’s maintenance plan. On the day of inspection several doors were seen to be wedged open, the Manager was made aware of the safety implications surrounding this. Larkswood H60-H11 S14601 Larkswood V235115 090805 Stage 4.doc Version 1.40 Page 16 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, 29 and 30 Larkswood is adequately staffed with employees who appear competent to care for older people. National Vocational Qualification is on going and further development training is expected. All training is recorded on staff member’s files. EVIDENCE: Staff members spoken to on the day of inspection were able to give a clear picture of the needs and preferences of the residents, and were clearly enthusiastic about working at Larkswood. Many of the staff member have worked at the home for a long time, and one staff member spoken to on the day of inspection told the Inspector that they “ wouldn’t change anything, the running of the home is just great” and a second said “I love it here”. Staffing records were examined and it was seen that all necessary procedures had been followed, with regard to recruitment of staff, including ensuring that all staff members have received Criminal Records Bureau enhanced checks, so that they are safe to work with vulnerable people. Records were seen to be kept in a locked cabinet. Records showed that all staff members had received the appropriate training, and that supervision was being carried, out and notes kept. The Manager informed the Inspector that Larkswood is very committed to the training of staff. Residents told the Inspector that there always appear to be enough people on duty to assist them when they need it, and that their bell was always answered when they rang it. A visitor confirmed that there was
Larkswood H60-H11 S14601 Larkswood V235115 090805 Stage 4.doc Version 1.40 Page 17 always sufficient staff around, when they visited. Everybody who the Inspector talked with, on the day of inspection, spoke very highly of Larkswood. Larkswood H60-H11 S14601 Larkswood V235115 090805 Stage 4.doc Version 1.40 Page 18 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 and 38 Ms. Jones, the registered Manager, is qualified, and experienced in working with older people. Records needed for the safe running of a care home are kept up to date. Policies and procedures are available for staff members to refer to, to ensure the safety of the people who live and work at Larkswood. Staff receive regular supervision, which is recorded. EVIDENCE: All the residents, relatives and visitors confirmed to the Inspector, that the Manager is extremely approachable and supportive. All the staff members that the Inspector spoke to echoed this. Residents told the Inspector that they liked the way Larkswood was run. Larkswood was seen to have appropriate Health and Safety policies, and risk assessments are completed for both the home and individual residents. Records of accidents, injuries and incidents are recorded and reported appropriately. Training records indicated that staff members have received
Larkswood H60-H11 S14601 Larkswood V235115 090805 Stage 4.doc Version 1.40 Page 19 induction training together with fire safety, manual handling and infection control. Larkswood H60-H11 S14601 Larkswood V235115 090805 Stage 4.doc Version 1.40 Page 20 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 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3
COMPLAINTS AND PROTECTION 3 x x 3 x x 3 3 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 3 3 3 x 3 x x 3 Larkswood H60-H11 S14601 Larkswood V235115 090805 Stage 4.doc Version 1.40 Page 21 na 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. 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 Good Practice Recommendations Larkswood H60-H11 S14601 Larkswood V235115 090805 Stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection 2nd Floor, Ridgeworth House, Liverpool Gardens Worthing West Sussex BN11 1RY National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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