Inspection on 21/03/07 for Lavender House

This inspection was carried out on 21st March 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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

Lavender House 04/09/06

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE Lavender House Newtown Road Woolston Southampton Hampshire SO19 9HR Lead Inspector Craig Willis Unannounced Inspection 21st March 2007 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 Lavender House DS0000066534.V326875.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. Lavender House DS0000066534.V326875.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Lavender House Address Newtown Road Woolston Southampton Hampshire SO19 9HR 02380444234 08712248456 richardkitchen.com 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) Mr Richard Edward Kitchen Mrs Elizabeth Kitchen Mrs Elizabeth Kitchen Care Home 18 Category(ies) of Dementia - over 65 years of age (18), Old age, registration, with number not falling within any other category (18) of places Lavender House DS0000066534.V326875.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. One service user in the category DE may be accommodated under 55 years of age One service user in the category MD may be accommodated above 55 years of age 4th September 2006 Date of last inspection Brief Description of the Service: Lavender House is a care home providing personal care and accommodation for up to 18 older service users, some of whom have dementia. It is owned by Mr and Mrs Kitchen, who have several years experience of owning care homes. The home is located in Woolston on the outskirts of Southampton, and the nearest shops and other public amenities are relatively accessible. The home comprises a detached property with on street car parking for several vehicles to the side of the building and an accessible garden to the front. There are eight single bedrooms, two with an en-suite facility, and there are five double bedrooms, two with en-suite facilities. The bedrooms are situated on both ground and first floors. There is a lounge on the ground floor, which includes a dining area. The manager reported in the pre-inspection questionnaire that the fees for a place at the home range from £386 to £440 per week. Lavender House DS0000066534.V326875.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The evidence used to write this report was gained from a review of the information the provider sent to the Commission for Social Care Inspection (CSCI) following the last inspection, a pre-inspection questionnaire completed by the provider, comment cards received from residents, their relatives and visiting professionals and a site visit to the home on 21st March 2007. During the site visit the inspector spoke with residents, visiting relatives, a visiting community nurse, care staff and the manager. A tour of the building was made and the inspector observed the care that staff were providing to residents. Documents relating to the running of the home were inspected during the visit. There have been significant improvements in this service and all fourteen of the requirements made at the last inspection have been complied with. What the service does well: What has improved since the last inspection? All residents are assessed before they move into the home. The manager only offers a place to those people whose needs can be met by the home. People Lavender House DS0000066534.V326875.R01.S.doc Version 5.2 Page 6 who do move into the home are provided with information about the cost of the service and what is included in that cost. The care planning process has been reviewed and residents’ needs are now set out in clear care plans, with information on how these needs should be met. Care plans are regularly reviewed. The home has clear medication procedures and staff complete assessed training in the administration of medicines. The laundry room has been refurbished, there are new washing machines and infection control procedures have been introduced. All staff are checked before starting work to ensure they are suitable to work in the home. A new training programme has been introduced, which will help to ensure staff receive the training necessary for their role. Chemicals used in the home are now safely stored. 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. Lavender House DS0000066534.V326875.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 Lavender House DS0000066534.V326875.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): Standards 1, 2, 3 and 4. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has good systems to assess the needs of potential residents, which provides assurance that their needs can be met. Residents are given good information about the services provided by the home and current cost of the service. EVIDENCE: Since the last inspection the manager has developed a new statement of purpose and service users guide for the home. These set out the service that is provided at the home. Following discussion with the manager during the visit, it was agreed that additional details of the manager’s experience and qualifications would be added to the documents. Residents and relatives spoken with said they received sufficient information about the home before making a decision to move in. Lavender House DS0000066534.V326875.R01.S.doc Version 5.2 Page 9 The files of six residents were inspected during the visit. These all contained a contract or statement of terms and conditions of residence, which had been signed by the resident or their representative. These documents included the fee level and services that this covered. All six residents whose records were inspected had a needs assessment that was completed prior to them moving into the home. This assessment included their physical, psychological and spiritual needs and was completed by the manager or duty manager. An additional nutritional assessment has also been completed for residents to assess dietary needs. The needs of all service users appeared to fall within the home’s registration and the manager reported that she had recently been unable to offer a potential resident a place at the home because she felt they could not meet their needs. Residents and relatives spoken with said that they were reassured that the home would be able to meet their needs prior to moving in. Lavender House DS0000066534.V326875.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): Standards 7, 8, 9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The details recorded in care plans, support to access health services and the way staff support residents ensures that they are treated with dignity and respect and their needs are met. EVIDENCE: The files of six residents were inspected during the visit. All six had a current care plan, which set out how their assessed needs should be met. The manager reported that following the last inspection all of the care plans had been updated and were now being reviewed monthly. Evidence was seen of plans that had been amended following reviews. Residents spoken with said they were aware of their care plans and happy with their contents. Staff spoken with demonstrated a good understanding of the care planning system and the needs of residents. Records were kept of residents’ medical appointments, including any advice that was given by the practitioner. Evidence was seen of residents’ Lavender House DS0000066534.V326875.R01.S.doc Version 5.2 Page 11 appointments with their GP, chiropodist, optician, dentist, district nurse and community psychiatric nurse. The inspector spoke with a visiting community psychiatric nurse who said she had a very positive relationship with the home and staff always seek advice and work well with residents. A CSCI comment card was received from one of the GPs with patients living in the home. This GP said they find the care “exceptionally good” and “I am always dealt with appropriately and the staff clearly care for the residents who do very well in their care”. There was also a comment card from a community nurse, who said “staff are always willing to discuss situations they find difficult”; and “The staff are supportive and caring towards the client group. They are keen to learn and adapt.” Since the last inspection the home has developed a new medication policy and procedure, which has been signed by staff responsible for medication administration. Medication is stored in a locked trolley and a monitored dosage system is used, with medication supplied from the pharmacist in sealed cassettes. A separate fridge is available for any medication that requires refrigeration. Records were kept of medication received into the home, administered to residents, removed from the home and disposed of and these records had been fully completed. Staff responsible for administering medication are currently completing an assessed qualification through a local college, which takes approximately five months to complete. None of the residents were administering their own medication at the time of the visit. Residents spoken with said they are well treated and staff respect their privacy. Throughout the visit staff were observed providing care and support in a sensitive manner that respected the privacy of residents. Lavender House DS0000066534.V326875.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): Standards 12, 13, 14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides good support to residents to take part in social activities and visitors are made to feel welcome. A choice of good food is provided for residents and meal times are a relaxed, social occasion. EVIDENCE: Residents spoken with said they enjoyed the activities available in the home, which include music sessions, visiting entertainers, bingo, art and games. The needs assessment completed prior to a resident moving in includes details of social activities and hobbies and residents are supported to continue these where possible. Newspapers are delivered for those that want them and there are books, games, videos and magazines available. Support is provided for residents to meet their spiritual needs and ministers from different Christian denominations currently visit the home. The manager said support would be provided to meet other religious needs if necessary and information on spiritual needs is obtained as part of the initial needs assessment. Lavender House DS0000066534.V326875.R01.S.doc Version 5.2 Page 13 The home has an open visiting policy and visitors spoken with said they were always made to feel very welcome. Relatives who completed a CSCI comment card said they were made to feel welcome and were offered drinks and meals during their visits. Residents are able to control their own financial affairs and bring their personal possessions into the home. During the visit a mealtime was observed. Staff were observed providing appropriate support to residents and there was a relaxed and friendly atmosphere in the dining room. Residents are able to take meals in their bedrooms if they wish. Residents spoken with said that the food was good. Lavender House DS0000066534.V326875.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): Standards 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has good systems to investigate complaints and protect residents from abuse. This gives residents and their representatives confidence that their concerns will be taken seriously and acted upon. EVIDENCE: The home has a complaints procedure, which sets out who will respond to a complaint and how long a response will take. Residents and relatives spoken with said that were confident any complaints they made would be taken seriously and investigated. This was also reflected in the comment cards received from residents and relatives. There have been no complaints to the home or CSCI since the last inspection. Since the last inspection some staff have received training in abuse and adult protection and the manager reported that an additional training package had been purchased so that all staff could receive formal training. Staff spoken with demonstrated a good understanding of types of abuse and action they must take if abuse is suspected, reported or witnessed. The home has a copy of the local authority adult protection procedures, which supplements their own policy. The home makes sure that any money they hold for residents is safely stored, recorded and available to the resident at any time. Lavender House DS0000066534.V326875.R01.S.doc Version 5.2 Page 15 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): Standards 19 and 26. 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 maintained, clean and hygienic, which provides a safe, comfortable and homely environment for residents. EVIDENCE: All of the communal areas of the home and some of the bedrooms were inspected during the visit. All areas were clean and smelt fresh and residents and visitors spoken with said this was always the case. Furniture throughout the home is clean and of good quality. All areas of the home are well maintained, with quick action taken to complete any maintenance. The manager reported that she planned to work on the garden before the summer, to make it a more accessible and attractive place for residents. Since the last inspection the laundry room has been completely refurbished, with new washing machines that meet waste water regulations, new flooring Lavender House DS0000066534.V326875.R01.S.doc Version 5.2 Page 16 and cupboards. The manager has also introduced new infection control procedures, with clear systems to prevent cross infection through mops and cleaning cloths and for ensuring soiled laundry does not come into contact with other items. A paper towel dispenser has been fitted in the staff toilet. Lavender House DS0000066534.V326875.R01.S.doc Version 5.2 Page 17 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): Standards 27, 28, 29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Robust recruitment procedures and the deployment of staff in sufficient numbers help to ensure that residents are protected. The home’s new training programme will help to ensure that all staff receive the training necessary for their role. EVIDENCE: Residents and visitors spoken with said that they were always sufficient staff with the right skills to meet their needs. This was also reported in the CSCI comment cards received from residents, relatives and visiting professionals. Six of the fourteen staff currently have the National Vocational Qualification in Care at level 2 or above. The manager reported in the pre inspection questionnaire that all staff now have a Criminal Records Bureau (CRB) disclosure. Six new staff have started work at the home since the last inspection. The files of these staff were inspected during the visit and found to contain all of the information required, including CRB disclosures and written references, including one from their last employer. Staff had completed an application form prior to being interviewed by the manager and duty manager. Since the last inspection the home has introduced a new training programme, which has been bought in from a specialist company. All of the new staff have Lavender House DS0000066534.V326875.R01.S.doc Version 5.2 Page 18 completed or are in the process of completing an induction programme. Training staff have completed includes dementia care, infection control, first aid, food hygiene, abuse and adult protection, fire safety, and moving and handling. The duty manager has completed an appraisal for all staff, which includes an assessment of any training needs. Lavender House DS0000066534.V326875.R01.S.doc Version 5.2 Page 19 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): Standards 31, 33, 35, 37 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 and has good systems to keep residents and staff safe. There are good systems to gain the views of residents, although a more formal approach to planning changes will help to ensure standards continue to improve. EVIDENCE: The registered manager has many years experience and staff spoken with said she was supportive and knowledgeable. The registered manager is assisted on a day to day basis by the duty manager, who was also present during the visit. It was reported that the intention is for the duty manager to submit an application for registration to CSCI, enabling the registered manager to spend Lavender House DS0000066534.V326875.R01.S.doc Version 5.2 Page 20 more time on the other homes she owns. Staff, resident sand visitors also spoke highly of the duty manager and her abilities. Since the last inspection the manager has introduced surveys of residents and their relatives and staff to gain their views of how the home can improve. The provider completes monthly visits to the home, which includes gaining the views of residents. The manager reported that the home does not have a specific development plan as issues are responded to immediately. The home has made significant improvements over the last five months, complying with all fourteen requirements made at the last inspection. In order to ensure this improvement is maintained the manager should use the quality assurance information that is obtained to plan further developments in a strategic manner. During the visit the records of residents’ money held by the home were sampled. Details were accurately recorded and the balance recorded matched the cash held. Money is individually stored in a safe in the office. The manager reported that she does not act as an appointee for handling the financial affairs of any residents. All of the records that were requested as part of the inspection visit were available in the home and had been kept up to date. Records were kept in locked cabinets when not in use to maintain confidentiality. Since the last inspection the manager has reviewed and amended the home’s policies and procedures. These have been made available to staff and staff spoken with were clear on where to find information they needed. All harmful chemicals were stored in a locked cupboard in the laundry room when not in use. The manager had also completed a hazard information sheet for all chemicals used in the home, which gave information on what the product contained and the dangers it presented. Regular maintenance, servicing and checks are completed on the fire system and equipment, gas system, electrical systems, hoists and stair lift, water quality and portable electrical appliances. Accidents and injuries are recorded and reported where necessary. Lavender House DS0000066534.V326875.R01.S.doc Version 5.2 Page 21 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 3 3 3 3 X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 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 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X 3 3 Lavender House DS0000066534.V326875.R01.S.doc Version 5.2 Page 22 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. Refer to Standard Good Practice Recommendations Lavender House DS0000066534.V326875.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Lavender House DS0000066534.V326875.R01.S.doc Version 5.2 Page 24 - 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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