Inspection on 19/01/06 for Lavenders

This inspection was carried out on 19th January 2006.

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

Lavenders 19/01/09

Lavenders 06/02/07

Lavenders 12/10/05

Lavenders 01/09/04

Lavenders 04/05/04

Similar services:

Wingham Court

Old Hastings House

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

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

CARE HOMES FOR OLDER PEOPLE Lavenders Lavenders Road West Malling Kent ME19 6HP Lead Inspector Wendy Jones Unannounced Inspection 19th January 2006 09:30 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 Lavenders DS0000023974.V277416.R01.S.doc Version 5.1 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. Lavenders DS0000023974.V277416.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Lavenders Address Lavenders Road West Malling Kent ME19 6HP 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) 01732 844744 Mr Keith Robert Webb Mrs Madeleine Ellen Webb Mrs Madeleine Webb Care Home 61 Category(ies) of Old age, not falling within any other category registration, with number (61) of places Lavenders DS0000023974.V277416.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. Care of one service user is restricted to one person whose date of birth is 20/04/1946. 12th October 2005 Date of last inspection Brief Description of the Service: Lavenders is a family owned and run care home for older people. It is a spacious, well-decorated detached property set in its own grounds in the village of West Malling near Maidstone. It is close to the village High Street and a mainline railway station and has ample car parking facilities. The home cares for 61 older people in three wings, the Regency wing, the Lavinia wing and the Boswell wing, which was a new extension to the home in October 2005. All but three rooms have en suite facilities and eight of these also have en suite showers. Lavenders DS0000023974.V277416.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection carried out by Wendy Jones, Regulatory Inspector between 9:30am and 1:30pm. Judgements are based on conversations with residents, management and staff, reading of care plans and a tour of the home. What the service does well: What has improved since the last inspection? What they could do better: Staff who are responsible for carrying out risk assessments must receive appropriate training to give them the skills and knowledge to carry out more detailed risk assessments. Risk assessments must cover manual handling and areas of the home or grounds that present a risk of falling to individual residents. Lavenders DS0000023974.V277416.R01.S.doc Version 5.1 Page 6 It is recommended that the current informal arrangement for supervision be formalised. Records should be kept of supervisions, i.e. observation of care practice, feedback and discussions with staff and should be carried out at least every two months. 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. Lavenders DS0000023974.V277416.R01.S.doc Version 5.1 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 Lavenders DS0000023974.V277416.R01.S.doc Version 5.1 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 the following standard(s): These standards were not assessed on this occasion. EVIDENCE: All standards in this section were met when assessed at the previous announced inspection on 12 October 2005. Lavenders DS0000023974.V277416.R01.S.doc Version 5.1 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 the following standard(s): 7, 8, 10 and 11 Residents’ health, personal and social care needs are met and they are treated with respect. However, some risks of falling could be missed, as risk assessments are basic and not detailed enough for individual residents. Residents can be confident their wishes at the time of their death will be carried out and that they and their family will be treated sensitively and respectfully. EVIDENCE: Care plans seen contained detailed information about residents’ personal and health care needs and evidenced that doctors and other healthcare professionals are asked to visit when needed. Daily records detailed how they have spent their day and recorded any other relevant information. Basic risk assessments that ensure the general safety of residents have been carried out. However, more detailed assessments, covering manual handling and areas of the home or grounds that present a risk of falling to individual residents would improve on these and must be carried out. The Care Manager advised that she and some senior carers have responsibility for carrying out risk assessments, but that they do not always feel confident or sure of the best Lavenders DS0000023974.V277416.R01.S.doc Version 5.1 Page 10 way to do these. They have not received training in assessing of risk. Staff who are responsible for carrying out risk assessments must receive appropriate training to give them the skills and knowledge to carry out more detailed assessments. Residents said that all their needs are being met and they are very happy with the help and support they get. They said they “can’t fault the staff”, “they are very good” and “know what they are doing”. Staff were clearly knowledgeable about what help and support the residents need, got on well with them and treated them with respect. Residents clearly trusted and had a good relationship with them. Some residents have chosen to have a key and lock their doors. The care manager advised that it is recorded in the care plan if any resident prefers not to. Two residents had died over the previous week. Staff were very caring and supportive to the relatives who were visiting on the day of the inspection to sort out their relative’s belongings. They were clearly very appreciative of the staff and of how they had cared for and supported their relative during their time in the home. Lavenders DS0000023974.V277416.R01.S.doc Version 5.1 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 the following standard(s): 12 - 15 Residents enjoy a wide range of cultural, social and religious activities and have regular contact with their family and friends. Residents have a wide choice of wholesome and appealing meals, which are taken in very pleasant surroundings. EVIDENCE: A range of activities is available for residents to take part in. A cinema show was being shown in the main lounge in the Lavinia wing that was obviously popular with the residents. Some residents were waiting in the lounge and others were seen going there. They said they enjoyed these shows and talked of others they had seen previously. Residents are able to use all communal areas in all three wings of the home and have favourite areas where they like to sit. Some were seen sitting in the lounges in the home and one resident said they liked to sit in the gardens in the summer. They said “there are lots of seats around the grounds and tables and chairs are put out”. Residents have a wide choice of nutritious meals. There are kitchens and dining rooms in each of the three wings of the home. Meals are all prepared in the main kitchen in the Lavinia wing and taken to the other wings in heated Lavenders DS0000023974.V277416.R01.S.doc Version 5.1 Page 12 food trolleys. The care manager advised that residents do not have to eat in the wing their room is in. They can choose to eat in any of the dining rooms. There are water coolers in the lounges in each of the wings for residents and visitors to have cold water whenever they wish. Residents can also buy stamps and a limited range of snacks and toiletries from the “shop” in the home. Residents can also buy clothes from a clothing company that visits the home and was due to visit that week. Lavenders DS0000023974.V277416.R01.S.doc Version 5.1 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 the following standard(s): These standards were not assessed on this occasion. EVIDENCE: All standards in this section were met when assessed at the previous announced inspection on 12 October 2005. Lavenders DS0000023974.V277416.R01.S.doc Version 5.1 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 the following standard(s): 19, 20, 21, 23, 24, 25 and 26 Residents live in a clean, pleasant, safe, comfortable and well-maintained environment. EVIDENCE: The home is situated in a rural area of West Malling but close to the village High Street. It has a pleasant and welcoming entrance hall with corridors leading to the three wings of the home. The home is mainly all on one level. There are 61 single rooms. 49 of these are on the ground floor leaving only 12 on the first floor. Six of these are in the Lavinia wing and six in the Boswell wing. There are chairlifts for residents to use to reach these rooms. 58 of the 61 rooms have en suite facilities and 8 of these also have en suite showers. Each wing has three assisted bathrooms with bath hoists and there are ample communal toilets around the home. Each wing has very comfortably furnished and attractively decorated lounges and dining rooms. There is a smaller dining room for residents and visitors to Lavenders DS0000023974.V277416.R01.S.doc Version 5.1 Page 15 use in the Lavinia wing. This room also houses an electrical cupboard. This is not currently locked but the business manager advised that a lock is to be fitted shortly for safety and security. There is a large car parking area and an extremely well landscaped and attractive garden area. There is a raised patio area with steps to the garden. This had been restricted for safety reasons and was not being used by residents at the time of the inspection. A notice advised that this was because it was to be re-pointed. The care manager and a resident said that tables and chairs are provided on the patios and the grounds in the summer. There are also benches and a path has been built for residents and visitors to walk around the home. The grassed area has been raised and flattened. Residents’ rooms were comfortably furnished and contained the residents’ own furniture and effects. Locked drawers had been provided to lock away personal items and money. Residents said they had all they need and were very happy with their rooms. Some rooms have patio doors leading onto attractive deck or patio areas that are for the exclusive use of the residents in these rooms. Despite it being a cold day the home was warm and residents said they were comfortable. Everywhere was extremely clean and there were no offensive odours. The laundry has one large and one small drier and two washing machines with sluice facilities to control the spread of infection. The laundry person on duty said that although the laundry is small, she finds it manageable. She explained the procedure followed and how clean and dirty laundry are kept separate. Lavenders DS0000023974.V277416.R01.S.doc Version 5.1 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 consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were not assessed on this occasion. EVIDENCE: All standards in this section were met when assessed at the previous announced inspection on 12 October 2005. However, it was clear through discussion with the care manager and business manager that great importance is put on training and development so that they can provide the care that residents need. Lavenders DS0000023974.V277416.R01.S.doc Version 5.1 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35, 36 and 37 Residents benefit from living in a home which is well managed and safeguards their best interests. However, residents would benefit further by the current informal supervision arrangements being formalised. EVIDENCE: Currently the provider manages the home and there is no registered manager. The business manager advised that they are considering making application for the current care manager to be registered manager. She is very experienced and has achieved the Registered Managers Award. Currently she oversees the home on a day-to-day basis for the provider. There is a calm and pleasant atmosphere in the home and residents spoken with were happy and contented. Residents said they like living there, feel well cared for and the staff “know what they are doing”. Lavenders DS0000023974.V277416.R01.S.doc Version 5.1 Page 18 Although financial records and accounts were not seen on this occasion there was evidence that the home was financially viable. Ample resources were available for staff to meet the needs of the residents and the structure and contents of the home were in very good condition. Appropriate insurance cover is provided for the home and a current insurance certificate is displayed. No cash is kept for residents. The business manager said that the home runs a sundry account, which is used to pay for hairdressing etc., and residents are then billed for these amounts, separately to their fees. Staff are appraised on a yearly basis when their training and development needs are identified. The care manager advised that she carries out informal supervision on an ad hoc basis, which involves observation of staff care practice. No formal supervision is carried out at present. However, all staff were clearly competent and aware of the help and support that residents need and receive the training and support required to do their jobs. It is recommended that the current informal arrangements be formalised. Supervisions, i.e. observation of care practice, feedback and discussions with staff should be carried out at least every two months with records kept. All records seen were stored securely and confidentially in locked cabinets. Lavenders DS0000023974.V277416.R01.S.doc Version 5.1 Page 19 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 X X X X X x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 X 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 x 4 4 3 X 3 3 3 3 STAFFING Standard No Score 27 X 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 2 3 3 Lavenders DS0000023974.V277416.R01.S.doc Version 5.1 Page 20 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 OP8.8 Regulation 12(1)(a) Requirement Residents’ health and welfare must be promoted in that staff with the appropriate skills and knowledge carry out risk assessments, which cover manual handling and risk of falls. Action plan including timescales to be received by the Commission within one month. Timescale for action 24/02/06 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 OP36.2 Good Practice Recommendations It is recommended that the current informal supervision arrangements be formalised and carried out at least every two months. Lavenders DS0000023974.V277416.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Lavenders DS0000023974.V277416.R01.S.doc Version 5.1 Page 22 - 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. 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