Inspection on 06/02/07 for Lavenders

This inspection was carried out on 6th February 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

Lavenders 19/01/09

Lavenders 19/01/06

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 Gary Bartlett Key Unannounced Inspection 09:40 6th February 2007 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.V311493.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. Lavenders DS0000023974.V311493.R01.S.doc Version 5.2 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 Candyce Amelie Kaye Brockwell Care Home 61 Category(ies) of Old age, not falling within any other category registration, with number (61) of places Lavenders DS0000023974.V311493.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Care may be provided to one service user under 65 years of age whose date of birth is recorded at the CSCI office. 19th January 2006 Date of last inspection Brief Description of the Service: Lavenders is a family owned and run care home that is located close to the village of West Malling. The village offers a variety of shops, pubs and restaurants and a train station. The home comprises of three wings, the Regency wing, the Lavinia wing and the Boswell wing. Twenty-four hour care is provided for 61 older people, most of who have lower levels of dependency care needs. Current fees range from £410 to £495 per week. Lavenders DS0000023974.V311493.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key unannounced inspection was conducted by Gary Bartlett, Regulatory Inspector, who was in The Lavenders from 9.40 a.m. until 5.50 pm. During that time the Inspector spoke with some residents, visitors and some staff. Parts of the Home and some records were inspected and care practices observed. A large number of comment cards were received prior to the inspection. Residents and their relatives generally responded that they liked the home and staff. Responses from health professionals also indicated good standards of care. Statements on comment cards included: • ““I can not imagine anywhere else I would rather live”. • ““We find the home has a happy friendly atmosphere”. • “I have always been happy at Lavenders. Everyone is so kind to me”. • “I am very satisfied with the home, staff and the care given”. • The home provides excellent care and support for the residents”. • “Well run home, always friendly”. Further statements are quoted in the text of the report. The Manager and staff gave their full co-operation throughout the inspection. What the service does well: The Lavenders provides a comfortable environment that is bright and airy. There is an open and friendly atmosphere with good interaction between residents, staff and visitors. The standard of cleanliness around the Home is very good. Information about the Home is easily accessible. Staff are good at helping residents to settle in. The Home enjoys good relationships with other health care professionals. Personal health care needs are well supported and residents’ individual preferences are catered for where practicable. Residents enjoy the range of activities available to them. Staff are encouraged to undertake training. There are good procedures to protect residents from abuse. The Manager is approachable and has high expectations of the standards of care for residents. Residents are regularly asked for their views about the home. Lavenders DS0000023974.V311493.R01.S.doc Version 5.2 Page 6 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. Lavenders DS0000023974.V311493.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 Lavenders DS0000023974.V311493.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3, 4, 5 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can be confident that they are appropriately placed due to good preadmission assessments and benefit from being able to visit the home prior to admission. The home does not provide intermediate care. EVIDENCE: The Manager described how a pre-admission assessment is made of each prospective resident using an aide-memoir. Prospective residents, their families, advocates, and relevant health care professionals are involved in the assessment process. Specialist advice is sought from external sources where required. Residents said they or their families had been able to visit Lavenders before moving in. This was confirmed by a relative present. They also said staff were very helpful in assisting them to settle in. Lavenders DS0000023974.V311493.R01.S.doc Version 5.2 Page 9 Intermediate care is not offered at Lavenders. Lavenders DS0000023974.V311493.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 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. Care plans are being improved but some still need to be more detailed to promote residents’ health and welfare. Residents’ health needs are met with good liaison with relevant health care professionals. Staff treat residents with respect and maintain their privacy and dignity. EVIDENCE: Resident’s comment card received prior to the inspection included the statements: • “The routine care is excellent and I feel secure”. • “My medical needs are always attended to”. Each resident has a care plan and three were inspected in detail. There are clear improvements to care planning and the Manager is aware that some need to be more detailed to comprehensively reflect the resident’s current needs. The Manager is addressing this through the regular review of care plans and Lavenders DS0000023974.V311493.R01.S.doc Version 5.2 Page 11 risk assessments and by staff training. The standard of daily record keeping is generally good. The key worker system is now formalised with monthly meetings ensuring a good exchange of information about residents’ health and welfare. Visiting relatives said staff are very good at keeping them informed. The medicines room is clean and well maintained. The Manager is in the process of introducing a system to monitor the temperature of the room to ensure medicines are stored at an appropriate temperature. Records show that all staff administering medications have been trained and signed off as being competent to do so. The Medication Record Administration Record (MAR) sheets seen were completed appropriately. The Home continues to have a good working relationship with the specialist and local health care professionals. This greatly assists in supporting residents in their health care needs. Lavenders is taking part, along with other healthcare professionals, in a pilot of the Telehealth scheme to monitor the health of residents. Residents felt that staff are kind and gentle, this was confirmed by observation. Staff are very considerate of the age and dignity of residents and treat them with courtesy. Lavenders DS0000023974.V311493.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 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. Residents enjoy routines of daily living and activities that are flexible and varied to suit their preferences. Dietary needs of resident are well catered for with a balanced and varied selection of food that meets their tastes and choices. EVIDENCE: Resident’s comment card received prior to the inspection included the statements: • “(Activities): These are varied and well received”. • “The meals are varied, well presented. Our tastes are catered for”. • “Meals are second to none”. A relative’s comment card received prior to the inspection included the statement: • “Lavenders provides a very open community environment”. Lavenders DS0000023974.V311493.R01.S.doc Version 5.2 Page 13 Staff spoken with are aware of the rights of residents to have the opportunity to have choice in daily routines and activities. Residents and their visitors spoke very favourably of the activities and outings available. Residents are happy with the manner in which their links with the local community are maintained according to their wishes and take account of their capabilities. During the inspection a number of visitors were seen in the home and the visitors book recorded regular visits by families, friends and others. Residents can meet with visitors in various communal rooms or in their bedrooms. Residents said they were happy with the arrangements. Visitors described how they can visit at any reasonable time and are always made welcome by staff. The Manager stated residents are supported to manage their own affairs for as long as they wished and are able. Residents have a choice of nutritious meals. Meals are all prepared in the main kitchen in the Lavinia wing and taken in heated food trolleys to the other wings, where there are dining rooms. The Manager advised that residents can choose to eat in any of the dining rooms. Mealtimes are relaxed; staff are patient and helpful and allowed residents the time they needed to finish their meal comfortably. There are water coolers in the lounges in each of the wings for residents and visitors to have cold water whenever they wish. Hot drinks and snacks are served throughout the day. Lavenders DS0000023974.V311493.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and their relatives know their complaints will be listened to and acted on. There are systems to ensure residents are protected from abuse. EVIDENCE: A resident’s comment card received prior to the inspection included the statement: • “I feel safe and happy in Lavenders”. The residents and their relatives are aware of the home’s complaints procedure and said they felt confident that they would be listened to. There are procedures for responding to suspicion or evidence of abuse or neglect to ensure the safety and protection of residents. The Manager and other staff spoken with have a sound understanding of adult protection procedures and stated that any allegation of abuse would be referred to the concerned agencies without delay. An unannounced inspection was conducted on 24th January 2006 in response to an allegation in respect of poor staffing levels at night, the care of residents and the sufficiency of moving and handling equipment. No part of the allegation was substantiated. Lavenders DS0000023974.V311493.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 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The standard of the environment within the home is good; providing residents with an attractive and homely place to live. EVIDENCE: Lavenders 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 warm and residents said they are comfortable. Everywhere is very clean and there are no offensive odours. Each wing has comfortably furnished and attractively decorated lounges and dining rooms. There is a smaller dining room for residents and visitors to use in the Lavinia wing. Since the last inspection, two of the dining rooms have been redecorated and there is ongoing redecoration and refurbishment. Lavenders DS0000023974.V311493.R01.S.doc Version 5.2 Page 16 Residents’ rooms are comfortably furnished and contained the residents’ own furniture and effects. Locked drawers are provided to lock away personal items and money. Residents said they have all they need and are 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. For the size of the home, the laundry is small and staff are managing as best they can to keep clean and dirty items separated. The home is not equipped commode washers. As a result, although staff are being as diligent as they can be, it is more difficult for them to effectively maintain infection control. A resident’s comment card received prior to the inspection included the statement: • “The water system does not always have sufficient supply to cope with everyone’s needs and I sometimes do not get my bath”. The hot water pressure at two baths is very low and staff acknowledge it takes a long time to run these baths. Consequently, residents in these parts of the home are kept waiting longer for their baths. Plumbers were present at the time of inspection, improving the water/heating supply in other parts of the home. Residents spoke of how they enjoy the extensive grounds that are well maintained and attractive. Lavenders DS0000023974.V311493.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home provides ongoing training for staff so they have the skills to meet the needs of the residents. The home needs to be able to more readily show its recent recruitment processes consistently offer protection to people living there. EVIDENCE: Residents’ comment card received prior to the inspection included the statements: • “All the staff are only too happy to meet your requirements”. • “Staff are always friendly and helpful”. • “I would like to thank the staff for their happy smiles”. Residents and visitors spoke highly of the staff and consider them to be very caring and hard working. The Manager uses a computerised system for easy monitoring of staff training/update requirements. This indicated there is a range of training for staff. NVQ training is encouraged for care staff and ancillary staff. The Manager has a sound understanding of good staff recruitment processes and this is underpinned by the home’s policies and procedures. Most staff files Lavenders DS0000023974.V311493.R01.S.doc Version 5.2 Page 18 showed robust recruitment processes had been adhered to, thereby ensuring only people properly vetted work at the home. However, the files of some recently recruited staff members do not readily show that necessary C.R.B. checks and references had been obtained in good time prior to these people commencing duties. The Manager is planning to arrange for the application forms to be updated and to introduce a system of recording the questions and answers at staff interviews. The staff roster seen indicated that staffing levels are geared to peak times of activity. Lavenders DS0000023974.V311493.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35, 36, 37 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from a Manager who is accessible and has high expectations of the service to be delivered. Residents’ financial interests are protected. EVIDENCE: The Manager has worked at the Home since January 2002 having been originally employed as the Care Manager and became registered Manager in July 2006. She has the Registered Managers Award and holds current certificates of training in care practices appropriate to the service. The management approach to The Lavenders creates an open, positive and inclusive atmosphere in which people who live there are able to influence the way in which the home is run. Lavenders DS0000023974.V311493.R01.S.doc Version 5.2 Page 20 Lavenders operates a comprehensive quality assurance system based on seeking the views of residents, their relatives/representatives and other concerned parties to measure the success in meetings the aims and objectives of the home. Residents are encouraged to manage their own financial affairs or to have assistance from their families / representatives. The home does not hold any monies on their behalf. 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. An Environmental Health Officer had inspected the kitchen recently and the Catering Manager said there had not been any resultant recommendations. The standard of cleanliness in the kitchen was good. Dates have been arranged for all kitchen staff to have their food hygiene training updated. Appropriate insurance cover is provided for the home and a current insurance certificate is displayed. Staff are appraised annually when their training and development needs are identified. There is still a need to formalise staff supervision arrangements to ensure all staff receive the supervision necessary to ensure standards of care practice. Feedback and discussions with staff should be carried out at least every two months with records kept. Staff spoken with have a sound understanding of emergency procedures. The Manager described a system of ongoing environmental risk assessments. The Manager stated that all records of maintenance and safety checks are up to date and that policies and procedures are regularly reviewed by a competent individual to ensure they comply with current legislation and good practice advice. These were not inspected on this occasion. Records seen are kept in a manner that preserve confidentiality. Lavenders DS0000023974.V311493.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 X X 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 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 3 3 X 3 3 2 2 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 2 3 3 Lavenders DS0000023974.V311493.R01.S.doc Version 5.2 Page 22 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 OP7 Regulation Requirement Timescale for action 30/05/07 2. OP25 15(2)17Sc “The registered person shall hedules3 maintain records as specified in and 4 Schedules 3 and 4. The registered person shall keep the service user’s plan under review” in that the improvements in care plans must be continued to ensure they are all accurately reflective of service users current conditions and needs. This must be completed by the given timescale and maintained thereafter. 23(2)(j) “The registered person shall 30/05/07 having regard to the number and needs of the service users ensure that there are provided at appropriate places in the premises sufficient numbers of lavatories, and of wash basins, baths and showers fitted with a hot and cold water suuply” in that the hot water supply pressure to the bathroom near room 53 and the bathroom opposite room 60 must be improved” This must be completed by the given timescale and maintained thereafter. DS0000023974.V311493.R01.S.doc Version 5.2 Lavenders Page 23 3. OP29 19 The registered person shall not employ a person to work at the care home unless(b) subject to paragraphs (6), (8) and (9) he has obtained in respect of that person the information and documents specified in paragraphs 1 to 9 of Schedule 2 in that staff must not be employed prior to obtaining a satisfactory Protection Of Vulnerable Adults check, a satisfactory Criminal Records Bureau check and satisfactory references. Records must be in place to clearly show this is being done by the given timescale and maintained thereafter. 08/02/07 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. 2. 3. Refer to Standard OP26 OP26 OP36 Good Practice Recommendations It is recommended laundry facilities are improved to provide easier separation of clean and soiled laundry. It is strongly recommended facilities are provided for washing commodes to better promote infection control. It is recommended that the current informal supervision arrangements be formalised and carried out at least every two months. Lavenders DS0000023974.V311493.R01.S.doc Version 5.2 Page 24 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.V311493.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!