CARE HOME ADULTS 18-65
Lawn Court 26-27 Park Road Bexhill-on-sea East Sussex TN39 3BZ Lead Inspector
Rebecca Shewan Unannounced Inspection 14th February 2006 09:45 Lawn Court DS0000021153.V282168.R01.S.doc Version 5.1 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 Lawn Court DS0000021153.V282168.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 Adults 18-65. 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. Lawn Court DS0000021153.V282168.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Lawn Court Address 26-27 Park Road Bexhill-on-sea East Sussex TN39 3BZ 01424 211476 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) www.together-uk.org Together Working for Wellbeing Mrs Sandra Collins Care Home 18 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (18) of places Lawn Court DS0000021153.V282168.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. 3. The maximum number of service users to be accommodated is eighteen (18) Service users must be aged between eighteen (18) and sixty-five (65) years on admission Service users with a diagnosis of mental disorder, excluding learning disability or dementia only to be accommodated 5th July 2005 Date of last inspection Brief Description of the Service: Lawn Court is situated in Bexhill on Sea, overlooking Egerton Park. The home is near to the town centre and seafront, and to the local facilities. The building comprises of four levels with the lounge, dining room and kitchen located on the lower ground floor, the building also has a non-smoking lounge. The service has a self-contained bed sit incorporated in the building for service users to try more independently living. The service has sixteen single rooms and one double room, which is used as a single room. There is only one service user room that has en-suite facilities. Lawn Court DS0000021153.V282168.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was the second unannounced inspection to take place in the CSCI inspection year of 2005/2006. To gain a complete overview of the standards assessed it will be necessary to read both inspection reports for this inspection year. This inspection took place during the morning and early afternoon of the fourteenth February 2006. Before the inspection papers held by the Commission for Social Care Inspection were read. The inspection of the home took three and three quarter hours. A tour of the whole home was undertaken and the Senior Social Care Worker, one Care Worker and two service users were spoken with. The home currently accommodates fourteen service users. What the service does well: What has improved since the last inspection?
From the care plans viewed it was evidenced that the previous inspection requirement that the service must ensure it has sufficient risk assessments in place for residents and that staff must be aware of risk areas, has now been met. The previous inspection requirement (the target date for which remains the first of April 2006), that bedrooms require redecorating (apart from bedroom 11); all the bedrooms within the service require replacement carpets and a percentage of the rooms also require new furniture, has been partly met. Redecoration had been commenced but due to the number of people in the home carrying out the redecoration, service users daily routines were affected and it was decided to halt the redecoration plan in order to protect service users psychological welfare. The home is currently sourcing other means of redecorating the premises, with service user involvement where appropriate. Lawn Court DS0000021153.V282168.R01.S.doc Version 5.1 Page 6 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. Lawn Court DS0000021153.V282168.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Lawn Court DS0000021153.V282168.R01.S.doc Version 5.1 Page 8 Choice of Home
The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: These standards were fully assessed at the previous unannounced inspection. Lawn Court DS0000021153.V282168.R01.S.doc Version 5.1 Page 9 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6&9 There is a need for the home to consider varying its conditions of registration to include that some service users accommodated are now aged over 65 years. Risk assessments are satisfactory and encourage service user independence, where possible. EVIDENCE: The home currently accommodates three service users who are aged 65 years or over. A discussion was held between the Senior Care Worker and the Inspector relating to care of older people and the need for the service to vary its conditions of registration to include the changing age of current service users. From the care plans viewed it was evidenced that the previous inspection requirement that the service must ensure it has sufficient risk assessments in place for residents and that staff must be aware of risk areas, has now been met. Lawn Court DS0000021153.V282168.R01.S.doc Version 5.1 Page 10 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16 & 17 The home assists service users with maintaining independence in their daily living and daily routines. Service users are treated with respect and there is good rapport between staff of the home, other community services and service users. The home arranges meals that are suitable in quantity and variation and provide service users with the means to maintain a healthy diet. EVIDENCE: The Senior Social Care Worker said that service users are assisted to maintain attendance to day centres, college courses and jobs whilst they are resident at the home. Service users spoke of their attendance at 73a, a local day centre and the Working Together For Wellbeing day centre located in Hastings. Two service users currently work voluntarily. Service users are free to participate in activities, held by the home or within the local community at a level of their choice. Where it is appropriate service
Lawn Court DS0000021153.V282168.R01.S.doc Version 5.1 Page 11 users are encouraged to maintain relationships. Smoking is permitted in the lounge area only, there is no smoking permitted in any other area of the home. The home assists service users with maintaining independence in their daily living and daily routines. Service users are treated with respect and there is good rapport between staff of the home, other community services and service users. Service users spoke of how approachable and friendly the staff at the home were. This was evident at the time of the inspection. Service users are involved with menu planning. The menu’s viewed showed that there is a variety of food and that the menu’s are varied. Alternatives are available for the service users if they do not wish to eat what is on the menu. Records viewed detailed where an alternative meal option had been taken. Mealtimes can be flexible dependent on the service users daily plans. Drinks and snacks are available at all times. Service users who are able are encouraged and/or assisted to cook meals for themselves. Lawn Court DS0000021153.V282168.R01.S.doc Version 5.1 Page 12 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: The core standards to be assessed were completed during the previous inspection. Lawn Court DS0000021153.V282168.R01.S.doc Version 5.1 Page 13 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 23 The homes procedures, processes and staff training should protect service users in the event of an allegation of abuse. EVIDENCE: The Senior Social Care Worker said that staff had completed training in the protection of vulnerable adults within the last year. Criminal Record Bureau (CRB) checks have been carried out on all existing staff. Both CRB and Protection of Vulnerable Adult (POVA) checks are carried out on all new staff. The home has a copy of the East Sussex County Council Multi-agency Procedures for the Protection of Vulnerable Adults. Lawn Court DS0000021153.V282168.R01.S.doc Version 5.1 Page 14 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25 & 30 The home provides a good quality of accommodation. Actions are being taken to address any area of redecoration required within the home. An Infection Control policy is in place, although there is a need for the home to ensure that appropriate infection control measures are in place at all times. EVIDENCE: The location and layout of the home are suitable for its stated purpose. The home is generally well maintained and all areas of the home, including the garden, are accessible to service users. The home has an ongoing plan of refurbishment in place. The previous inspection requirement (the target date for which remains the first of April 2006), that bedrooms require redecorating (apart from bedroom 11); all the bedrooms within the service require replacement carpets and a percentage of the rooms also require new furniture. has been partly met. The Senior Social Care Worker said that redecoration had been commenced but due to the number of people in the home carrying out the redecoration, service user’s daily routines were affected and it was decided to halt the redecoration plan in order to protect service users psychological welfare. The home is currently sourcing other means of redecorating the premises, with service user involvement where appropriate.
Lawn Court DS0000021153.V282168.R01.S.doc Version 5.1 Page 15 It was evident from the tour of the premises that towels were present in all of the home’s communal bath and toilet areas. The infection control hazard implications of towels, which could be deemed as for use communally, were discussed between the Senior Social Care Worker and the Inspector at the time of the inspection and an immediate requirement was made. Lawn Court DS0000021153.V282168.R01.S.doc Version 5.1 Page 16 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 34 Staff records are stored in an appropriate manner. EVIDENCE: Staff files are kept in a locked filing cabinet and only the Registered Manager has access to these files. On the day of the inspection it was not possible to view staff files. The Registered Manager, who is the designated key holder for the cabinet where staff files are stored, was unwell on the day of the inspection and it was deemed inappropriate to disturb her in order to collect the key. Lawn Court DS0000021153.V282168.R01.S.doc Version 5.1 Page 17 Conduct and Management of the Home
The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 39,40 & 42 Effective Quality Assurance procedures are in place. However there is a need for the home to provide CSCI with copies of Regulation 26 reports. There is a need for the home to: report incidents/accidents to CSCI in accordance with Regulation 37 of the Care Homes Regulations 2001, to ensure that fire doors are not wedged open and to maintain daily records of fridge and freezer temperatures. EVIDENCE: There is a Quality Assurance policy in place. The Senior Social Care Worker said that annual Quality Assurance audits are conducted by Working Together For Wellbeing. Monthly audits are conducted by the homes Area Manager, at the time of the inspection it was unclear whether a report was generated as a result of this. In accordance with Regulation 26 of the Care Homes Regulations 2001, a copy of this report must be sent to the CSCI. Monthly service user meetings are held and staff meetings are held fortnightly, minutes of such meetings were viewed. Lawn Court DS0000021153.V282168.R01.S.doc Version 5.1 Page 18 The previous inspection requirement that the service must ensure it has the relevant policies and procedures in place to protect vulnerable adults and children, has now been met in full. Working Together For Wellbeing is currently implementing a national policy as a result of this requirement. The Senior Care Worker said that once this is available a copy would be sent to the CSCI Eastbourne office. The homes maintenance files were viewed and it was evident that fire drills, fire alarm testing and fire equipment checks, water checks and Portable Appliance Testing (PAT) had been carried out. Accidents are well documented in the homes accident book. However, a discussion was held between the Senior Care Worker and the inspector regarding the reporting of incidents and accidents in accordance with Regulation 37 of the Care Homes Regulations 2001. The Senior Care Worker said that with effect from today’s inspection all accidents and incidents would be reported to the CSCI Eastbourne Office. Immediate requirements were made at the time of the inspection as it was noted that potential risks to both service users and staff were apparent: A number of fire doors had been wedged open. Fridge and freezer temperatures are usually checked on a daily basis, however on the day of the inspection it was noted that such checks had not been recorded since the twentieth January 2006. The homes chef said that daily food temperature probes are taken, however the home does not currently maintain records of such checks being taken. Therefore a recommendation has been made. Lawn Court DS0000021153.V282168.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 Adults 18-65 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 X 2 X 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 X 23 3 ENVIRONMENT Standard No Score 24 3 25 2 26 X 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 X 33 X 34 3 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 X X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X X X X X X 2 3 X 2 X Lawn Court DS0000021153.V282168.R01.S.doc Version 5.1 Page 20 Are there any outstanding requirements from the last inspection? Yes 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 YA25 Regulation 16(2)(c) & 23(2)(d) Requirement Timescale for action 01/04/06 2. YA30 3. YA39 4. YA42 5. YA42 6. YA42 Bedrooms require redecorating (apart from bedroom 11); all the bedrooms within the service require replacement carpets. A percentage of the rooms also require new furniture. The service has planned for this maintenance work to be completed within the year. 13(3) & That towels are removed from (4)(a)(c) the home’s bathroom and toilet areas and replaced with a single use method for hand drying. This is an immediate requirement. 26 That copies of the homes monthly audit conducted by the Area Manager are sent to the CSCI Eastbourne Office. 12(1)(a) That fridge & freezer & temperatures are recorded on a 16(2)(g) daily basis. This is an immediate requirement. 12(1)(a)& That fire doors are not wedged 23(4)(c)(i) open, in the interests of the health, safety and welfare of service users and staff. This is an immediate requirement. 12(1)(a) That risk assessments are in place for items such as nonDS0000021153.V282168.R01.S.doc 14/02/06 14/03/06 14/02/06 14/02/06 21/02/06 Lawn Court Version 5.1 Page 21 7. YA42 37 static soap, washing powder and washing up liquid, which are freely accessible to service users. That incidents and accidents that 14/02/06 occur within the home are reported to the CSCI Eastbourne Office, in accordance with this regulation. This is an immediate requirement. 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 YA6 Good Practice Recommendations That application is made to CSCI to vary the current conditions of registration to include that three service users have now reached an age over 65 years. That records are maintained of any food temperature probe checks that are carried out. 2. YA42 Lawn Court DS0000021153.V282168.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection East Sussex Area Office Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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 Lawn Court DS0000021153.V282168.R01.S.doc Version 5.1 Page 23 - 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!
