Inspection on 15/03/07 for Lawn Court

This inspection was carried out on 15th 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 found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Lawn Court 10/02/09

Lawn Court 14/02/06

Lawn Court 05/07/05

Lawn Court 02/12/04

Lawn Court 30/06/04

Lawn Court 04/02/04

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

CARE HOME ADULTS 18-65 Lawn Court 26-27 Park Road Bexhill-on-sea East Sussex TN39 3HZ Lead Inspector Judy Gossedge Key Unannounced Inspection 15th March 2007 11:00 Lawn Court DS0000021153.V306043.R01.S.doc Version 5.2 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.V306043.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 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.V306043.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Lawn Court Address 26-27 Park Road Bexhill-on-sea East Sussex TN39 3HZ 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.V306043.R01.S.doc Version 5.2 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 14th February 2006 Date of last inspection Brief Description of the Service: Lawn Court is a residential home owned and managed by the organisation Together: Working for Wellbeing, providing emotional and practical support to enable service users to be as independent as possible. 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 a lounge, dining room and kitchen located on the lower ground floor. Another lounge is situated on the ground floor, which is a non-smoking lounge. There are sixteen single bedrooms and one double bedroom, which is used as a single bedroom situated on the ground, first and second floors. The service has a self-contained bed sit incorporated in the building for service users to try more independently living. There is only one service user bedroom that has en-suite facilities, but there are adequate toilet and communal bathing facilities in the home. There is a garden at the back of the home with a patio area. A handbook is given to each service user. At the time of the inspection fees were documented to be between £534.97 and £613.57 per week. There are no additional charges. Lawn Court DS0000021153.V306043.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over five hours on 15 March 2007. A tour of the premises took place to look at communal areas and a selection of service user’s bedrooms and care records were inspected. Sixteen service users were resident and the majority were spoken with as part of the inspection process. The support that four of the service users received was reviewed. One service user chose to speak with the Inspector individually. The opportunity was also taken to observe the interaction between staff and service users in the communal areas. Ten service user surveys were sent out and nine came back completed. Three social care workers all of whom as well as working during the day also provide sleeping in cover at night; a housekeeping assistant, the deputy manager and the Registered Manager were all spoken with. Staff surveys and comment cards for visiting healthcare professionals were not sent out on this occasion. What the service does well: What has improved since the last inspection? To improve infection control procedures towels have been removed from the home’s communal bathroom and toilet areas and have been replaced with paper towels for hand drying. Lawn Court DS0000021153.V306043.R01.S.doc Version 5.2 Page 6 Copies of the homes monthly audit conducted by the organisations Area Manager are available to view in the home. Copies of these visits are not now required to be sent to the CSCI. The fridge and freezer temperatures are now recorded. The Manager stated that a system is in place to report any incidents and accidents that occur within the home to the CSCI. Generic risk assessments are not in place for items such as non-static soap, washing powder and washing up liquid, which are freely accessible to service users. But the Manager stated that any risk from the accessibility of these products would be looked at on an individual basis and a risk assessment completed if required. 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.V306043.R01.S.doc Version 5.2 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.V306043.R01.S.doc Version 5.2 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): 1, 2 and 4. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Detailed information about Lawn Court is available to be viewed and prior to any admission to the home. There are pre-admission procedures in place to ensure that service users support needs can be met at Lawn Court. EVIDENCE: There is a detailed handbook available for potential service users to view. There is quality assurance information collated for service users and their representatives to read. Five service users surveys stated they had not received enough information about Lawn Court prior to moving into the home and four stated they had. This was shared with the Manager and deputy manager for their consideration and who both stated that a copy of the handbook has been given to all service users resident in the home. One service user commented, ‘I asked to move here from the place I was before.’ There were three new service user’s resident at Lawn Court since the inspection. So it was possible to evidence that an assessment had been completed with the new service user by staff as part of the admissions process. The admissions process is arranged to meet individual service users needs and can take a number of weeks with service users being enabled to Lawn Court DS0000021153.V306043.R01.S.doc Version 5.2 Page 9 visit the home and trail stays being arranged. During the inspection a potential new service user was accompanied by a social worker on a first visit to look around the home. Lawn Court DS0000021153.V306043.R01.S.doc Version 5.2 Page 10 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, 7 and 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service users individual plans in place adequately provide staff with the information they need to ensure that service users individual support needs are met. Service users are enabled to make decisions in all areas of their daily living. EVIDENCE: Four service users individual plans were viewed, which were detailed, and are drawn up with the service user. Supporting risk assessments were also seen to be in place. The Manager and staff stated that individual risks are considered on admission and risk assessments are completed to meet individual service users needs and encourage service user independence, where possible. Lawn Court DS0000021153.V306043.R01.S.doc Version 5.2 Page 11 Service users individual plans viewed and service users were observed being given opportunities to make decisions in all areas of their daily living whilst at Lawn Court. Six service users surveys stated they always make decisions about what they do each day, two usually and one sometimes. Lawn Court DS0000021153.V306043.R01.S.doc Version 5.2 Page 12 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 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are assisted 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 and service users. The meals on the home are good offering both choice and variety and catering for any special dietary needs. EVIDENCE: The pre-inspection questionnaire and staff spoken with stated that service users are supported to maintain attendance to local day centres, college courses and voluntary jobs whilst they are resident at the home. On the day service users were observed going out from the home and spoke of different activities they were attending that day. Lawn Court DS0000021153.V306043.R01.S.doc Version 5.2 Page 13 Service users are free to participate in activities, held by the home or within the local community at a level of their choice. One service user spoke of enjoying a walk along the seafront. The pre-inspection questionnaire detailed that the organisation facilitates a yearly fund for subsidising outings and detailed recent events, which have been available for service users to attend which have included 20:20 cricket at Hove, the Chinese State Circus in Hastings and tenpin bowling in Eastbourne. Where it is appropriate service users are encouraged to maintain relationships and two service users confirmed they visited friends and family outside of the home. One service user spoken with had just returned from visiting their family and spoke of their family visiting the home. Smoking is permitted in the lounge area only, there is no smoking permitted in any other area of the home. The home supports service users with maintaining independence in their daily living and daily routines. Service users observed were seen to be treated with respect and there was a good rapport between service users and staff in the home. Five service users surveys stated that carers always acted on what they say and two stated usually. Two service users on the day spoke of how approachable and friendly the staff at the home are and one commented, ‘ the staff are marvellous.’ All service users surveys stated they could do what they wanted during the day, evening and weekends. One commented, ‘I am always free to do what I please.’ A social care worker was cooking on the day of the inspection as the cook was not on duty and who stated he held a basic food hygiene certificate. There is a rotating menu in place detailing a choice at all meals, a sample of which was included in the pre-inspection questionnaire. Staff spoke of service users being involved with menu planning and of recent new additions to the menu for service users to try. Special diets are catered for and one service user on a special diet confirmed their dietary requirements are met in the home. A vegetarian option is also available daily if required. The meals are served in the dining room and lunch on the day was chicken curry and rice or chilli con carne and rice followed by apple crumble and cream. One service user who did not want either option had chosen a jacket potato with cheese and salad. Fresh fruit is available on the home. Service users were observed at lunchtime to have chosen their preferred option from the choice available and records are kept of individual food consumption. When asked all the service users stated that they were enjoying their meal. Drinks and snacks are available at all times. Service users who are able are encouraged and where required assisted to cook meals for themselves. Staff stated that the home had been recently been visited by the Environmental Health Department and following that a report on the visit is awaited, but that no issues had been highlighted. They also confirmed that Lawn Court DS0000021153.V306043.R01.S.doc Version 5.2 Page 14 new documentation introduced during the visit is in the process of being implemented in the home. Lawn Court DS0000021153.V306043.R01.S.doc Version 5.2 Page 15 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): 18, 19 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care and support is provided which is flexible and sensitive to individual service users. It was observed that positive relationships had been formed between staff and service users. There are policies and procedures in place in relation to medication and residents are encouraged to be involved in managing their own medication. EVIDENCE: Service users receive support and guidance from staff but are not assisted with bathing or nursing care. The sample individual care plans viewed, service users and staff spoken with, and observations during the inspection confirmed that the support given is sensitive to the individual care needs of each of the service users. Records referred to specialist advice and guidance, which had been sought. Staff spoke of receiving good support from health care professionals and community mental health teams and that service users are encouraged to attend medical health reviews and the dentist, but if they decide not to attend that is their decision. Relationships between staff and service Lawn Court DS0000021153.V306043.R01.S.doc Version 5.2 Page 16 users and the care given were observed to be very good, and service users were treated with respect at all times. There are policies and procedures in relation to medication in place. Two of the social care workers spoken with confirmed they had received medication training provided by the organisation, the third was a new member of staff who was awaiting the training. The deputy manager also stated that they are looking at arranging further medication training to be provided by local health care professionals to further enhance the current medication training provided. The social care worker who takes the lead in medication in the home and undertakes the regular checks of the systems in place was spoken with. A number of the service users self administer their medication and staff confirmed the process in place to support service users to do this. One service user spoken with confirmed self-administration and that there was lockable storage facilities provided in their bedroom. The storage of medication viewed was adequate, but there were some omissions in the recording of administration. The deputy manager confirmed an awareness of this issue and spoke of work already being undertaken with staff to address this issue and that it would be raised again at the next staff meeting. Regular visits from a pharmacist for advice and support is in place. Lawn Court DS0000021153.V306043.R01.S.doc Version 5.2 Page 17 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): 22 and 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a clear complaints procedure in place, which enables service users and their representatives to raise any concerns. There are detailed policies and procedures in place to protect service users from abuse. EVIDENCE: The organisation has a detailed complaints, compliments and comments policy and procedure in place. Any complaints received are monitored through the line management arrangements in place within the organisation. Three complaints were recorded in the pre-inspection questionnaire since the last inspection, the records of which were not available to view during the inspection as are kept at the organisations head office. So it was not possible to evidence if these had been recorded and how the issues raised had be addressed. The CSCI have not received any concerns in relation to Lawn Court. All the service users surveys stated they knew who to speak to if they were unhappy and seven stated they know how to make a complaint and two stated they did not. The home has a copy of the East Sussex County Council Multi-agency Procedures for the Protection of Vulnerable Adults. The three social care workers stated they had an awareness of and had completed training in the protection of vulnerable adults. The pre-inspection questionnaire detailed that Criminal Record Bureau (CRB) checks have been carried out on all existing Lawn Court DS0000021153.V306043.R01.S.doc Version 5.2 Page 18 staff. Both CRB and Protection of Vulnerable Adult (POVA) checks are carried out on all new staff and this was evidenced for the last member of staff recruited to work in the home. The pre-inspection questionnaire detailed that service users receive their allowances directly and staff in the home are not involved in any of the service users financial arrangements. Lawn Court DS0000021153.V306043.R01.S.doc Version 5.2 Page 19 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 and 30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The standard of the environment varies within the home and would benefit from a maintenance plan being in place and followed to ensure service users are always provided with an attractive place to live. EVIDENCE: A tour of the building was made. The location and layout of the home are suitable for its stated purpose and all areas of the home, including the garden, are accessible to service users. The décor, carpeting and furnishing in the home is variable with a number of areas in the home showing significant wear and tear, which would benefit from redecoration. The last inspection detailed that the home has an ongoing plan of refurbishment in place. Previous inspection requirements, the last target date detailed as 1 April 2006, detailed that 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. But this issue has not been fully addressed. The Manager and deputy manager confirmed that a Lawn Court DS0000021153.V306043.R01.S.doc Version 5.2 Page 20 further request for refurbishment in the home had been made to the organisation and the outcome of this request is awaited. The home would benefit from an ongoing maintenance plan to ensure service users are always provided with an attractive place to live. There are sixteen single bedrooms of which two the pre-inspection questionnaire detailed do not meet the minimum space requirements and one double bedroom situated on the ground, first, and second floors in the home. The bedrooms viewed reflected a range of individual styles and interests. Only one bedroom has en-suite facilities, but there are sufficient toilets, and a selection of communal bathing facilities in the home. There are two large lounges for service users to use, one on the ground floor, which is a non-smoking lounge and a further lounge in the lower ground floor where service users can smoke and a separate dining room for service users to eat their meals. New sofas and armchairs had been purchased for one of the lounges. There is no passenger lift in the home. There is a garden with seating and a barbeque area at the rear of the home and staff and service users spoke of using the garden in the better weather. Currently the garden is being used to store old furniture and rubbish and the deputy manager stated that following the completion of the clearing out of rubbish from the home arrangements would be made to remove this. The home was clean and free from offensive odours. All service users feedback confirmed the home was always or usually kept fresh and clean. One member of the housekeeping team was spoken with, who confirmed that they were due to attend control training on infection control and the control of hazardous substances (COSHH) and spoke of good access to protective clothing. Routine fire checks of the building were viewed and were adequate. Lawn Court DS0000021153.V306043.R01.S.doc Version 5.2 Page 21 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): 32, 34, 35 and 36. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Adequate staffing was in place on the day. Social care workers are provided with regular supervision and opportunities for training to develop their skills and ensure the individual support needs of service users can be met. Robust recruitment procedures are in place. EVIDENCE: The home was calm and relaxed on the day of the inspection, and the staffing in place was adequate to meet the needs of current service users resident. The pre-inspection questionnaire included a sample of the staff rota followed, which detailed a minimum of three staff are on the rota to work during the waking day, and one waking night staff and a sleeping in member of staff are on duty at night. All staff spoken with confirmed staffing arrangements and spoke of a good supportive team, good communication with good management support and access to training. Lawn Court DS0000021153.V306043.R01.S.doc Version 5.2 Page 22 Standard 32 has not been met as fifty percent of the staff have not achieved NVQ level 2 or equivalent in care by April 2005. The pre-inspection questionnaire detailed there social care workers hold an NVQ level 2 in care or above. This equates to twenty-seven and a half percent of the homes social care workers and four further social care workers are currently working towards NVQ Level 3. All recruitment of staff is co-ordinated by the Personnel Section at the organisation’s head office. Service users are encouraged to participate in the recruitment process of new staff to work in the home. Evidence of the recruitment process followed for the last three members of staff were viewed. The Manager stated that all had completed an application form, and the latest member of staff spoken with cofirmed this, but these were not available to view as are kept at the organisations head office. Evidence of all the recruitment process followed should be available to view at inspections. The Manager detailed in the pre-inspection questionnaire that all staff have undertaken a CRB check and the documentation viewed for the last member of staff recruited to work in the home confirmed a CRB and a POVA check had been completed. Staff spoke of good access to training and of attending a range of training and training updates. The organistion arranges training for its staff and through yearly appraissals and the social care workers confirmed that with their manager thay are able to look at their individual training needs. Staff training records were not available to view during the inspection as are held at the organisations head office. Some training details had been supplied with the pre-inspection questinnaire The last social care worker recruited to work in the home confirmed that they had received an induction. The Manager stated that the induction-training course meets the requirements of General Skills for Care induction standards. The Manager and the three social care workers spoken with confirmed that regular staff supervision and team meetings occur to meet the requirements of the standard. Lawn Court DS0000021153.V306043.R01.S.doc Version 5.2 Page 23 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): 37, 39 and 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home benefits from an experienced manager who has managed the home for many years and who ensures a supportive, homely and caring environment. Quality assurance systems are in place to enable ongoing feedback about the support provided in the home and the outcome from the quality assurance process has been collated and is available to view. But systems need to be in place and maintained to ensure a safe environment for staff and service users. EVIDENCE: The Registered Manager has worked in the home for many years and stated she has completed the Registered Managers Award and NVQ Level 4 in care and that the organisation provides regular training opportunities to attend. Lawn Court DS0000021153.V306043.R01.S.doc Version 5.2 Page 24 The organisation has a management structure and senior responsibilities within the home are clearly defined. There are opportunities for service users to put forward their views about the home and the support that they receive, which informs the organisation and staff in the home of the quality of the service being provided. Staff and documentation viewed referred to service users meetings and the minutes of the last meeting were read. The service users care plans are regularly reviewed. The quality assurance process also enables relatives/representatives and other professionals who attend the home to give their views on the care provided. The pre-inspection questionnaire detailed that policies and procedures are in place in the home and the Manager stated that representatives within the organisation keep these under regular review and the organisation also runs a user involvement group where policies and procedures are discussed with service users. The outcome from the quality assurance process has been collated and is available to the CSCI, service users and their representatives, and other stakeholders. Sixteen service user feedback forms were sent out during the last report period. Seven were returned, of which fifty-seven percent of the service users stated the service was excellent or very good and forty-three percent stated the service was good. Regular monthly visits by a representative of the organisation, which are recorded to meet the requirements, are in place. Staff spoken with confirmed attendance on moving and handling, health and safety training, basic food hygiene, infection control and first aid training/awareness. Training records were not available to view as are kept at the organisations head office. Evidence of training provided to meet the Requirements of Standard 42 should be available to view during an inspection. The Manager stated that the frequency that moving and handling training updates is provided would be reviewed to ensure staff receive this training to ensure current requirements are met. The deputy manager evidenced the risk assessments in place in relation to the building and stated a regular detailed check of the environment and fire precautions is carried out, but were not viewed during the inspection. The three social care workers confirmed that they had attended a fire drill in the last year, but the recording of the drills did not confirm this and the deputy manager stated the recording would be developed to ensure a record of staff in attendance is kept. Staff did not confirm they had received regular fire training, which was discussed during the inspection with the Manager and deputy manager and a requirement has been made to ensure that staff received adequate training in fire precautions. An Immediate Requirement Form was left following the last inspection, that fire doors are not wedged open, in the interests of the health, safety and welfare of service users and staff. Whilst walking around the home it was observed that there was Lawn Court DS0000021153.V306043.R01.S.doc Version 5.2 Page 25 extensive use of door wedges in the home. An Immediate Requirement Form was left to consult with the East Sussex Fire and Rescue Service and act upon advice given in relation to this practice. The CSCI has subsequently received a satisfactory response as the Manager has stated and evidenced that she is in contact with East Sussex Fire and Rescue Service and will be consulting with the organisations Area Manager as to the actions to be put in place to safe guard service users. There were records to view of regular checks of the hot water temperature delivered to the baths in the home, which detailed was consistently in excess of the recommended safe temperature of 43° C. This was discussed with the Manager and deputy manager during the inspection, and both stated that thermostatic values have not been fitted at the point of delivery in the home. A request has been made to the organisation for this work to be completed and the outcome of the request was awaited. Hot water signs are sited in the home, but risk assessments in relation to hot water are not in place. Radiators in the home are not guarded and risk assessments are not in place. A requirement has been made to consult with the Environmental Health Department to ensure that current safeguards in place in relation to these two issues are adequate and to act upon any advice received. It was also recommended that advice be sought to ensure the sample of outlets tested is adequate. The pre-inspection questionnaire detailed the maintenance of equipment and services has been carried out and the Manager confirmed that further checks are to be completed shortly in the home. A requirement has been made to ensure that the electrical wiring certificate for the home is still current. Information is kept in the home in relation to the control of substances hazardous to health (COSHH.) This information would benefit from a review to ensure the information is up-to-date and the Manager confirmed that this would be undertaken. Recording was viewed of incidents and accidents, which had occurred in the home. The deputy manager confirmed that a system is in place to ensure that accidents and incidents are reported to the CSCI. Lawn Court DS0000021153.V306043.R01.S.doc Version 5.2 Page 26 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 3 2 3 3 X 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 2 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 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 3 3 3 X 3 X 3 X X 2 X Lawn Court DS0000021153.V306043.R01.S.doc Version 5.2 Page 27 No 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 YA42 Regulation 13 (4) (a) (c) Requirement That the Environmental Health Department is consulted with and any advice received acted upon in relation to the unguarded radiators in the home and the temperature that hot water is delivered in the home. That staff attend fire training as required. That it is ensured that the electrical certificate for the home is still current. Timescale for action 30/04/07 2. 3. YA42 YA42 23 (4) (d) 23 (2) (b) 30/04/07 30/04/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Lawn Court DS0000021153.V306043.R01.S.doc Version 5.2 Page 28 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 Lawn Court DS0000021153.V306043.R01.S.doc Version 5.2 Page 29 - 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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