CARE HOMES FOR OLDER PEOPLE
Lawn Park Care Home Lucknow Drive Sutton In Ashfield Nottinghamshire NG17 4LS Lead Inspector
Karmon Hawley Unannounced Inspection 18th January 2006 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Lawn Park Care Home DS0000024645.V266926.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Lawn Park Care Home DS0000024645.V266926.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Lawn Park Care Home Address Lucknow Drive Sutton In Ashfield Nottinghamshire NG17 4LS 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) 01623 515340 01623 440174 Keslaw ltd Mrs Rosalind Kennedy Brown Care Home 49 Category(ies) of Old age, not falling within any other category registration, with number (49), Physical disability (10) of places Lawn Park Care Home DS0000024645.V266926.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Service user shall be within categories OP (49) and PD (over 60 10 beds) 24th May 2005 Date of last inspection Brief Description of the Service: Lawn Park is situated in an idyllic position overlooking the park in Sutton In Ashfield near Mansfield Nottingham and is within walking distance to a bus route into the main town. It provides 34 beds for personal care with nursing and 15 beds for older people with either nursing or personal care needs. The home comprises of two floors and is furnished at a good standard. 32 bedrooms have ensuite. There is a large and comfortable lounge, conservatory, smaller sitting room and a dining room from which the wild life can be observed in the pleasant and accessible gardens, there is also a large car park. Lawn Park Care Home DS0000024645.V266926.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection took place in three hours and was performed by one inspector. The main method of inspection was case tracking, this is a method of sampling the records of four randomly selected service users to ascertain if the needs of service users are appropriately assessed and identified needs are being catered for by the home to maintain optimum health and wellbeing of the service user. Four service users were spoken with and three relatives so as to give the inspectors an insight into the conditions and standards within the home. Those spoken with were happy with the staff, care received and the standards within the home. The registered manager assisted in the inspection process and three members of staff were spoken with. Staff were able to demonstrate a good understanding of service users needs and the core values and principles in relation to their job role. The focus of this inspection was to concentrates on the remaining core standards not assessed and the requirements made at the previous inspection. What the service does well: What has improved since the last inspection?
Many improvements have been made since the last inspection. All service users now have relevant contracts of care in place ensuring they are protected in this area. Medicine arrangements have changed, stock medicines are no longer in use and a separate drugs fridge has been purchased which is located in the manager’s office, thus further protecting service users.
Lawn Park Care Home DS0000024645.V266926.R01.S.doc Version 5.1 Page 6 Although the required work with regards to the replacement of carpets and the repair/maintenance of windows has yet to be done, this has been discussed along with a twenty five thousand pound refurbishment for which a date is soon to be arranged, thus enhancing the environment within which service users live. Further consideration has been given to a private area for service users to use should they desire, the quiet room is available along with service users own rooms, also should privacy be required the staff training and step down room is available after 5pm and during the weekend. One fire drill has taken place, however further attention is still required to ensure all staff have undertaken this process and signed to demonstrate their attendance. Service users reviews have developed and are more service user focussed thus evaluating the care given is at the correct level ensuring service users needs are met. The gas appliances have been checked and a safety certificate is in place ensuring service users are further protected. Staff training has continued to develop and demonstrates a commitment to achieving all mandatory training. 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 Park Care Home DS0000024645.V266926.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Lawn Park Care Home DS0000024645.V266926.R01.S.doc Version 5.1 Page 8 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Each service user has a written/contract statement and terms and conditions with the home. EVIDENCE: Service users now have written contracts in place as required at the previous inspection. Lawn Park Care Home DS0000024645.V266926.R01.S.doc Version 5.1 Page 9 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,9 Service users health, personal and social care needs are set out in an individual plan of care and whilst it is acknowledged that various risk assessments are in place, further attention is required to ensure these are comprehensive and cover all identified needs. EVIDENCE: Within case files examined evidence was available to demonstrate service users undergo various assessments such as the activities of daily living, social, nutritional, pressure area care and manual handling. Information gained from these assessments forms the basis of the plan of care, which were personalised and reflected choices and preferences. There was also evidence of reviews taking place and service users and relevant others involvement. Reviews were service user focused and reflected care and condition. Daily progress notes were maintained and contained information with regards to significant events, care and condition of service users. There was also evidence to demonstrate that the multidisciplinary team and other specialist services are liaised with as required.
Lawn Park Care Home DS0000024645.V266926.R01.S.doc Version 5.1 Page 10 Risk assessments were in place, however further information with regards to specific specialist conditions such as diabetes mellitus and infection with regards to specialist enteral feeding is required. The home no longer uses stock medicines as previous, individual prescriptions are now used. A new drug fridge has been purchased and is located in the managers office. Lawn Park Care Home DS0000024645.V266926.R01.S.doc Version 5.1 Page 11 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 14,15 Service users are helped to exercise choice and control over their lives. Service users receive a wholesome, appealing and balanced diet in pleasing surroundings. EVIDENCE: To enable personal choice and autonomy prospective service users are invited to view the home and spend time prior to making a decision to enter. Once this decision has been taken a social care assessment is undertaken to ascertain service users choices and preferences. Service users are able to choose what time they rise and retire and service users spoken with substantiated this. Service users may also choose where they spend the day and the activities they partake in. Service users are facilitated to bring in their own personal possessions and service users spoken with substantiated this. Should a service user wish they may handle personal finances and are facilitated in this process. Lockable facilities and doors are available. There are leaflets available on advocacy services, which have been used in the past.
Lawn Park Care Home DS0000024645.V266926.R01.S.doc Version 5.1 Page 12 A four weekly menu is followed with was observed to be wholesome and appealing. Choices are offered at each meal and personal preferences and specialist needs accommodated. Cleaning rotas were available, there were some gaps in these records, however the kitchen was noted to be clean and tidy. All other records were observed and were satisfactory with the exception of written documentation to evidence that goods have been checked on receipt, however the head cook stated this was performed. The manager was advised to liaise with the environmental health officer with regards to hazard analysis critical control points and the documentation of evidence to demonstrate these checks take place. Service users spoken with stated meals in general were at a good standard and choices are offered. Staff stated specialist diets are catered for and could discuss what this entailed. Lawn Park Care Home DS0000024645.V266926.R01.S.doc Version 5.1 Page 13 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 Service users are protected from abuse. EVIDENCE: Relevant polices and procedures are in place with regards to adult protection, within the staff induction package there was evidence to demonstrate that policies and procedures are covered during this period. All staff employed have undergone successful criminal records bureau checks, evidence of which was available, staff were also able to confirm this. The majority of staff have also completed the protection of vulnerable adult training. Staff spoken with were able to discus the relevant policies and procedures and the action they would take in the event of abuse occurring. Service users and relatives spoken with were happy with life within the home and care received, it was stated that staff are respectful and attended to needs appropriately. Lawn Park Care Home DS0000024645.V266926.R01.S.doc Version 5.1 Page 14 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: Not assessed during this inspection. Lawn Park Care Home DS0000024645.V266926.R01.S.doc Version 5.1 Page 15 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): 28 Service users are in safe hands at all times. EVIDENCE: Four seasons have commenced its own training centre in order to enhance the National Vocational Qualification Training. Training within the home is as follows; 6 staff have completed the NVQ level 2/3, 2 are currently working towards and 10 have been registered and are awaiting a starting date. An intensive induction programme is also in place and covers all aspects required. Staff spoken with stated they felt supported in their training and sufficient training is offered to enable them to carry out their job role. Service users spoken with felt confident that staff were trained appropriately to meet their needs. Lawn Park Care Home DS0000024645.V266926.R01.S.doc Version 5.1 Page 16 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 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 her responsibilities. EVIDENCE: The manager has worked at the home since 1986, initially as a registered nurse and the deputy manager. She is currently working towards the NVQ registered managers award and also maintains up to date will mandatory training and other training related to her job role. She was able to demonstrate competency in her job role and is aware of the support networks in place. staff and service users spoken with spoke highly of the manager and stated she was caring and approachable and managed the home well. The gas appliances have been tested as required and a current certificate is now in place.
Lawn Park Care Home DS0000024645.V266926.R01.S.doc Version 5.1 Page 17 One fire drill has been carried out since the previous inspection, however not all staff have attended a drill and staff signatures were not available to substantiate their attendance. Lawn Park Care Home DS0000024645.V266926.R01.S.doc Version 5.1 Page 18 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 3 X X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 X 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 X X X X X X X X STAFFING Standard No Score 27 X 28 3 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X X X X 2 Lawn Park Care Home DS0000024645.V266926.R01.S.doc Version 5.1 Page 19 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 OP7 Regulation 13(4,c) Requirement Timescale for action 21/02/06 2. OP19 23(2b) 3. OP38 23 (4c) Appropriate risk assessments and management plans are required to be in place for service users identified risks to ensure they are fully protected. Windows and carpets as 21/02/06 identified are to be replaced. This has been partly met as discussions and plans are underway, a date for work to commence is now required to demonstrate compliance. Fire practices are to be carried 21/02/06 out and records maintained. This has been partly met; further drills are now to be carried out in order to fully comply with this 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 OP15 Good Practice Recommendations The manger is to liaise with the environmental health officer with regards to hazard analysis critical control points and food safety records.
DS0000024645.V266926.R01.S.doc Version 5.1 Page 20 Lawn Park Care Home Commission for Social Care Inspection Nottingham Area Office Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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