Inspection on 24/05/05 for Lawn Park Care Home

This inspection was carried out on 24th May 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Lawn Park Care Home 01/10/08

Lawn Park Care Home 02/10/07

Lawn Park Care Home 14/09/06

Lawn Park Care Home 18/01/06

Lawn Park Care Home 21/01/05

Lawn Park Care Home 06/09/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Lawn Park Lucknow Drive Sutton in Ashfield Nottinghamshire NG17 4LS Lead Inspector Karmon Hawley Unannounced 24/05/05 10.00 am 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 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 C53 C03 S24645 Lawn Park V229965 240505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Lawn Park Address Lucknow Drive Sutton in Ashfield Nottinghamshire NG17 4LS 01623 515340 01623 440623 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Keslaw Ltd Rosalind Kennedy Brown Care Home 49 Category(ies) of OP 49 registration, with number PD 10 of places Lawn Park C53 C03 S24645 Lawn Park V229965 240505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Service users in category PD shall be over 60 years. Date of last inspection 21st January 2005 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 C53 C03 S24645 Lawn Park V229965 240505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. What the service does well: What has improved since the last inspection? What they could do better: Several areas were improvement is required were identified, which include the following: finalising contacts of care and negotiation with service users, developing service users reviews, reviewing medication procedures, consideration to ensuring the continued safeguarding of service users finances, minor improvements in ensuring the continued health, safety and welfare of service users and relevant others and completing the outstanding requirements from the previous inspection. Lawn Park C53 C03 S24645 Lawn Park V229965 240505 Stage 4.doc Version 1.30 Page 6 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 C53 C03 S24645 Lawn Park V229965 240505 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Lawn Park C53 C03 S24645 Lawn Park V229965 240505 Stage 4.doc Version 1.30 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 standard(s) 2,3,5,6 There are currently no contracts in place for negotiations to take place between the responsible individual and service user, which may leave service users in a vulnerable position until these are finalised. Trial visits and respite care arrangements ensure service users are able to make an informed choice prior to making a commitment. The step down service offered is of a good standard. EVIDENCE: The contract between service users and the responsible individual are being developed. Contacts have been devised which were observed, the office of fairtrading is currently assessing these. Once this has happen the deputy manager stated that these would be issued to service users. The manager or deputy manager prior to service users being admitted into the home completes pre assessments, which cover the requirements of this standard. Trial visits are arranged as required and service users may visit the home prior to making a decision. The deputy manager stated respite care is available so service users may stay for a short period before making a commitment. Emergency admissions are accepted and the same procedures followed. Step-down services are offered to service users. The plan of care observed was detailed and reflected the care required, the discharge and home Lawn Park C53 C03 S24645 Lawn Park V229965 240505 Stage 4.doc Version 1.30 Page 9 living arrangements, support and networks. One service user spoken with was able to discuss the care she receives with regards to this service. Lawn Park C53 C03 S24645 Lawn Park V229965 240505 Stage 4.doc Version 1.30 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 standard(s) 7,8,9,10 Plans of care, daily records, assessments and specialist services accessed ensure individual needs and preferences are identified and met. Continuity of care is demonstrated, however service users reviews should be developed so as to become service user focused to reflect individual outcomes. With regards to medicine arrangements, these may indirectly put service users at risk due to procedures followed. EVIDENCE: Various assessment tools were noted to be in use to assess service users needs. Care plans are based upon identified outcomes of these assessments and the daily activities of living. Within one file observed not all records were completed however on speaking to the deputy manager, she stated that this was due to the time scales of the homes policy, which was observed. Risk assessments were also in place and covered identified risks. Care plans were in-depth and covered all identified needs, however outcomes were not service user focussed. Although reviews were observed to take place, these stated no changes on many occasions. Daily records noted concerns and changes and there was evidence that advice following GP visits were followed. Detailed social assessments were in place which observed individual likes and dislikes. There was also evidence of specialist services visiting service users and Lawn Park C53 C03 S24645 Lawn Park V229965 240505 Stage 4.doc Version 1.30 Page 11 relevant equipment and aids being in place. Staff spoken with were knowledgeable and spoke of core values and principles. A service user spoken with substantiated that staff knock on doors prior to entering. Medication procedures were satisfactory. However the storage area is very small, due to the lack of space a stock of paractetamol and lactulose is used rather than individual medication. There is no room for a specific drug fridge; therefore medicines are kept in a lockable container in a fridge in the staff room. The deputy manager stated that medical emergency equipment is not in working order. Lawn Park C53 C03 S24645 Lawn Park V229965 240505 Stage 4.doc Version 1.30 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 standard(s) 12,13 The activities coordinator has only been in post for three months, however she is making good progress to continue that which was previously developed, and to introduce her own ideas. Sufficient activities are in place to meet service users needs. Although contact with family and relevant others is facilitated this may be enhanced further by providing an additional private area. EVIDENCE: Detailed social assessments which observed likes, dislike and preferences were observed within care files examined, the activities coordinator has access to these should she wish. There is an allocated budget of forty pounds a month for activities. This is mainly spent on entertainers visiting the home, as there are already ample resources available. Activities take place both inside and outside the home and the adjacent park is made use of. Records are maintained with regards to activities service users have undertaken. Service users spoken with stated they may get up when they want and may go to bed as they wish. Meals were plentiful and of a good standard. It was expressed that staff are nice; they knock on doors and listen to their needs. However one service user spoken with stated that he had requested a door lock for his room, due to personal items being mislaid in the past and he had to pay for the key, the regional manager disputes this and stated that on no occasion has any service users been charged for a lockable facility. There is an open visiting policy within the home and visitors may stay for meals for a small Lawn Park C53 C03 S24645 Lawn Park V229965 240505 Stage 4.doc Version 1.30 Page 13 charge should they wish. Service users who have partners facilitated to spend as much time together as desired. There is no private area that visitors may be received in but service users may use their bedrooms. The deputy manager stated that service users can choose who they wish to see and this is recorded in notes. The visitor’s policy is discussed on admission and displayed in the main entrance. The vicar visits the home and Holy Communion is held for those who request it, a church group also visits. There are currently no community links. Lawn Park C53 C03 S24645 Lawn Park V229965 240505 Stage 4.doc Version 1.30 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 standard(s) 16,17 Complaints and concerns received are taken seriously and acted upon to ensure service users and relevant others feel that issues will be resolved. Staff were able to discuss service users rights and protect them accordingly. EVIDENCE: There was evidence of a clear, accessible complaints procedure. Complaints had been sufficiently recorded which included the complaint, summary of the preliminary response, follow-up action and action plans, lessons to be learnt and the time scales for action. It also stated the outcome of the complaint. The deputy manager stated some service users had received a postal vote for the last elections that took place. Advocacy services have been used in the past and there was information available on the notice board in the main entrance, also included were contacts for associations that may also be of use. The deputy manager stated that staff sometimes act on behalf of service users but it would be referred as appropriate source should the need arise. Staff spoken with were able to discuss how they facilitate the maintenance of service users rights, choices and preferences. Lawn Park C53 C03 S24645 Lawn Park V229965 240505 Stage 4.doc Version 1.30 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 standard(s) 19, 21,22,24,26 One of the outstanding requirements is the replacement of identified carpets, not only do they look worn and unattractive they present a potential trip hazard putting service users and others at risk. Ample facilities, specialist adaptations and aids are available ensuring service users needs can be met. However there is question with regards to the appropriateness of charging for a lockable facility such as a room key. The home in general is clean and tidy ensuring comfort. EVIDENCE: On the day of the inspection the home was clean and tidy. There are ample washing and toilet facilities in place for service users and visitors. There is one large lounge a smaller sitting room, a conservatory and a dining room providing ample seating space for service users. Service users rooms were well decorated and personalised with ample storage space if required. There was also an intercom in each room so service users may speak directly to staff if needed. Service users rooms were well personalised and there was evidence of required equipment in place. There was screening available in the double room. One service user spoken with stated he had had to pay for a key to Lawn Park C53 C03 S24645 Lawn Park V229965 240505 Stage 4.doc Version 1.30 Page 16 enable him to lock his room. The occupational therapist uses the homes equipment and adaptations as resources for those service users who are on the step down programme. The carpet in the main entrance and the top landing area have not yet been replace, the top landing area has a large rucked up area and could be a potential trip hazard. Windows that were required to be replaced identified during the previous inspection have not as yet been done. Lawn Park C53 C03 S24645 Lawn Park V229965 240505 Stage 4.doc Version 1.30 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,29,30 Ample staff are employed to facilitate the needs of service users, staff are knowledgeable when discussing service users needs, however some areas of mandatory training is lacking and may result in limitations imposed upon care delivered within these areas. Service users are protected by the recruitment and selection policies and procedures in place. EVIDENCE: Staffing rotas were observed and demonstrated that sufficient staffing levels are employed. The induction programme in place within staff files was in depth and also used a questionnaire afterward to ascertain understanding. One member of staff spoken with stated that the induction programme held her in good stead for the job. All senior carers employed have attained the National Vocational Qualification in Care and two members of staff are currently working towards the qualification. Staff training demonstrated manual handling and fire training are up to date however there were deficits in health and safety, first aid, infection control, adult abuse and food hygiene. Staff files observed demonstrated all necessary checks had taken place and all required documentation was available. Staff had signed to state they have read and understood policies and procedures within the home. Lawn Park C53 C03 S24645 Lawn Park V229965 240505 Stage 4.doc Version 1.30 Page 18 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33,35,36,38 Attention is taken to ensure the home is run in the best interest of service users and relevant audits are in place to facilitate this. Personal allowances are kept in a pooled account; the deputy manager and administrator stated this method works well, however this may affect the interest of service users. Staff supervisions are satisfactory to ensure individual development continues. Records with regards to health and safety were satisfactory with the exception of the gas testing, and staff fire drills, which may put service users, and relevant others at risk. EVIDENCE: With regards to quality assurance the responsible individual ensures that regulation 26 forms are completed and sent to the Commission for Social Care Inspection. A positive review audit was held during December 2004 documentation if which was seen, quality assurance questionnaire are being sent to service users this month. These are of a simple tick box format with an additional space for comments. These are then sent to the regional office Lawn Park C53 C03 S24645 Lawn Park V229965 240505 Stage 4.doc Version 1.30 Page 19 where they are consolidated and the results are then sent back to the home so an action plan can be devised if required. Service users personal allowances are kept in a pooled bank account. The bank account statement was observed. Within the home is a float of money to which service users have access. Each service user has a separate account where transactions are recorded and receipts are obtained. Two members of staff sign for all transactions. Accounts are checked monthly by the administrator to ensure all accounts are accurate and correspond. All testing and maintenance records were observed and were up to date and satisfactory with the exception of the gas testing which demonstrated that there are several issues that do not comply to current regulations. Accident statistics are kept for the prevention and monitoring of accidents occurring. Whilst staff attend routine fire testing, actual mock drills are not carried out. Staff supervision records were observed and staff spoken with were able to substantiate that these take place and were beneficial. Lawn Park C53 C03 S24645 Lawn Park V229965 240505 Stage 4.doc Version 1.30 Page 20 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x 1 3 x 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 1 8 3 9 1 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 1 14 x 15 x COMPLAINTS AND PROTECTION 1 x 3 3 x 1 x 3 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 x x x 3 x 2 3 x 1 Lawn Park C53 C03 S24645 Lawn Park V229965 240505 Stage 4.doc Version 1.30 Page 21 yes 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. 2. 3. 4. Standard OP2 OP7 OP9 OP9 Regulation 5 (1c) 15 (2b) 13(2) 13(2) Timescale for action Appropriate contracts of care are 31st August required to be in place. 2005 Service user reviews should be 31st July more foccused towards individual 2005 needs. Consideration of an alternative 10th July arrangement for the use of stock 2005 medicines is required Medication is required to be 10th July stored in an appropriate manner 2005 to safeguard the health, safety and welfare of service users. It is required that evidence be 31st July available to demonstrate that 2005 there is no fee charged for room keys. A private area other than service 31st July users rooms is to be available for private consulations if requested. Windows and carpets as Immediate identified are to be replaced. This is an outstanding requirement from the previous inspection to be completed by 22/04/05 and must be addressed to avoid enforcement action. Fire practices are to be carried out and records maintained. Mock fire drills are to be carried out Fire practices are to be carried 10th July out and records maintained. 2005 Version 1.30 Page 22 Requirement 5. OP13 12(4a) 6. 7. OP13 OP19 23(2i) 23(2b) 8. OP38 23 (4c) Lawn Park C53 C03 S24645 Lawn Park V229965 240505 Stage 4.doc 9. OP 38 23(2b) Further advise is to be sought 10th July from the appropriate authority 2005 with regards to the testing of gas appliances. 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 OP35 Good Practice Recommendations Alternative arrangements other than a pooled account for service users money is considered. Lawn Park C53 C03 S24645 Lawn Park V229965 240505 Stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection Edgeley House Tottle Road Nottingham NG2 1RT Address 4 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 Park C53 C03 S24645 Lawn Park V229965 240505 Stage 4.doc Version 1.30 Page 24 - 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. 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