This inspection was carried out on 20th June 2005.
CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.
The inspector made no statutory requirements on the home as a result of this inspection
and there were no outstanding actions from the previous inspection report.
CARE HOMES FOR OLDER PEOPLE
The Lawns Nursing Home 31 Oatlands Drive Harrogate North Yorkshire HG2 8JT Lead Inspector
Bridgit Stockton Unannounced 20 June 2005 09:30 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. The Lawns Nursing Home J04 J53 The Lawns S28032 V234441 200605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service The Lawns Nursing Home Address 31 Oatlands Drive Harrogate North Yorkshire HG2 8JT 01423 889353 01423 887055 N/A Amocura Limited 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) Position Vacant Care Home with Nursing 32 Category(ies) of Dementia - over 65 years of age (32) registration, with number Mental Disorder, excluding learning disability or of places dementia - over 65 years of age (32) The Lawns Nursing Home J04 J53 The Lawns S28032 V234441 200605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Service Users to include up to 32 (DE(E))and up to 32 (MD(E)) up to a maximum of 32 Service Users. 2. No-one admitted under the Mental Health Act 1983 Date of last inspection 23/02/05 Brief Description of the Service: The Lawns is a large three storey converted and extended detached house situated in its own grounds in quiet residential area of Harrogate It offers nursing care for up to 32 elderly service users who have dementia or a mental disorder.This inspection was an announced inspection The plan for the inspection was to check whether the home had met previous requirements and recommendations; to observe and talk to with service users about living in the home; to meet with care and kitchen staff and the home’s management team; and to look at records. The Lawns Nursing Home J04 J53 The Lawns S28032 V234441 200605 Stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection was an announced inspection The plan for the inspection was to check whether the home had met previous requirements and recommendations; to observe and talk to with service users about living in the home; to meet with care and kitchen staff and the home’s management team; and to look at records. What the service does well: What has improved since the last inspection?
Since the last inspection this home has improved in several areas. Staff have been trained in looking after people with dementia. Training for all staff has taken place in infection control, health and safety awareness and nutrition The home was clean and fresh, the redecoration of the main corridors has made the home brighter and more pleasant. Some of the bedrooms have been refurbished along with some communal areas. The care plans for people living at the home have improved so staff can give the service users care and support when they need it. An enclosed garden area with raised beds has been improved allowing service users the added benefit of a more secure area should they choose to sit there. A manager has now being appointed at the home, and is introducing a relatives group meeting to the home. She is also ensuring that staff have been
The Lawns Nursing Home J04 J53 The Lawns S28032 V234441 200605 Stage 4.doc Version 1.30 Page 6 checked properly before they start working at the home. In addition she is also making sure that staff have been properly trained so that they are equipped with the skills and knowledge to look after people with dementia. There was a purposeful atmosphere at the home, and it was evident that the new manager was confident and knowledgeable about the service users requirements, demonstrating good leadership and support for both service users and the staff group. 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. The Lawns Nursing Home J04 J53 The Lawns S28032 V234441 200605 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 The Lawns Nursing Home J04 J53 The Lawns S28032 V234441 200605 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) 3 The assessment of service users is managed well ensuring that individual care needs can be met within the service. EVIDENCE: The assessment documentation and recording of a new resident was good and In sufficient detail so as to make it possible for the care needs to be identified and from which a comprehensive care plan has been developed. The manager confirmed that she visits all new residents prior to admission, and takes into consideration the equipment they require and the dependency of the other residents living at the home and the bedroom available with regard to location and size of room. The Lawns Nursing Home J04 J53 The Lawns S28032 V234441 200605 Stage 4.doc Version 1.30 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 standard(s) 7,8,10 Good systems are in place to ensure that health care needs of the service users are met. EVIDENCE: A service user plan has been developed for each service user that identifies needs associated with health, personal and social care. This ensures that staff are clear about what is required of them in meeting a service user’s needs. Each plan sets out the tasks that a service user can manage without help and those where support is required from staff and other health care professionals. Risk assessments were in place and strategies for service users who may have challenging behaviour. From observation staff were treating service users with dignity, Care was given discreetly and sensitively in order to maintain service users privacy. The Lawns Nursing Home J04 J53 The Lawns S28032 V234441 200605 Stage 4.doc Version 1.30 Page 10 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) None of these standards were assessed on this occasion EVIDENCE: The Lawns Nursing Home J04 J53 The Lawns S28032 V234441 200605 Stage 4.doc Version 1.30 Page 11 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 &18 Residents concerns are dealt with. Service users are protected and their interests are safeguarded. EVIDENCE: There are adequate written policies and procedures in place to deal with complaints and the care staff spoken to confirm they were aware of these. Staffs knowledge of these help ensure that they were able to address any issues or anxieties of the residents, relatives and visitors to the home. Staff training has taken place in the protection of vulnerable adults in abuse. Staff recruitment procedures were adequate and staff were employed and deployed following appropriate CRB and POVA checks. The Lawns Nursing Home J04 J53 The Lawns S28032 V234441 200605 Stage 4.doc Version 1.30 Page 12 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 &26 The home was well maintained, safe and clean. EVIDENCE: Since the last inspection a team of maintenance workers have visited the home to work on improving the environment at the home. The main corridor on the ground floor has been redecorated along with the refurbishment of some bedrooms. The large stone fire places in both communal areas now have guards fitted. Other health and safety requirements regarding the environment, that were identified at the previous inspection have also been completed. The home was clean and fresh and all staff have been trained in the control of infection. It is important that this work continues and the planned refurbishment of other bedrooms and communal rooms continues. The Lawns Nursing Home J04 J53 The Lawns S28032 V234441 200605 Stage 4.doc Version 1.30 Page 13 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 The staffing levels at the home are adequate and service users are protected by the recruitment procedure in the home. EVIDENCE: Following the last inspection, staffing numbers have been increased at busy periods of the day, this ensures that staff are deployed in appropriate numbers to ensure the safety and well being of service users. Staff files were inspected, all staff has a valid criminal bureau record (CRB) check, a new starters file contained all appropriate checks such as two valid references and a record of the CRB check undertaken. Since the last inspection training has improved. From the training records examined staff had received training in the following areas • Infection control • Protection of vulnerable adults • Health and safety • Nutrition • Dementia Care in the Elderly The Lawns Nursing Home J04 J53 The Lawns S28032 V234441 200605 Stage 4.doc Version 1.30 Page 14 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) None of these standards were assessed on this occasion. EVIDENCE: The Lawns Nursing Home J04 J53 The Lawns S28032 V234441 200605 Stage 4.doc Version 1.30 Page 15 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 x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 x
COMPLAINTS AND PROTECTION 3 x x x x x 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 x 3 x x x x x x x x The Lawns Nursing Home J04 J53 The Lawns S28032 V234441 200605 Stage 4.doc Version 1.30 Page 16 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 Regulation Requirement Timescale for action 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 Good Practice Recommendations The Lawns Nursing Home J04 J53 The Lawns S28032 V234441 200605 Stage 4.doc Version 1.30 Page 17 Commission for Social Care Inspection York Area Office Unit 4, Triune Court Monks Cross York, YO32 9GZ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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