Inspection on 09/06/08 for Lawrence Court Care Home

This inspection was carried out on 9th June 2008.

CSCI found this care home to be providing an Good service.

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.

Other inspections for this house

Lawrence Court Care Home 13/06/06

Lawrence Court Care Home 16/11/05

Lawrence Court Care Home 19/05/05

Lawrence Court Care Home 02/12/04

Lawrence Court Care Home 11/05/04

Lawrence Court Care Home 27/02/04

Similar services:

Turret Villa Retirement Home

Moor House

Mendip House

Beaconsfield Court Care Home

Little Sisters Of The Poor

Manor House

Middleton Hall Ltd

Middlesbrough Intermediate Care Centre

Extracts from inspection reports are licensed from CQC, this page was updated on 28/09/2008.

CARE HOMES FOR OLDER PEOPLE Lawrence Court Care Home Allendale Road Byker Newcastle Upon Tyne Tyne & Wear NE6 2SB Lead Inspector Mary Blake Key Unannounced Inspection 09:00 9th June 2008 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 Lawrence Court Care Home DS0000000400.V363160.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 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. Lawrence Court Care Home DS0000000400.V363160.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Lawrence Court Care Home Address Allendale Road Byker Newcastle Upon Tyne Tyne & Wear NE6 2SB 0191 276 0017 0191 276 0296 Lawrence.Court@fshc.co.uk www.fshc.co.uk Tamaris Healthcare (England) Ltd 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) Care Home 46 Category(ies) of Dementia - over 65 years of age (23), Old age, registration, with number not falling within any other category (23) of places Lawrence Court Care Home DS0000000400.V363160.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. At any time up to 10 beds can be used to provide care for service users in either category OP or DE(E) 10th January 2008 Date of last inspection Brief Description of the Service: Lawrence Court is a purpose built care home located in Byker. It is situated on the same site as another care home owned by the same company. The home is currently only providing social and personal care for twenty three older persons on the ground floor. The first floor is currently not in use. There are lounge, dining room and a designated smoking lounge. All of the bedrooms are single en suite and there are adapted bathing, showers, and toilet facilities throughout the home. The lower ground floor is not readily accessible to residents. This floor has the staff room, kitchens and laundry services. The home has an accessible garden area and there is ample car parking. The home is close to local shops and leisure facilities and is on a local bus route. The current scale of charges is £389 to £401 per week. The statement of purpose, service user guide and last inspection report were available at the main entrance. Lawrence Court Care Home DS0000000400.V363160.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means that the people who use this service experience good quality outcomes. An unannounced visit was made on the 9th June 2008. The acting Manager was present throughout the inspection. Before the visit: We looked at: • Information we have received since the previous random inspection of 10th January 2008 and annual service review of 10th March 2008 • How the service dealt with any complaints and concerns since the previous inspection. • Any changes to how the home is run. • The provider’s view of how well they care for people. • The views of people who use the service and their relatives, staff and other professionals, including surveys. • The Annual Quality Assurance Assessment (AQAA), which is a selfassessment document, was well completed and returned to CSCI. • Sent “have your say” questionnaires out to people who have used or had interest in the home, two of which were returned to us. During the visit we: • Talked with people who use the service, relatives, staff and the acting manager. • Looked at information about the people who use the service and how well their needs are met, • Looked at other records which must be kept, • Checked that staff had the knowledge, skills and training to meet the needs of the people they care for, • Looked around the building/parts of the building to make sure it was clean, safe and comfortable. • Checked what improvements had been made since the last visit We told the acting manager and the company representative what we found. Lawrence Court Care Home DS0000000400.V363160.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? What they could do better: To review the medication systems and training to ensure that people who use the service are protected. Lawrence Court Care Home DS0000000400.V363160.R01.S.doc Version 5.2 Page 7 To consider the needs of people with dementias when completing the redecoration programmes to assist them in their daily living. To review the outdoor space to provide an improved area for use by people who use the service. To continue to develop the staff training programme. This will enable the manager to have an overview of staff skills and knowledge and help them to provide individual care for residents. 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 summary of this inspection report can be made available in other formats on request. Lawrence Court Care Home DS0000000400.V363160.R01.S.doc Version 5.2 Page 8 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 Lawrence Court Care Home DS0000000400.V363160.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Admissions to the home are appropriately managed and people who use the service know how their needs will be met. EVIDENCE: The care plans all have pre-admission assessments, these had been carried out by either the acting manager or by a senior member of the staff team. The people who use the service also have a care management assessment, which is provided to the home on admission. An individual care plan is produced from these documents. The home is not registered for, and therefore does not provide, intermediate care. Lawrence Court Care Home DS0000000400.V363160.R01.S.doc Version 5.2 Page 10 As part of the preadmission process people who use the service had visited the home, including with their relatives if they wished, had meals, stayed overnight and met other people who use the service and the staff. In this way they got to know the home before moving in. People who use the service commented, “I got to look around before I came” “my family came and liked it”. Lawrence Court Care Home DS0000000400.V363160.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People receive care and support that is well planned and takes into account their diverse needs whilst promoting their privacy and dignity. EVIDENCE: All people who use the service have a care plan which includes an assessment of their needs and a plan of how these should be met. This documentation includes risk assessment for fall prevention, moving and assistance as well as clinical areas such as continence assessment. Those that had been completed were to a good standard, which reflected the health needs of the people who use the service. The care plans were up to date and contained the information to assist the staff to care for the people who use the service. Lawrence Court Care Home DS0000000400.V363160.R01.S.doc Version 5.2 Page 12 People who use the service and their relatives commented, “I am well looked after” “they get me the doctor whenever I need him”. The people who use the service receive personal support the way they prefer and their physical and emotional health needs are met. Staff were confident when giving care and are supported by effective training in areas such as moving and handling. The individual health needs of people who use the service are identified and people are supported to access community health services such as doctor, district nurse, dentist, and optician. Residents commented, “I have just got new glasses”. Relatives commented, “Staff are good at getting her any help she needs”. Staff training has been undertaken to provide awareness and additional support for health related needs. People who use the service are protected by the homes policies and procedures in dealing with medicines. There is good liaison with supporting professionals. A full medication audit was not carried out but case tracking and discussion of medication administration showed that staff were knowledgeable and skilled in this area but there were shortfalls within the system and training that had already been identified by the acting Manager. People who use the service feel their privacy and dignity is respected and that they are listened to and what they say is acted upon. Relatives commented, “Staff are always very pleasant and polite” “nothing is too much trouble”. Staff receive training that helps them to make sure that everyone is treated with respect, and as an individual. Staff help people make their own decisions and provided information and assistance when it is needed. Staff were friendly toward the people who use the service and were attempting to engage them in conversation. Staff seek permission prior to entering individual rooms and were communicating well with people. People who use the service were observed to move freely around the home. Lawrence Court Care Home DS0000000400.V363160.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service are part of the local community and participate in leisure activities. They are supported to retain personal and family relationships and their rights are respected in their daily lives. EVIDENCE: People who use the service are offered the opportunity to join in a range of social and leisure activities. They have the opportunity to use community facilities for leisure activities e.g. pub, cafes, shops etc. They are offered the opportunity to experience new activities and leisure pursuits as well as supported where necessary to continue with hobbies and interests. Social needs of the people who use the service are assessed and then plans made to make sure that the people living in the home live fulfilled lives taking into account their level of dependency. People who use the service and their families raised the range of activities that are in place and at the time of Lawrence Court Care Home DS0000000400.V363160.R01.S.doc Version 5.2 Page 14 inspection a singer was entertaining the majority of people who use the service. Other recent activities have included bingo, craft, baking, cake decoration, Chinese evening and beauty treatments. People who use the service commented, “you can do as much or as little as you want” “I like the old photographs of Walker”. Relatives commented “lots of things happening” “I visit most days and there is usually something or other going on”. Staff assist and encourage people who use the service to maintain family links and previous friendships, respecting the individual’s wishes. Staff seek permission prior to entering individual rooms and were communicating well with people. People who use the service were observed to move freely around the home. The four weekly menus are currently under review. People who use the service were positive about the choice and range of food available. Mealtimes were seen to be a relaxed and sociable occasion, with nicely laid tables and with good staff support. People who use the service and relatives commented, “I am able to choose” “some days I feel more hungry than others and staff always understand” “ I visit most days and have lunch with my sister, always first rate”. Lawrence Court Care Home DS0000000400.V363160.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The views of people who use the service, and their relatives are listened to and acted upon. People who use the service are protected from abuse, neglect and self-harm EVIDENCE: The complaints procedure is available in the service users guide and a copy is available at the front entrance of the home. There have been no complaints received by the home or Commission for Social Care Inspection since the previous inspections. People who use the service and relatives spoken to understood how to make a complaint, and could identify the way this would be dealt with. People who use the service commented, “I always ask to speak to the manager or deputy manager”. Relatives commented “I know who to talk to if I need things looked at but at the moment very happy with everything I see”. Staff have undertaken the one day training on the Protection of Vulnerable Adults and there is further training planned. Staff were aware of the whistle Lawrence Court Care Home DS0000000400.V363160.R01.S.doc Version 5.2 Page 16 blowing policy and felt able to raise concerns if necessary. The acting Manager was aware of the need to protect all people who use the service. Lawrence Court Care Home DS0000000400.V363160.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The facilities are designed to meet the needs of people who use the service. It is homely, generally well maintained and clean. EVIDENCE: The home is comfortable and attractively furnished. The bedrooms are attractive and homely and reflect their individual styles and tastes. The home has sufficient and suitably equipped bathrooms. Many of the carpets, furniture and furnishing had been replaced or were part of the refurbishment programme and the general maintenance was good. The home was clean with no offensive odours. Lawrence Court Care Home DS0000000400.V363160.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are adequate numbers of appropriately skilled and experienced staff to care for the people who use the service. The recruitment processes in place protect people who use the service. EVIDENCE: Staffing rotas showed that there are enough staff on duty to meet the necessary staffing levels. There has been a limited turnover providing people who use the service with a consistent approach and familiarity. People who use the service commented, “They are lovely” “familiar faces” “just got to ask and they will help”. Relatives commented, “Kind and considerate” “know my sister really well” “feel confident that they will look after her”. Health and social care professionals commented, “the staff know their residents very well, they are very caring”. Lawrence Court Care Home DS0000000400.V363160.R01.S.doc Version 5.2 Page 19 Recruitment procedures within the home are safe. Records confirm that appropriate checks are carried out for all staff. The home has an induction programme and the acting manager is currently developing the training programme for all staff working in the home. Staff spoke knowledgably about the individual needs of people who use the service. Staff had undertaken refresher in mandatory training. Staff said that they are undertaking or had completed National Vocational Qualification in Care level 2 (NVQ) or over, with eight staff having or undertaking NVQ 2 or above. Staff meetings are used to provide additional in-house training for staff across all grades. Lawrence Court Care Home DS0000000400.V363160.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33 & 38 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The view of residents and their families and supported underpin the development of the home and their health, safety and welfare are protected. EVIDENCE: The new manager has been in post since April of this year and has not yet completed the fit person process with CSCI. There have been a number of managers in recent years and this was commented upon by relatives and people who use the service. Observations of staff and residents showed that they felt confident with the openness and approachability of the acting Manager. The acting Manager is qualified and experienced and communicates a clear sense of direction and leadership and has already implemented positive Lawrence Court Care Home DS0000000400.V363160.R01.S.doc Version 5.2 Page 21 changes. For example update of care plans, re-establishing of resident meetings. The leadership in the home both in the way the care is being delivered to the people who use the service and the overall organisation is good. This includes the organising of training, staffing and ensuring that the home was being well maintained and equipped. Staff are confident in their work and now said they feel well supported. The staff, people who use the service and relatives were confident that their views were listened to and valued by the acting Manager. Relatives commented “she has patience, understanding and tolerance” “gets on well with people” “sets a good example to all of her staff”. Accident and risks assessment are appropriately documented. The Annual Quality Assurance Assessment was well completed and returned to Commission for Social Care Inspection. This document reflects the standard of the service being provided and the way the manager/provider plan to improve it further. The provider has good quality assurance systems in place including annual surveys, monthly provider visits, audits on areas such as menus, service user plans, staff recruitment and training, health and safety and are currently developing a self assessment tool. The providers’ remedial action plan (RAP) had identified where the acting manager with the support of the locality manager could make improvements with many already actioned. Meetings have recommenced for people who use the services and their relatives. Regular staff meetings are also held. The health and safety audit and maintenance of the home were generally satisfactory with any issues being addressed. Lawrence Court Care Home DS0000000400.V363160.R01.S.doc Version 5.2 Page 22 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 X 3 X X N/a HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X X X X 3 Lawrence Court Care Home DS0000000400.V363160.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No 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 OP9 Regulation 13(2) Requirement The registered provider must address all medication issues a) Clear administration records b) Clear records of disposal of medication c) Staff to undertake further training Timescale for action 01/09/08 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 2 3 Refer to Standard OP19 OP19 OP31 Good Practice Recommendations To review the decoration/signage to provide more support for people who use the service who have dementias To review the use of the outdoor area to provide more space for people who use the service to enjoy. To submit an application for the manager to undertake registration with the commission for social care inspection Lawrence Court Care Home DS0000000400.V363160.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Lawrence Court Care Home DS0000000400.V363160.R01.S.doc Version 5.2 Page 25 - 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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