Inspection on 21/07/05 for Lawrence House

This inspection was carried out on 21st July 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.

Other inspections for this house

Lawrence House 26/02/08

Lawrence House 09/01/07

Lawrence House 06/12/05

Lawrence House 04/10/04

Lawrence House 13/05/04

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

CARE HOMES FOR OLDER PEOPLE Lawrence House 15 St Marks Close Shorncliffe Folkestone, Kent CT20 3LY Lead Inspector Wendy Mills Announced 21 July 2005 13:30 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. Lawrence House H56-H05 S37880 Lawrence House V232124 210705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Lawrence House Address 15 St Marks Close, Shorncliffe, Folkestone, Kent, CT20 3LY 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) 01622 671411 Kent County Council Caroline Hillen Care home only 30 Category(ies) of Dementia over 65 x 16; Mental Disorder x 1; registration, with number Older People x 13 of places Lawrence House H56-H05 S37880 Lawrence House V232124 210705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 4th October 2004 Brief Description of the Service: Lawrence House is a Kent County Council run Home providing care, rehabilitation and step down care for up to thirty people. There are sixteen places for those with failing mental capacity. The Home was purpose built in the 1980s and is a single story building set in pleasant and safe gardens. The accommodation is divided into homely living units. It is well staffed and the recuperative care unit has the benefit of on-site occupational therapy services. Lawrence House is situated in the residential area of Shorncliffe. Cheriton High Street is close by and provides amenities such as post office and shops. Lawrence House H56-H05 S37880 Lawrence House V232124 210705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection began at 13.45 hours and lasted five hours. The registered manager, Mrs Caroline Hillen assisted the inspector throughout. During the course of the inspection three members of staff were interviewed in private and twelve residents were spoken to without any staff being present.. A tour of the home was undertaken and key documentation examined. Both direct and indirect observation was used throughout the inspection. Information was also gathered from the pre-inspection questionnaires that were sent out to both residents and their relatives. The residents, staff and the registered manager are all thanked for their welcome and their assistance during the inspection. The home meets all the National Minimum Standards very well. All the residents said they are happy and have no complaints whatsoever. What the service does well: The home is well managed and cares for the residents very well indeed in a friendly, clean and comfortable environment. It recognises their needs and meets them in a proactive and innovative way. It listens to the views of the residents and staff and acts upon these opinions when appropriate. Staff pay attention to detail and are good at responding positively to specialist needs. The home responds to complaints in a positive way within agreed timescales. It actively learns from complaints and makes appropriate changes to improve the running of the home. there is good consultation and communication between management, staff and residents. The home manages nutrition well. It provides a varied and interesting menu, caters for choice and special diets and recognises the nutritional needs of those no longer able to make informed choices for themselves. Staffing levels and staff training at the home are good. Morale is very good and staff express high levels of job satisfaction. Documentation is of a high standard. Lawrence House H56-H05 S37880 Lawrence House V232124 210705 Stage 4.doc Version 1.40 Page 6 What has improved since the last inspection? 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. Lawrence House H56-H05 S37880 Lawrence House V232124 210705 Stage 4.doc Version 1.40 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 Lawrence House H56-H05 S37880 Lawrence House V232124 210705 Stage 4.doc Version 1.40 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) 1,2,3,4,5&6 The statement of purpose and the service user guide are comprehensive and good. The residents and their supporters know what to expect from the home. The needs of prospective residents are for the most part, properly assessed and only those suitable to the home are admitted. However, a recent exception gave cause for concern. The home provides excellent intermediate care and works positively towards rehabilitation and independence. EVIDENCE: Inspection of documentation shows that it is clear and understandable. The residents are clear about what to expect form the home and said that it meets their needs very well. The standard of pre-admission documentation is good and all the residents at the time of inspection were appropriate to the home and were receiving the care and support they needed. However, the home had recently admitted a resident who was out of category, as an emergency. The CSCI had been informed that authorisation for this admission had been given at a high level of Lawrence House H56-H05 S37880 Lawrence House V232124 210705 Stage 4.doc Version 1.40 Page 9 management within Kent County Council, but without full understanding of the case, its implications or the Care Standards Act 2000. This admission of a very disturbed person not only put other residents and staff at risk but was unhelpful to the individual concerned. The home must ensure that it does not allow a similar breech of the Care Standards Act to reoccur. Conversation with residents who were staying in the home for intermediate care confirmed that they are receiving good rehabilitive therapy. The said that they were very pleased with their progress and the way the home is supporting them to regain their independence. The home has a high success rate of enabling intermediate care residents to return to their own homes. Lawrence House H56-H05 S37880 Lawrence House V232124 210705 Stage 4.doc Version 1.40 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 The health and social needs of the residents are well provided for by the home. Personal support is offered in a way that protects the privacy and dignity of the residents and promotes their independence. There are clear and comprehensive systems for the management and administration of medicines and the home promotes good health EVIDENCE: Both direct and indirect observation showed that the residents are spoken to in a respectful and kindly way. Staff offered personal care in a discreet and sensitive manner. Health and social needs are clearly identified and documented. Residents said that they appreciate the way the home helps them make sure they have their medication and records show that appropriate healthcare appointments are made and supported. Inspection of the storage of medicines and observation of the evening medication administration showed that all proper precautions are taken. Medicines are stored appropriately and the temperature at which they are stored is monitored daily. The home has a room specifically for the storage Lawrence House H56-H05 S37880 Lawrence House V232124 210705 Stage 4.doc Version 1.40 Page 11 and management of medicines. There is a wash hand basin in this room. In addition, information about the various medicines and their side effects is stored in this room. The medicine trolleys were seen to be clean and well organised and recording is meticulous. Lawrence House H56-H05 S37880 Lawrence House V232124 210705 Stage 4.doc Version 1.40 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) 13,14&15 The home fosters good relationships with family, friends and other supporters. It promotes the well-being, independence and autonomy of the residents and helps them to maintain control over their lives. There is a good understanding of the meaning of informed choice and how to offer choice. The home puts good nutrition as a high priority and offers a varied and nutritious diet, it also caters for special diets. EVIDENCE: Responses to the relatives’ questionnaires were very positive. They said that the staff at the home are always helpful, welcoming and understanding. The resident said that they knew the home would contact their families if necessary. On the day of inspection, news was breaking about more bombings in London and the residents were watching this on the television. Staff were sensitive in their conversations with the residents and it was noted that they checked gently to make sure none of the residents was worried about family who may have been involved. Likes and dislikes are recorded and choices are offered appropriately. The inspector was present at a mealtime and was able to observe the way in which food was offered. Lawrence House H56-H05 S37880 Lawrence House V232124 210705 Stage 4.doc Version 1.40 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 standard(s) 16&18 Staff have a good knowledge and understanding of Adult Protection issue. The residents and their relatives and friends know that their complaints will be listened to and acted upon. This protects the service users from abuse EVIDENCE: Adult Protection issues were discussed with staff. It was clear that they had received appropriate training and they were able to explain the procedures clearly to the inspector. Residents said that they had no complaints about the home and that the staff are very helpful, caring and kind. They know how to complain if necessary but said that they did not think it was likely to be necessary. Responses to relatives questionnaires all indicated that they know how to complain but again said they had never had cause to make a complaint. There has been one formal complaint since the last inspection. The complainant challenged the home’s policy for managing medicines brought into the home. Whilst it was found that the home’s policies and procedures for the management of medicines in the home are sound, the home realised that it needed to provide clearer explanations and written information for prospective residents and their relatives.. Therefore, the complaint was partially substantiated. An explanatory letter has now been drawn up and this is sent out to all new residents before they are admitted. The documentation pertaining to this complaint was examined. The complaint was dealt with promptly and within agreed timescales. The registered manager is commended for the professional way in which she dealt with this complaint and for the way in which she improved documentation following the complaint. Lawrence House H56-H05 S37880 Lawrence House V232124 210705 Stage 4.doc Version 1.40 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 standard(s) 19,20,21,22,23,24,25&26 The standard of the environment is very good. It provides the residents with a pleasant and homely place in which to live. EVIDENCE: A tour of the home was undertaken. All areas were found to be very clean and free from offensive odours. The home has plenty of bathrooms and toilets even though one bathroom is out of action at present. There are good facilities for bathing, including a Parker bath, hoists and walk in showers. There are good laundry facilities and a good system to ensure clothes are returned to the right resident. A number of bedrooms were inspected. These were found to be pleasant and homely. Residents are able to personalise their rooms and bring furniture and soft furnishings from home, providing they meets fire safety requirements. Lawrence House H56-H05 S37880 Lawrence House V232124 210705 Stage 4.doc Version 1.40 Page 15 The décor throughout the home is in good order, although some wallpaper is now rather dated and carpets in some areas are looking rather tired. Some rooms would benefit from redecoration and new carpeting in the halls would brighten up the home. Lawrence House H56-H05 S37880 Lawrence House V232124 210705 Stage 4.doc Version 1.40 Page 16 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) 27,28,29&30 There are good staffing levels and staff morale is high. There is good induction of staff and ongoing staff training. Staff have a good understanding of the residents’ support needs and good relationships exist between the manager, staff teams and residents. Recruitment policies and procedures are rigorous and ensure that all staff are appropriately vetted. EVIDENCE: Inspection of staff rosters, staff files and training matrix confirmed that all necessary checks have been carried out during the recruitment process and that a high level of training takes place in the home; that there are adequate staff numbers on duty at all times; and that appropriate training, including induction, statutory and specialist training, takes place and is recorded. There is a stable workforce and regular one-to-one staff supervision takes place. The home has recently developed a system to ensure that staff attend the specialist training that is pertinent to their specific area of work. Staff said that they valued the training opportunities and that they love working in the home. They were positive about the support and guidance they receive from the manager and their team leaders. Conversation with staff confirmed that they have a good understanding of the needs of the residents and good care practice. Lawrence House H56-H05 S37880 Lawrence House V232124 210705 Stage 4.doc Version 1.40 Page 17 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) 31,32,33,36,37&38 The registered manager has a clear development plan and a vision for the home that she has effectively communicated to the staff, residents and their supporters.. She is well supported by senior staff in providing clear leadership throughout the home. The home regularly reviews its performance and the residents benefit from a well run home. EVIDENCE: The registered manager, Mrs Caroline Hillen has many year experience in care home management and has achieved the NVQ level V. Discussion with her confirmed that she has a clear understanding of the needs of the staff and residents. She maintains documentation to a very high standard and there is clear evidence that she takes the views of staff and residents and their supporters into consideration. She manages change well and is valued by her staff. Staff said that they know that they can talk easily to her about any Lawrence House H56-H05 S37880 Lawrence House V232124 210705 Stage 4.doc Version 1.40 Page 18 concerns. They said that there is a good team system in place and for the most part, they talk about any concerns with their team leaders. Regular staff and resident meetings are held and minutes are taken. Staff said that they feel free to express their views both individually and in the meetings. They said that they can put forward ideas for improvements at these meetings and feel that their views are valued. Residents said that the home is well run and that they can talk to any of the staff if they have concerns. Policies and procedures are rigorous and kept up-to-date. Records are well maintained and health and safety at the home is given high priority. No health and safety hazards were noted during a tour of the home. Lawrence House H56-H05 S37880 Lawrence House V232124 210705 Stage 4.doc Version 1.40 Page 19 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 3 3 2 3 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 3 15 4 COMPLAINTS AND PROTECTION 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 4 3 3 x x 3 3 3 Lawrence House H56-H05 S37880 Lawrence House V232124 210705 Stage 4.doc Version 1.40 Page 20 no Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 3 Regulation 14(1)(ad) Requirement The registered persons must ensure that, in future, no resident is admitted to home without proper assessment and without consultation with registered manager. They must not, in future, over-ride her decisions. Written assurances in respect of this are required to be given to the CSCI. Timescale for action 30th August 2005 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 19 Good Practice Recommendations The home should undertake some re-decoration and fit new carpets in areas where the colours have faded. Lawrence House H56-H05 S37880 Lawrence House V232124 210705 Stage 4.doc Version 1.40 Page 21 Commission for Social Care Inspection 11th Floor, International House Dover Place Ashford, Kent TN23 1HU 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 Lawrence House H56-H05 S37880 Lawrence House V232124 210705 Stage 4.doc Version 1.40 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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