Inspection on 16/10/07 for Laywell House Ltd

This inspection was carried out on 16th October 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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

Laywell House Ltd 06/06/07

Laywell House Ltd 15/11/06

Laywell House Ltd 29/11/05

Laywell House Ltd 07/06/05

Laywell House Ltd 18/01/05

Laywell House Ltd 09/06/04

Laywell House Ltd 02/03/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Laywell House Ltd Laywell House Summer Lane Brixham Devon TQ5 0DL Lead Inspector James Rose Unannounced Inspection 16th October 2007 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Laywell House Ltd DS0000018384.V352830.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. Laywell House Ltd DS0000018384.V352830.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Laywell House Ltd Address Laywell House Summer Lane Brixham Devon TQ5 0DL 01803 853572 01803 853572 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) Laywell House Limited ****Post Vacant**** Care Home 30 Category(ies) of Old age, not falling within any other category registration, with number (30), Physical disability over 65 years of age of places (30) Laywell House Ltd DS0000018384.V352830.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: (30) Old age not falling into any other category. (30) Physical disability over the age of 65 years. Date of last inspection 6th June 2007 Brief Description of the Service: Laywell House is a large extended detached residence that has two stories and stands in its own grounds. The home offers 24-hour residential care for up to 30 persons in the category of Old Age and Physical Disability over the age of 65 years. The home has available four separate communal lounge areas and a dining room. There are 28 single rooms and 1 double, 12 of the single rooms have on suite facilities. Two vertical lifts are provided and bathing and toileting aids are available for persons with mobility issues. At the front of the building there is a hard standing car park, which has the capacity to take several vehicles. At the rear of the home there is a large well-tended garden, which has views of the surrounding area. There are also productive vegetable and fruit plots that supply the home. Access into the building is by a single step; a folding ramp is available for use when required, all other entrances into the building are level. The weekly fees payable are: lowest £330.00 and the highest is £400.00. Laywell House Ltd DS0000018384.V352830.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was undertaken over 10 hours. Samples of the care records were examined and six residents were consulted about life at the home. Evidence was also taken from returned relatives questionnaires, and healthcare professionals that provide a service to the home were asked for their views. A complete tour of the building was undertaken and three carers were also interviewed. The way care was delivered was observed and the new proposed registered manager assisted throughout the inspection process. What the service does well: What has improved since the last inspection? What they could do better: Since the time of the last inspection the then registered manager has retired and a new proposed registered manager is in post. There has been a substantial administration task to be completed and this has been started. This was discussed with the Chairperson of the Committee of the home who has undertaken to ensure that the manager has enough time to ensure these tasks are completed without delay. Laywell House Ltd DS0000018384.V352830.R01.S.doc Version 5.2 Page 6 The requirements raised in the last report are repeated here, these were discussed with the new proposed registered manager and she has undertaken to ensure they are given the highest priority. The outstanding requirements are: To ensure that new assessments are carried out on all residents and appropriate individual care plans are provided along with the necessary risk assessments. The registered manager must ensure that all staff that administers medication in the home follows the correct procedure. The registered manager must ensure that all care staff receive formal supervisions a minimum of six times per year. The registered manager must ensure that monthly reviews are carried out on all care plans. The registered manager must ensure that all new carers received basic training. The registered manager must undertake to provide a quality assurance system and quality monitoring systems in the home. A recommendation was made in the last report that the home should review residents to ensure the registration of the categories accurately reflects the service provided. This was discussed in detail with the new manager who is going to ensure this process is undertaken at the same time as her registration is carried out with the Commission. 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. Laywell House Ltd DS0000018384.V352830.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Laywell House Ltd DS0000018384.V352830.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6. Quality in this outcome area is adequate. Some of the assessments in place of residents needs did not contain all the information needed for the care planning process. Standard 6 refers to a service not provided at Laywell House. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Laywell House has a new manager in post who hopefully is about to be registered. The outstanding work to reassess all the residents in the home to ensure all their needs are known is about to be undertaken. This will ensure that the service provided for each individual is appropriate. Currently the home has the original assessments available although incomplete will inform the care planning process until replaced. New residents are only admitted on the basis of a comprehensive assessment being completed to ensure an appropriate service can be provided to meet those needs. Laywell House Ltd DS0000018384.V352830.R01.S.doc Version 5.2 Page 9 If a resident were admitted on an emergency basis an assessment would be undertaken by the home as a matter of priority. Standard 6 refers to a service not provided at Laywell House. Laywell House Ltd DS0000018384.V352830.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is adequate. The care planning undertaken by the home did not cover all the residents’ needs and some risk assessments were missing. Care plans had not been reviewed. Residents are able to self medicate. The administration of medication in the home has improved but there are still some difficulties. Residents felt they are always treated with respect and their privacy is maintained. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The new manager in the home is about to provide new care plans that will be informed by the reassessments being undertaken of all the residents in the home. This process will include a review of all the risk assessments to ensure that each resident is safe. The new care plans will then be subject to a monthly review as required. The requirements raised in the last report covering the above will be repeated here to ensure this is achieved. Currently the home continues to function with the existing care plans with the deficits well known to the care team who will make the necessary adjustments. Laywell House Ltd DS0000018384.V352830.R01.S.doc Version 5.2 Page 11 Three healthcare professionals that provide a service to the home were consulted as part of this inspection process and they advised that the service at the home was much improved and they had no concerns. The recordings undertaken by the home of the administration of medication were examined at this inspection and these were found to be incomplete. The requirement concerning the correct administration of medication has been repeated in this report. Six residents were consulted individually as part of the inspection process, they All advised that they were very happy with life at Laywell House and advised that they felt they were always treated with respect and care was taken to ensure their privacy was maintained. One resident remarked, “This couldn’t be better for me” and another advised, “We are very well looked after and I enjoy the food”. All the residents consulted during the inspection advised that all their needs were met by the home. Laywell House Ltd DS0000018384.V352830.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is adequate. The home meets residents’ needs where these are known. Residents advised that they enjoyed life at the home and felt they were in control of their lives and they could maintain contact with family and friends. All the residents advised that they were very happy with the food provided at the home and the facilities of the dining room. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Six residents were consulted individually and other residents were seen in groups and they all advised that they liked the life at the home and praised the care team and the meals provided. From observations made during the inspection it was clear that care was delivered in a sensitive way to residents and they were encouraged to make their own decisions. When asked questions by staff residents were given time to consider and respond to carers. Residents confirmed when asked that they could change mealtimes and cleaning times of their rooms if they wished. Residents felt that they had control over decisions that affected them and the staff had their confidence Laywell House Ltd DS0000018384.V352830.R01.S.doc Version 5.2 Page 13 Three visitors were also asked for their views of the service on the day of the inspection and they were all very complimentary and felt that their relatives were well cared for. The home has an unrestricted visiting policy in place and visits confirmed that they were always made welcome. Residents praised the quality of the food provided at the home. A varied menu was available that offers choice and meals are taken in a spacious dining room that is easily able to accommodate wheelchairs and walking aids. Laywell House Ltd DS0000018384.V352830.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is good. Residents and visitors were confident that any issues raised would be dealt with appropriately to their satisfaction. Service users are protected from all types of abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Laywell House has a comprehensive complaints procedure in place. Six residents and three visitors were consulted during the inspection and all were confident that if they raised an issue it would be taken seriously and a resolution found without delay. The home has available a policy and procedure concerning adult protection that is based on the Department of Health Guidelines ‘No Secrets’, this includes an element on whistle blowing. This issue is taken seriously by the home and they have had printed their own booklets which forms part of the home’s training to the care staff team to ensure residents are safe. Three carers were interviewed individually in private and they all clearly understood the range of abuse that is possible and what action should be taken if it was found. Laywell House Ltd DS0000018384.V352830.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26. Quality in this outcome area good. Laywell House provides a safe, comfortable and well-maintained environment for the residents who live there. The home is clean and pleasant throughout with high standards of hygiene apparent. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A complete tour of the home and grounds was undertaken as part of the inspection process. All the bedrooms were seen and no malodour was apparent. The home has an active maintenance programme running and bedrooms are redecorated if needed when they become available. Since the last inspection three residents bedrooms have been redecorated and new carpets were fitted. Currently the first floor landing is being redecorated. Six residents were consulted as part of the inspection process and they advised that they were very happy with their rooms and the communal facilities available in the home. Laywell House Ltd DS0000018384.V352830.R01.S.doc Version 5.2 Page 16 Laywell House Ltd DS0000018384.V352830.R01.S.doc Version 5.2 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 consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is adequate. There are always sufficient numbers of carers available to meet the needs of the residents. The home ensures that residents are protected by having appropriate recruitment practices undertaken. There is a satisfactory training programme planned and the new manager is ensuring that all basic training is undertaken. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a core of experienced carers available and they can undertake further training when they wish. A requirement was raised in the last report concerning the basic training of carers and this has been repeated here to ensure this is achieved. Currently the new manager is arranging the necessary courses The new manager is currently ensuring that formal supervision sessions are undertaken with all carers. A requirement has been repeated in this report to ensure this is completed. The home has an appropriate policy and procedure for the recruitment of new staff, four files were examined and all clearances and references were in place to ensure the safety of residents. Three carers were interviewed individually and in private during the inspection, they were all clear on the types of abuse that can be found and what action should be undertaken if abuse was discovered. Laywell House Ltd DS0000018384.V352830.R01.S.doc Version 5.2 Page 18 All the residents consulted were very complimentary about the staff at the home and one said, “You can always get one of them (carers) to help you” and another remarked “The staff are very good and they go at your pace not theirs”. Laywell House Ltd DS0000018384.V352830.R01.S.doc Version 5.2 Page 19 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, 35 and 38. Quality in this outcome area is adequate. The new manager has a good and full understanding of the changes required in order to make the necessary improvements, however, it is too soon for results to be fully apparent. Consultation takes place with residents and the home is run in their interest. Residents’ financial interests are appropriately safeguarded. Health and safety issues are given priority and are promoted. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Laywell House has a new manager in post since the last inspection and she is currently about complete the registration process with the Commission. She has taken over this role when there are several outstanding requirements and she is now going to give these priority. The home has a new quality assurance system available and the new manager is introducing this shortly. Residents have filled out questionnaires in the past Laywell House Ltd DS0000018384.V352830.R01.S.doc Version 5.2 Page 20 and residents meetings are undertaken; consultation is also carried out individually. The home assists some of the residents with the administration of their pocket monies. Four of the records of these transactions were examined and found to be correct and the cash available was correct. Receipts are retained for any expenditure undertaken on behalf of a resident. This system ensures that residents are appropriately protected. The health, safety and welfare of residents and staff are given a high priority by the manager of the home. The fire precautions undertaken and recorded were up to date and complete. Secure storage is provided for cleaning chemicals and the appropriate regulations followed. Any dangerous occurrence that takes place in the home is reported as required and the water supply is tested for unwanted bacteria. Laywell House Ltd DS0000018384.V352830.R01.S.doc Version 5.2 Page 21 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 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 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 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Laywell House Ltd DS0000018384.V352830.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation 15 Requirement The registered manager must ensure that each resident in the home has a care plan that has the residents health, personal and social care needs set out in an individual plan of care. The registered manager must ensure that all staff adheres to the homes policy and procedures for the correct administration of medication. The registered manager must ensure that all care staff receive formal supervisions a minimum of six times per year and the areas covered are: All aspects of practice; Philosophy of care in the home. Career development needs. The registered manager must ensure that comprehensive assessments are undertaken of proposed residents needs in the areas of health, personal and social. The registered manager must DS0000018384.V352830.R01.S.doc Timescale for action 12/11/07 2. OP9 13 24/10/07 3. OP36 18 30/11/07 4. OP3 14 12/11/07 5. OP7 15 12/11/07 Page 23 Laywell House Ltd Version 5.2 6. 7. OP7 15 18 OP38 8. OP33 12 ensure that comprehensive risk assessments are undertaken for each resident in the home and these are added to the care plan. The registered manager must 30/11/07 ensure that monthly reviews are undertaken of all care plans. The registered manager must 30/12/07 ensure that all new carers receive training in: (a) moving and handling (b) fire safety (c) first aid (d) food hygiene (e) infection control The registered manager must 30/12/07 ensure there is effective quality assurance and quality monitoring systems in place in the home. 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 OP33 Good Practice Recommendations The registered manager should review the needs of residents in the home to ensure the registration of categories accurately reflects the service provided. Laywell House Ltd DS0000018384.V352830.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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. 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