Inspection on 07/06/05 for Laywell House Ltd

This inspection was carried out on 7th 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.

Other inspections for this house

Laywell House Ltd 16/10/07

Laywell House Ltd 06/06/07

Laywell House Ltd 15/11/06

Laywell House Ltd 29/11/05

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 TQ5 0DL Lead Inspector James Rose Announced 7 June 2005 th 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. Laywell House Ltd D54_D07 S18384 Laywell House V221686 070605 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service Laywell House Address Laywell House, Summer Lane, Brixham, Devon, TQ5 0DL 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) 01803 853572 01803 853572 Laywell House Limited Mrs Jennifer Victoire Dewaele Murray 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 D54_D07 S18384 Laywell House V221686 070605 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 18/01/05 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. Smoking is possible in one of the smaller lounges. There are 26 single rooms and 3 doubles, 8 of the single rooms and 1 of the double 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. Laywell House Ltd D54_D07 S18384 Laywell House V221686 070605 Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place over 6 hours on 7th June 2005. A pre inspection questionnaire had been received from the manager. A complete tour of the home was undertaken inside and out, a sample of staff and care records were examined. Seven residents were asked for their views of life at the home; this was undertaken in private and three carers were also consulted and the district nurse. The inspection was undertaken with the assistance of the registered manger and two members of the home’s committee. What the service does well: What has improved since the last inspection? New fire doors have been fitted to all the rooms in the new wing of the home and these have appropriate locks and closure devices. The refurbishment of the home continues and two bathrooms have been completely refitted and two of the on suits. Laywell House Ltd D54_D07 S18384 Laywell House V221686 070605 Stage 4.doc Version 1.20 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Laywell House Ltd D54_D07 S18384 Laywell House V221686 070605 Stage 4.doc Version 1.20 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 Laywell House Ltd D54_D07 S18384 Laywell House V221686 070605 Stage 4.doc Version 1.20 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) 1,3 and 6 The home provides appropriate information to enable an informed choice to be made about admittance by prospective residents. Detailed assessments are undertaken to ensure that all a persons needs can be met at the home. EVIDENCE: Detailed up to date information is provided to all prospective service users to enable them to make an informed decision about being admitted into the home. Comprehensive assessments were undertaken by the home to ensure that all the needs of the person could be met at Laywell House. Three assessments were examined during the inspection and seven residents were asked for their views and they confirmed that this process was undertaken and that their needs were well met at the home. Standard 6 refers to a service not provided at Laywell House. Laywell House Ltd D54_D07 S18384 Laywell House V221686 070605 Stage 4.doc Version 1.20 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) 7.8.9 and 10 Comprehensive care plans are available for each person receiving care. Health and social needs are met and appropriate procedures are in place for the administration of medication. Storage for controlled drugs needs to be expanded. Service users were treated with respect and their privacy was maintained at the home. EVIDENCE: An individual care plan was available for each person receiving a service at the home; these provided a foundation for the care provided. The plans have been developed further since the last inspection and these were discussed with the manager who advised that they intend to introduce a complete new system based on a nationally approved approach to ensure that all details are available to provide the appropriate care to residents. The home has in place an appropriate policy and procedure to ensure the correct administration of medication. Records were checked and were found to be correct and confirmed that residents were safe. The way medication was held was examined and some medication subject to the controlled process was found that did not have storage that was appropriately secure to meet the legislation. It is a requirement of this report that the home must provide a Laywell House Ltd D54_D07 S18384 Laywell House V221686 070605 Stage 4.doc Version 1.20 Page 10 facility that is able to store all controlled medication under suitable secure conditions to ensure residents safety. Seven residents were consulted during the inspection and they all confirmed that they had access to healthcare professionals when required and that they were always treated with respect and had their privacy maintained. One resident said “I have never been so well treated” and another advised, “ I can’t think of anything that would improve my life here”. The district nurse was also asked for her views and she stated that the home had the confidence of the nursing service. The way care was delivered was observed on many occasions during the inspection and it was clear that service was provided in a sensitive way, residents were given time to make decisions and were not rushed when mobile and their privacy was preserved when toileting and bathing. Carers were also seen to knock on doors before entering a resident’s room. Laywell House Ltd D54_D07 S18384 Laywell House V221686 070605 Stage 4.doc Version 1.20 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,14 and 15 The lifestyle experienced at the home was to residents liking. Contact was maintained with family and friends and residents were assisted when making decisions and exercising choice and control. A good quality balanced diet is provided and meals are taken in pleasing surroundings that are convenient. EVIDENCE: Seven residents were consulted in private about their life at Laywell House, they were open in their replies and were well able to express their views. They all advised that they enjoyed the lifestyle and were able to join in the activities offered or not as they wished. No resident could suggest any additions to the activities undertaken that they would like. One residents remarked “what more could I want?” A harpist regularly performs at the home and weekly crafts, occupational therapy and bowling are some of the activities undertaken. The home has an unrestricted visiting policy and procedure and residents confirmed that they were able to have their visitors at anytime. Residents also 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 management of the home and the staff had their complete confidence. Laywell House Ltd D54_D07 S18384 Laywell House V221686 070605 Stage 4.doc Version 1.20 Page 12 The meals provided at the home were praised by residents they were quick to advise that fresh produce was used from the home’s own garden. Vegetables, salad and soft fruit is available in season, this facility was praised by five of the seven residents consulted. A varied menu is available that offers choice and residents were unable to make any suggestions concerning additional foods. Meals are taken in a spacious dining room that is easily able to accommodate wheelchairs and walking aids. Laywell House Ltd D54_D07 S18384 Laywell House V221686 070605 Stage 4.doc Version 1.20 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) 16,17 and 18 The home gives an appropriate response to complaints and residents’ legal rights are protected and they are also protected from abuse. EVIDENCE: The home has available a comprehensive complaints procedure that includes an appropriate timescale. Seven residents were consulted and all were confident that if they raised an issue with the manager it would be taken seriously and a resolution would be found without delay. Residents are offered a postal vote at election time or if preferred the home will provide transport to the local polling station. The home has available a policy and procedure to protect residents concerning abuse that is based on the Department of Health Guidelines No Secrets and this includes an element on whistle blowing. A training video is also available and the alerters guide. This issue is taken seriously by the home and they have also 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 in private and they all clearly understood the range of abuse and the home’s procedure to be adopted if required. Laywell House Ltd D54_D07 S18384 Laywell House V221686 070605 Stage 4.doc Version 1.20 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 and 26 The home is safe and well maintained. The way a new hoist has been fitted requires attention as it represents a danger to residents. Laywell House provides a pleasant, clean and hygienic environment for residents. EVIDENCE: A complete tour of the building and grounds was undertaken during the inspection to ensure a safe environment was provided for residents. The home was well maintained and two bathrooms had been completely refurbished since the last inspection. One of the pillar hoists that had recently been fitted in a bathroom had exposed hexagonal nuts on the base plate; these are a danger to residents and should be covered. A requirement has been called for in this report to achieve this. The home was found to be clean and hygienic throughout, all cleaning chemicals are appropriately stored to provide a safe environment. Laywell House Ltd D54_D07 S18384 Laywell House V221686 070605 Stage 4.doc Version 1.20 Page 15 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 and 30 Laywell House has an experienced care staff team that are appropriately trained. The home takes appropriate precautions when recruiting new personnel. EVIDENCE: The home has a stable core of very experienced, well trained carers available. Carers are encouraged to undertake further training and this is rewarded financially by the home, this approach provides a well informed, up to date care team for residents. The home has an appropriate policy and procedure for the recruitment of new staff, three 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. These staff were found to be well qualified and understood the policies and procedures of the home this ensured residents were in experienced, competent hands. Residents that were consulted stated that they found all the staff to be “considerate and helpful and always willing to assist”. It was clear from observations made during the inspection that residents were given time to answer questions and were not rushed when they were walking around the home. Laywell House Ltd D54_D07 S18384 Laywell House V221686 070605 Stage 4.doc Version 1.20 Page 16 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33,35 and 38 Laywell House is run in the best interests of residents and their financial interests are appropriately administered. Health and safety issues are paid due regard at the home. The recent fitting of a new bathroom hoist requires some attention and the storage of controlled medication. EVIDENCE: The seven residents consulted during the inspection were very complimentary about the manager of the home and said she had their complete confidence. One resident said “I always know I can rely on the manager to sort things for me if necessary”. One resident who had recently been through a traumatic event went out of her way to say “I don’t know what I would have done without the managers support”. The home gives support to residents with their pocket money but does not get involved in other financial affairs. Five of the records of residents’ pocket Laywell House Ltd D54_D07 S18384 Laywell House V221686 070605 Stage 4.doc Version 1.20 Page 17 money were examined and were found to be clear, up to date and accurate. These records were then checked against the actual monies held for the resident concerned to ensure that the system was appropriate. Health and safety issues were inspected and were found to be correct and in line with the legislation to ensure residents and staff safety. Harmful chemicals had secure storage and all equipment in the home had regular maintenance. The water system was also regularly tested for unwanted bacteria to ensure it was safe for residents’ use. A new hoist had recently been fitted in a bathroom and needed the nuts on the base place to be covered to ensure the safety of residents and a requirement has been raised. The storage of medication subject to the controlled process needs to be expanded to ensure that all medication has appropriate storage for the safety of residents and a requirement has been made for this to be achieved. Laywell House Ltd D54_D07 S18384 Laywell House V221686 070605 Stage 4.doc Version 1.20 Page 18 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. Where there is no score against a standard it has not been looked at during this inspection. 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 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 4 COMPLAINTS AND PROTECTION 2 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 3 3 x x 3 x x x x 2 Laywell House Ltd D54_D07 S18384 Laywell House V221686 070605 Stage 4.doc Version 1.20 Page 19 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 OP9 Regulation 13 Requirement Timescale for action 14/06/05 2. OP38 23 The registered manger must ensure that there is appropriate secure storage for all medication subject to the controlled process. The registered manager must 14/06/05 ensure that the exposed hexagonal nuts on the bathroom hoist base plate are apporpriately covered. 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 OP7 Good Practice Recommendations The registered manger should ensure that the new care planning process is completed as soon as possible. Laywell House Ltd D54_D07 S18384 Laywell House V221686 070605 Stage 4.doc Version 1.20 Page 20 Commission for Social Care Inspection Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 Laywell House Ltd D54_D07 S18384 Laywell House V221686 070605 Stage 4.doc Version 1.20 Page 21 - 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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