Inspection on 23/10/07 for Lennox House Care Home

This inspection was carried out on 23rd October 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Lennox House Care Home 03/12/08

Lennox House Care Home 24/06/08

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

CARE HOMES FOR OLDER PEOPLE Lennox House Care Home 75 Durham Road London N7 7DS Lead Inspector Janet Pitt Key Unannounced Inspection 23rd October 2007 10:10 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 Lennox House Care Home DS0000069788.V350406.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. Lennox House Care Home DS0000069788.V350406.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Lennox House Care Home Address 75 Durham Road London N7 7DS 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) 020 7272 6562 0207 561 3638 manager.lennox@careuk.com Care UK Community Partnerships Ltd Sheila Ali Care Home 87 Category(ies) of Dementia (56), Old age, not falling within any registration, with number other category (87) of places Lennox House Care Home DS0000069788.V350406.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The Registered Person may provide the following categories of service only: Care home with Nursing - Code N to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories; Old Age, not falling within any other category - Code OP 2. Dementia - Code DE (maximum number of places: 56) The maximum number of service users who can be accommodated is: 87 N/a Date of last inspection Brief Description of the Service: Lennox Lodge is situated in Finsbury Park, in residential area. Good transport links are within walking distance from the home. There is pay and display parking on the street that Lennox Lodge is situated in. The home was purpose built as a care home and provides accommodation over three floors. There are communal lounges on each floor and all bedrooms have ensuite facilities. Lennox House Care Home DS0000069788.V350406.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Two inspectors undertook the site visit on this unannounced inspection. Staff files, care documentation and a brief tour of the premises was undertaken. The home provided CSCI with their Annual Quality Assurance Assessment (AQAA), which gave their perspective on how the home is run. Inspectors were able to talk with the manager and some members of staff. Lunchtime was observed and three residents were spoken with during this time. The site visit lasted a total of six hours. What the service does well: What has improved since the last inspection? What they could do better: Lennox Lodge has made a positive start to making people who live there feel it is their home. This needs to be continued by improvements in assessments and care planning. People who live in the home need to be consistently involved in this process to enable them to make decisions about their lives. Staff need to be aware that people who live at Lennox Lodge have choice in how they spend their day. Emphasis is needed on making sure that interests and hobbies are developed and maintained. Staff must treat people with respect at all times. Mealtimes need to be a social occasion in which people are able to relax and have control over what is happening to them. Lennox House Care Home DS0000069788.V350406.R01.S.doc Version 5.2 Page 6 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. Lennox House Care Home DS0000069788.V350406.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 Lennox House Care Home DS0000069788.V350406.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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People’s assessments need to be consistently completed to make sure all needs are identified. Care has been taken to make sure that admission to the home are planned and appropriate. EVIDENCE: Some people who live in the home were transferred from another home that was closed. The manager reported that these people were able to visit prior to moving in. People were given a choice of room and décor. Lennox Lodge is undertaking a slow admission process to make sure that there is stability for people who live there. The manager anticipated that the home would be full in about six months time. Assessment of needs are undertaken prior to and on admission. Lennox House Care Home DS0000069788.V350406.R01.S.doc Version 5.2 Page 9 The pre admission assessment included: the persons reason for admission, religion, diet, vision, hearing, communication, medical history, medication, and preferred gender of support worker. There was also information on significant others in their lives. One person has a civil relationship, but this was not detailed fully. It was noted that if the dependency and initial assessment were completed fully, there would be good details of how to plan to meet a person’s needs. Lennox House Care Home DS0000069788.V350406.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, 10 and 11 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Specific detail in care planning would enable peoples needs to be met consistently. People choices need to be reflected in all aspects of their plans. Good medication procedures protect people from harm. EVIDENCE: Peoples care plans were seen to lead from the assessment of need. More detail is needed to make sure that needs can be met consistently. There was some information on person preferences, but this should be evident across all plans. Risk assessments were in place for manual handling, falls and nutrition. Information on a person’s medication was also included. Lennox House Care Home DS0000069788.V350406.R01.S.doc Version 5.2 Page 11 One care plan examined evidenced an understanding of the holistic needs of the person. The plan included: mobility, challenging behaviour, independence/choice, spirituality, activities and personal care. There was evidence of assessment and condition of skin integrity. Information on behaviour needs to be detailed. ‘sometimes aggressive to staff’, does not enable appropriate interventions to be made. Bland information on care plans does not enable consistent care to be given. A person’s night care was assessed. There was some good information present on preferred routine, sleeping pattern and behaviour. A few plans evidenced a person centred approach, i.e. makes own bed, times for continence care. The person or their representative was not always involved in the formation of the plan. Evidence is needed of involvement of the person and their representatives. People’s wishes in relation to end of life care and death and dying must be recorded to make sure that their views are respected and acted upon. People who live in the home are protected from harm by medication procedures. It was noted that medications were stored securely; there were no gaps in the administration record. Only three record sheets did not detail any known allergies. The policy relating to covert medication must be reviewed to demonstrate what steps must be taken and who is involved in the decision to administer medications covertly. It is important that this policy gives guidance in line with the Mental Capacity Act. Daily records evidenced good information on how a person spent their day, this should continue. People who live in the home are able to access other health care professionals, such as doctors, when necessary. Lennox House Care Home DS0000069788.V350406.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. This judgement has been made using available evidence including a visit to this service. People who live in the home must be treated with respect and staff need to make sure that there is choice over events within the home. Mealtimes need improvement to make sure they are a social occasion. People who live in the home are able to receive visitors and access the local community. However, activities must be developed in line with peoples wishes. EVIDENCE: One person said that they like it at the home. The person commented that they are able to have visitors often. During the meal that was observed it was noted that more could be done to make the time a social event. Staff need to be aware of how they communicate with people who live in the home. Comments overheard included: ‘put bib on you’ which the person did not want. ‘Don’t mess up clothes’. A member of staff tried again to put bib on, another member of staff said [they] refused and they [the staff] would have to Lennox House Care Home DS0000069788.V350406.R01.S.doc Version 5.2 Page 13 change [them in the afternoon]. This does not evidence that people who live in the home are being treated as adults. There was limited evidence of choice being offered. Fluids were available, but there was no choice offered. Soup was served but there was no explanation of what kind it was. One person did not want to be near the table and kept pushing their chair away, but staff would put the chair nearer the table. Staff were seen standing up to assist people to eat and were talking with other people who live in the home across the dining room. The pudding from the published menu had changed; staff explained it as a chef’s surprise. A member of staff was doing a medication round during lunch. Televisions were left on during lunch and also in the afternoon when people were not watching it and were taking a nap. One person was escorted to a chair by staff despite wanting to sit in a different place. This person was unsettled until an inspector asked staff to support the person to sit in the place where they wanted to be. Staff must make sure that people who live in the home have choice in what they do. Limited information was available in plans on Lifestyle and Interests. One plan detailed that the person who lived in the home was single and ‘has a civil relationship’. There were very brief details on their life, interests and important events, which does not give a picture of who they are. Significant events/dates in life need to be documented. One person said birthdays are important, but no dates were available. Significant relationships and expressions of sexuality need to be addressed. The home employs a full time activities organiser. The activities co-ordinator spoke with the inspectors and demonstrated a good knowledge of learning about people as individuals. This must continue to be developed to make sure that activities provided reflect interests. Lennox House Care Home DS0000069788.V350406.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. This judgement has been made using available evidence including a visit to this service. People who live in the home can be confident that any concerns they have will be taken seriously and acted upon. They are protected from harm by Safeguarding Adults procedures. EVIDENCE: The manager reported that there have been three complaints. The complaints log evidenced that these had been investigated and there were outcomes present. There was one potential Safeguarding Adults investigation regarding staff behaviour in front of a person in the home. This was being dealt with at time of site visit. The AQAA stated that the home has an accessible complaints policy and people who live in the home are able to access an advocacy service. The AQAA also mentioned that an area for improvement is acknowledging that people have a right to raise concerns and the home has a duty of care to make sure people are happy with service provision. This is being addressed through training of staff. Lennox House Care Home DS0000069788.V350406.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 is good. This judgement has been made using available evidence including a visit to this service. People live in a home, which is clean, tidy and maintained. Emphasis is now needed to make Lennox Lodge a home. EVIDENCE: A brief tour of the premises was undertaken. Each person has a single room with ensuite facilities. Bedrooms were sparse with few personal items. There are appropriate communal areas for people to sit in. The environment was clean and tidy, the home should focus on making the building a ‘homely environment’ to live in. Lennox House Care Home DS0000069788.V350406.R01.S.doc Version 5.2 Page 16 Some small but significant changes have been made to the home, to enable people to identify particular rooms: different coloured handles on toilets/bathrooms. The AQAA states that when guarantees on equipment expires a system for contracted services will be implemented to make sure that appropriate checks are carried out routinely. Lennox House Care Home DS0000069788.V350406.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 good. This judgement has been made using available evidence including a visit to this service. People who live in the home are supported by suitably qualified staff. The recruitment process is thorough and appropriate checks are in place on employees. Training programmes are being targeted to make sure staff have the skills to meet needs. EVIDENCE: A good recruitment process makes sure that suitable staff are employed to care for people who live in the home. Staff files were selected randomly and examined. There was evidence that past employment had been explored and appropriate permissions to work are in place. References had been obtained from the previous employer and Criminal Records checks are carried out. Training programmes are being developed to make sure that staff have the necessary skills to meet people’s needs. All staff undergo induction training, which covers food safety, fire awareness and health and safety. Lennox House Care Home DS0000069788.V350406.R01.S.doc Version 5.2 Page 18 The manager is aware of the need to make sure that staff are appropriately supervised. She reported that senior staff have received supervision and this will be cascaded for all staff members. Lennox House Care Home DS0000069788.V350406.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 good. This judgement has been made using available evidence including a visit to this service. The manager of Lennox Lodge has a proactive approach to making a person centred home. Care must be taken to make sure that comments received from people who live in the home are acted upon when possible. EVIDENCE: The manager is a registered nurse who has worked in the community since 1994. The manager is supported by a suitably qualified team. The AQAA states that ‘residents’ meetings are held every two months and relatives meetings four monthly. There is a suggestion and comments box in the main reception. Lennox House Care Home DS0000069788.V350406.R01.S.doc Version 5.2 Page 20 The home has made a positive start in gathering views of people who live in the home. People who live in the home have recently been surveyed to see what they want, it is important to act on suggestions if it is possible, e.g. one person asked for a clock in a lounge, which has been provided, however requests for Yorkshire puddings with the Sunday Roast have not been fulfilled. The AQAA indicated that people are able to look after their own finances if they are capable. Records are maintained of any personal allowance managed by the home. No health and safety issues were identified at the time of the site visit. Lennox House Care Home DS0000069788.V350406.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 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 2 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 2 14 2 15 2 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 3 X X 3 Lennox House Care Home DS0000069788.V350406.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? N/a 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 OP3 Regulation 14 Requirement Assessments of people who live in the home must include sufficient detail to form an holistic view of that person’s need. People who live in the home must be involved in this process. This will make sure all needs are identified. Peoples care plans must lead from assessments, to make sure that all needs are addressed. People who live in the home must be involved in this process. Specific details of how needs are to be met is required, to make sure there is a consistent approach by staff. The policy on covert medications must be reviewed to demonstrate that there is a clear procedure in place. People who live in the home need to be given an opportunity to express their wishes for end of life care and dying. Activities provided by the home must reflect individual’s wishes and preferences. Staff must ensure that people DS0000069788.V350406.R01.S.doc Timescale for action 30/03/08 2 OP7 15 30/03/08 3 OP9 13 (2) 30/03/08 4 OP11 12 (2) 30/03/08 5 6 OP12 OP14 16 (2) (n) 12 (4) (a) 30/03/08 30/03/08 Page 23 Lennox House Care Home Version 5.2 7 OP15 12 (1) (a) who live in the home have choice in what they do and are treated with respect. This will make sure that people are treated as individuals. People who live in the home 30/03/08 must have the opportunity to enjoy meals that are a sociable occasion. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Lennox House Care Home DS0000069788.V350406.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Ilford Area office Ferguson House 113 Cranbrook Road Ilford Essex IG1 4PU 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 Lennox House Care Home DS0000069788.V350406.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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