Inspection on 10/05/05 for Lennox Wood

This inspection was carried out on 10th May 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Lennox Wood 04/12/07

Lennox Wood 16/01/07

Lennox Wood 24/07/06

Lennox Wood 31/10/05

Lennox Wood 17/01/05

Lennox Wood 24/11/03

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

CARE HOMES FOR OLDER PEOPLE Lennox Wood Petham Green Gillingham Kent ME8 6SY Lead Inspector Sue McGrath Unannounced 10 May 2005 10:00 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. Lennox Wood H56-H06 S28942 Lennox Wood V223506 100505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Lennox Wood Address Petham Green Gillingham Kent ME8 6SY 01634 869880 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) Kent Community Housing Trust Glynis Margaret Bingham Care Home only 50 Category(ies) of DE(E) Dementia - over 65 (50) registration, with number of places Lennox Wood H56-H06 S28942 Lennox Wood V223506 100505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Fifty (50) Older People with a Mental Infirmity 60 years of age and over Date of last inspection 17 January 2005 Brief Description of the Service: Lennox Wood is purpose built on two floors with a basement that is used as separate offices and for training. There is a courtyard garden in the centre of the quadrangle building, which is still under construction to make it more suitable for use by the service users.The home is situated in a residential area close to local shops and amenities. There are local bus routes nearby. Gillingham and Chatham town centres are approximately 2 miles away where there are main line stations. The service also benefits from its own transport.The home has 46 single rooms and 2 shared rooms, none have ensuite facilities. To support care staff there are additional staff employed to undertake regular activities with service users. Lennox Wood H56-H06 S28942 Lennox Wood V223506 100505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on the 10th May 2005 between 10.00 and 13.30. Two inspectors were in the home and the main focus of the inspection was on the progress of the home in meeting with requirements made at the last inspection, the general environment and the well being of the residents. During the course of the inspection many Residents were spoken with, as were several family members who were visiting. What the service does well: What has improved since the last inspection? Some leaking taps had been replaced. Lennox Wood H56-H06 S28942 Lennox Wood V223506 100505 Stage 4.doc Version 1.30 Page 6 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. Lennox Wood H56-H06 S28942 Lennox Wood V223506 100505 Stage 4.doc Version 1.30 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 Lennox Wood H56-H06 S28942 Lennox Wood V223506 100505 Stage 4.doc Version 1.30 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, 4, 5, 6 The homes Statement of Purpose and Service User Guide does not reflect the current physical environment of the home, but does provide prospective residents and their relatives with the information they need regarding levels of care and the philosophy of the home, to make an informed decision about moving into the home. EVIDENCE: The Statement of Purpose and Service User Guide were seen, which provided comprehensive and detailed information about the service as required by the regulations. Both documents were presented in a clear and concise format. Copies of both documents are given to all residents prior to admission and are readily accessible via the manager. The home is currently in the process of updating their Statement of Purpose to include the amended staff structure. The service user guide refers to the home as being based on a hotel model with an enclosed garden. The garden is currently out of use and the home is in need of urgent repairs and refurbishment. This section of the Statement of Purpose needs to be revised, as it does not truly reflect what the home offers. As seen during the inspection, the last inspection report is available on the resident’s notice board. The manager confirmed that trial visits were Lennox Wood H56-H06 S28942 Lennox Wood V223506 100505 Stage 4.doc Version 1.30 Page 9 encouraged and were an opportunity for the prospective resident and their family to identify how appropriate the home is for them in meeting their needs. The home does not provide intermediate care. Lennox Wood H56-H06 S28942 Lennox Wood V223506 100505 Stage 4.doc Version 1.30 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) Not assessed at this inspection EVIDENCE: Lennox Wood H56-H06 S28942 Lennox Wood V223506 100505 Stage 4.doc Version 1.30 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) 13,15 Residents benefit from being encouraged to maintain contact with families and friends. Residents also enjoy a good balanced and wholesome diet with special diets being well catered for. EVIDENCE: Several family members were spoken to and all were very happy with the level of care provided at the home. One daughter stated that she now had peace of mind and that she could not fault the home. Her mother had been on outings and although was reluctant to participate in an organised activities appeared happy and content. The daughter also stated that her Mother was always clean and tidy and that regular reviews were held and that she was always updated on any changes in her care plans. Many residents were spoken with and those that could communicate were happy to be at Lennox Wood. Several residents stated that the food was good and that ‘there was plenty of it’. Lennox Wood H56-H06 S28942 Lennox Wood V223506 100505 Stage 4.doc Version 1.30 Page 12 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) Not assessed at this inspection. These standards were met at the last inspection EVIDENCE: Lennox Wood H56-H06 S28942 Lennox Wood V223506 100505 Stage 4.doc Version 1.30 Page 13 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) 19,21,23,24,25,26 There had been little change to the décor or furnishing in the last twelve months and although this does not pose a risk to the residents it does not create a pleasant and pleasing environment to live in. The level of cleanliness and infection control procedures needs to be improved to ensure residents live in a safe, hygienic environment. EVIDENCE: The home seems to lack any form of routine maintenance and renewal of fabric programme. The general décor is adequate but would benefit from a general upgrade. The grounds were untidy and not accessible to residents in their current state. A requirement from the last inspection was that the garden was refurbished by the spring of 2005; this has not been complied with. The building does comply with the requirements of the local fire service. There were five bathrooms, which were seen to be clean and airy. There were sufficient toilets to meet the resident’s needs. Some taps that needed replacing and were highlighted during the last inspection had been replaced. The manager stated that 19 new sinks had been ordered. Lennox Wood H56-H06 S28942 Lennox Wood V223506 100505 Stage 4.doc Version 1.30 Page 14 Some of the room dimensions and layout options meant that there was insufficient room on either side of the bed to enable access for staff and equipment if needed. During the last inspection, the manager had discussed replacing some of the very old bedroom furniture, this had still not happened in most of the rooms. The lighting appeared adequate but some lampshades were in need of replacing, again this was discussed during the last inspection. The home remains without adequate sluicing facilities although the manager stated that a sluice had been purchased but was found not to be suitable and another one had been ordered. Evidence was seen that commodes were being emptied in the laundry sink and this practise must cease. Staff stated that the same sink was used to rinse residents clothing if soiled. The laundry room generally was found to be untidy and not very clean. A large sack of soda crystals was seen open on the floor. As the laundry room door was not locked this posed a major health and safety risk to residents with dementia who could have accessed the room. Many commode pots were seen stacked on top of the washing machines. It will be a requirement that advise is sought from the infection control nurse to ensure correct procedures are put in place with regard to the emptying and cleaning of commodes. A written policy will be required. The laundry room remains in need of urgent refurbishment and the floor needs to be impermeable and easily cleanable. A lot of dust and general rubbish was seen behind the washing machines. The machines also appeared to be leaking; as puddles were seen on the floor. The area outside the laundry was also untidy with open sacks of clinical waste seen lying around. There was also a lot of general rubbish, including upended billies, buckets, broken chairs and shopping trolleys. The registered manager will be required to ensure that domestic staff, in sufficient numbers, be employed in the home. It would appear that this is currently not the case. Some corridors areas had curtains and drapes that were dusty and in need of cleaning. It will be a requirement that a cleaning schedule is produced and that the Registered Manager ensures that regular cleaning audits are undertaken and that if these highlight a lack of cleaning hours, further hours should be sanctioned. On the day of the inspection the home was not free from offensive odours with the entrance hall being very offensive. Several bedrooms were also offensive. It will be a requirement that all carpets are professionally cleaned and if necessary replaced. Particular attention must be paid to the entrance hall, as this was particularly offensive. An ongoing programme of carpet cleaning must be instigated on a permanent basis. The serving area in the kitchen is in need of refurbishment with several drawer fronts missing and areas on the work surfaces showing signs of wear. The main kitchen was clean and tidy. One bed had cot sides but no bumpers in place and one bed was seen to have bumpers but they were in a poor state of repair. The airing cupboards on the upper floor which housed the boiler/hot water tank was very untidy with pillows and various pieces of bedding thrown over Lennox Wood H56-H06 S28942 Lennox Wood V223506 100505 Stage 4.doc Version 1.30 Page 15 the boiler/hot water tank to possible dry or air. This could be possible fire risk and needs to be assessed. The room used for smoking and for visitors had no ashtrays and the floor was sticky. The room needed to be redecorated. Several wheelchairs were seen to be very dirty and had footplates missing. It is recommended that all wheelchairs be cleaned and serviced. Lennox Wood H56-H06 S28942 Lennox Wood V223506 100505 Stage 4.doc Version 1.30 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 Residents who live in the high dependency unit are at risk due to lack of staff remaining in the unit. EVIDENCE: During the inspection it was seen that the unit where residents with high dependency live, was not staffed adequately. Although visiting the unit several times during the morning, members of staff were not to be found. Three members of staff were there to assist the residents with feeding at lunchtime. It will be a requirement that this unit is staffed at all times. Generally good interaction was seen throughout the home between staff and residents. Lennox Wood H56-H06 S28942 Lennox Wood V223506 100505 Stage 4.doc Version 1.30 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) Not assessed at this inspection EVIDENCE: Lennox Wood H56-H06 S28942 Lennox Wood V223506 100505 Stage 4.doc Version 1.30 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. 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 2 x 3 x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 x 8 x 9 x 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 2 x 2 x 2 2 2 1 STAFFING Standard No Score 27 2 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x x x x x x x x x Lennox Wood H56-H06 S28942 Lennox Wood V223506 100505 Stage 4.doc Version 1.30 Page 19 YES 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 OP26 Regulation 13(3) Requirement The Registered Person shall make suitable arrangements to prevent infection, toxic conditions and the spread of infection at the care home in that sluicing facilities be fitted. The Registered Person shall make suitable arrangements to prevent infection, toxic conditions and the spread of infection at the care home in that the laundry be refurbished to the required standards. The Registered Manager shall produce a cleaning schedule and ensure regular cleaning audits are undertaken The Registered Manager shall ensure sufficient domestic staff are employed The Registered Manager shall in consultation with the Infection Control Nurse produce an infection control procedure that covers laundry procedures and correct sluicing procedures The Registered Manager shall ensure that staffing numbers and skill mix are appropriate to the needs of the residents, Timescale for action Action plan by 28 days of receipt of report Action plan by 28 days of receipt of report 2. OP26 13(3) 3. OP26 13(3) 4. OP26 13(3) 5. OP26 13(3) Action plan by 28 days of receipt of report Action plan by 28 days of receipt of report Action plan by 28 days of receipt of report Action plan by 28 days of receipt of report Page 20 6. OP27 18 Lennox Wood H56-H06 S28942 Lennox Wood V223506 100505 Stage 4.doc Version 1.30 7. OP19 23(2)(o) 8. OP19 23(2)(d) particularly in the high dependency unit The Registered Manager shall ensure that the grounds are suitable for, and safe for, residenrts and are appropriately maintained A programme of routine maintenance and renewal of the fabric and decoration be provided to the Commission Action plan by 28 days of receipt of report Action plan by 28 days of receipt of report RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard OP38 OP22 Good Practice Recommendations It is again recommended that consideration be given to replacing the kitchen units in the near future it is recommended that all wheelchairs are cleaned and serviced Lennox Wood H56-H06 S28942 Lennox Wood V223506 100505 Stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection The Oast Hermitage Court Hermitage Lane, Maidstone Kent. ME16 9NT 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 Lennox Wood H56-H06 S28942 Lennox Wood V223506 100505 Stage 4.doc Version 1.30 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!