CARE HOMES FOR OLDER PEOPLE
Lilliput House Rest Home 299 Sandbanks Road Poole Dorset BH14 8LH Lead Inspector
Catherine Churches Unannounced 06 September 2005 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. Lilliput House Rest Home D55 S51239 Lilliput House V243520 060905 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service Lilliput House Rest Home Address 299 Sandbanks Road, Poole, Dorset, BH14 8LH 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) 01202 709245 Mr Mark Edney Mrs Louise Edney Mrs Victoria Lynes PC Care Home only 20 Category(ies) of OP - 20 registration, with number of places Lilliput House Rest Home D55 S51239 Lilliput House V243520 060905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 21 February 2005 Brief Description of the Service: Lilliput House was originally two detached residential properties, which have been linked on the ground floor. It is set in a residential area of Poole and close to local shops and facilities as well as transport links. The registered providers, Mr and Mrs Edney, are frequent visitors to the home and the registered, day to day manager is Mrs Lynes. The home is registered to provide care and accommodation to a maximum of 20 residents in the category of OP (older people) and had no vacancies at the time of the inspection. Accommodation is offered on both the ground and first floors of the home. All bedrooms are for single occupancy and have ensuite facilities. There is a passenger lift on each side of the home therefore making all areas of the home fully accessible. The home has a comforatble main lounge and a separate dining room that also has some comfortable seating. Both of these areas are on the ground floor at the rear of the property and have views of the garden which is attractively landscaped and well maintained. There are also communal bathrooms on both floors in addtiion to ensuite facilities. There is a parking area at the front of the property. Lilliput House Rest Home D55 S51239 Lilliput House V243520 060905 Stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place during the morning of 6th September 2005. The inspection took place as part of the regular, programmed inspection schedule for the home. The purpose of this visit was to check that the home continues to run in the same satisfactory way and that the people who are living in the home are properly cared for. The premises were inspected and a number of records examined. Time was also spent time observing routines within the home and talking with residents and staff. Mrs Lynes, the registered manager, was present throughout the inspection together with the newly appointed assistant manager, Miss Jackson. What the service does well:
Lilliput House provides a homely, relaxed and comfortable environment with a welcoming and friendly atmosphere. The home is very well presented and has beautifully maintained gardens that residents reported they enjoyed very much. The home consistently maintains good standards with regard to compliance with the National Minimum Standards. On this occasion thirteen of the nineteen key standards were assessed and all except one of these was fully met. The home is positively managed and well staffed. The staff group is stable and were observed to be respectful, helpful and caring. All residents spoken with were very positive about the care and attention that they receive. One person said, “This is a lovely, happy home. Its so free and easy” another resident who had only recently arrived commented that their” expectations had been exceeded”. Another person, when asked if they knew how to make a complaint commented, “ I’ve never been unhappy with them”. All of the required documentation with regard to care planning, staffing and health and safety was up to date and detailed, reflecting a responsible attitude towards this side of the work. Staff are well trained and competent to provide the levels of care required by the residents living at the home. There are satisfactory systems in place for the protection of residents from abuse.
Lilliput House Rest Home D55 S51239 Lilliput House V243520 060905 Stage 4.doc Version 1.40 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Lilliput House Rest Home D55 S51239 Lilliput House V243520 060905 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Lilliput House Rest Home D55 S51239 Lilliput House V243520 060905 Stage 4.doc Version 1.40 Page 8 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3, standard 6 is not applicable to this home. Assessments of residents and their needs, prior to their admission, were satisfactory. This means that residents and their representatives should feel confident that the home is aware of all the needs of the person and is able to meet them. EVIDENCE: The majority of residents have lived at Lilliput House for some time. The preadmission assessment for the most recently admitted resident was examined. The information in this record was detailed and informative and meets the requirements of the National Minimum Standards. The Inspector also spoke with the resident concerned who confirmed that they had been able to visit the home prior to admission and that they had been involved in the assessment process. Lilliput House Rest Home D55 S51239 Lilliput House V243520 060905 Stage 4.doc Version 1.40 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 and 10 Care plans for residents who live at Lilliput House are detailed and informative. This means that staff have sufficient information to provide a good level of care and the home can also demonstrate the care that has been provided. The home ensures that resident’s healthcare needs are met through seeking appropriate input from GP’s and other healthcare professionals. The ethos in the home is one of respect for the residents living there. This means that the residents feel settled and at home and their privacy is respected. EVIDENCE: Care plans and related documentation regarding 3 residents were examined. Files were well laid out and regular risk assessments had been undertaken. Reviews were being undertaken on a monthly basis or more frequently if changes dictated this. This has been improved since the last inspection. All of the residents whose documentation was examined were spoken with. They confirmed (where they were able) that they were happy with the care they receive and that either they or a representative are involved in reviews and are assisted appropriately to seek help from healthcare professionals such as Doctors, District nurses, chiropodists and opticians. This was also recorded
Lilliput House Rest Home D55 S51239 Lilliput House V243520 060905 Stage 4.doc Version 1.40 Page 10 in their files. Residents also confirmed that they feel respected by staff and are able to maintain their privacy when receiving personal visits from professionals such as GP’s and solicitors, family and friends. It was observed that staff knock on doors before entering and that residents preferred form of address is recorded and used. Policies for the promotion of privacy and dignity have been reviewed and improved since the last inspection. Lilliput House Rest Home D55 S51239 Lilliput House V243520 060905 Stage 4.doc Version 1.40 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 and 14 Residents have the opportunity to choose their own lifestyle within the home and this means that their individual preferences and routines are respected. Open visiting arrangements are in place enabling residents to retain contact with families and friends. The home also places great emphasis on involvement with the local community, particularly as the majority have spent much of their lives in the area. EVIDENCE: The visitor’s book showed that there is a constant stream of visitors to the home and discussions with staff and residents confirmed this as well as the fact that many residents are taken out by visitors. Staff also explained that one person continues to visit a local day centre and various other activities take place in the locality. Mrs Edney had recently taken a small group of people to a local park and a fund raising coffee morning was also being planned. Discussion with residents and staff as well as examination of records evidenced that residents are assisted appropriately to exercise choice and control over their lives. Lilliput House Rest Home D55 S51239 Lilliput House V243520 060905 Stage 4.doc Version 1.40 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) 18 Arrangements for protecting service users from abuse were satisfactory: staff had a good knowledge and understanding of Adult Protection issues. This means that Lilliput House is a safe environment that will protect residents from abuse. EVIDENCE: Staff have received training in recognising and preventing abuse as well as the action to take should they believe abuse has taken place. It was evident from discussion that they were clear about their responsibilities. There were also clear policies and procedures available within the home. Lilliput House Rest Home D55 S51239 Lilliput House V243520 060905 Stage 4.doc Version 1.40 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 and 26 The home is very well presented: it is nicely decorated and furnished and has a homely atmosphere. The grounds are also very well maintained, providing lots of colour and interest as well as a variety of places to sit and relax. The home maintains a good standard of hygiene and all areas seen were clean and free from offensive odours. EVIDENCE: A tour of the premises confirmed that the home is well decorated, furnished and equipped. Dorset Fire and Rescue Service has visited the home and confirmed that it complies with their requirements. The laundry area is well organised and equipped. The walls and floors were easily cleanable and separate hand washing facilities were available. Staff had a good understanding of infection control procedures and the relevant protective clothing was available. Lilliput House Rest Home D55 S51239 Lilliput House V243520 060905 Stage 4.doc Version 1.40 Page 14 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 and 29 The home was well staffed ensuring that residents receive the care and attention they need in an unrushed manner. Staff clearly enjoyed working in the home, there was a positive atmosphere and residents had a happy, relaxed relationship with the manager and staff. EVIDENCE: Examination of the staff rota and observation throughout the inspection demonstrated there was a sufficient number and skill mix of staff to meet the needs of residents. Staff and residents spoken with confirmed that they were satisfied with staffing levels. Two new staff had been recruited since the last inspection. Analysis of their files confirmed that appropriate recruitment procedures had been followed. Lilliput House Rest Home D55 S51239 Lilliput House V243520 060905 Stage 4.doc Version 1.40 Page 15 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) 35 and 38 Management practices, with regard to the financial interests of residents, have improved since the last inspection and now demonstrate that appropriate safeguards are in place. The health, safety and welfare of residents and staff is protected by the systems that the home has in place for staff training, maintenance and risk assessment. EVIDENCE: Mrs Lynes confirmed that residents are encouraged to retain control of their own finances for as long as possible. Where they state that they no longer wish to or they lack the capacity to do so then the home ensures that either family or other representatives such as solicitors take on this role. The home holds petty cash for some residents. Records and balances were randomly checked for 3 residents and were found to be satisfactory. Fire records, staff training records, accident books and risk assessments were examined and found to be up to date and detailed.
Lilliput House Rest Home D55 S51239 Lilliput House V243520 060905 Stage 4.doc Version 1.40 Page 16 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 x x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 3 15 x
COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x 3 x x x x 3 x x 3 Lilliput House Rest Home D55 S51239 Lilliput House V243520 060905 Stage 4.doc Version 1.40 Page 17 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 Regulation Requirement Timescale for action 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 Good Practice Recommendations Lilliput House Rest Home D55 S51239 Lilliput House V243520 060905 Stage 4.doc Version 1.40 Page 18 Commission for Social Care Inspection Unit 4, New Fields Business Park Stinsford Road Poole BH17 0NF National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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