Inspection on 23/06/05 for Lincoln House

This inspection was carried out on 23rd June 2005.

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

Lincoln House 28/10/08

Lincoln House 31/10/07

Lincoln House 18/12/06

Lincoln House 05/04/06

Lincoln House 29/11/05

Lincoln House 07/01/05

Lincoln House 23/06/04

Lincoln House 05/02/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE Lincoln House Lincoln Close, Off Gillett Road Wood Green, Banbury Oxfordshire OX16 0EF Lead Inspector Jane Handscombe Unannounced 23 June 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. Lincoln House v233928 h57-h08 s35671 lincoln house v233928 230605 stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Lincoln House Address Lincoln Close, Off Gillett Road, Wood Green, Banbury, Oxfordshire, OX16 0EF 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) 01295 257471 01295 266285 manager.lincolnhouse@osjctoxon.co.uk The Orders of St John Care Trust Acting Manager Care Home 44 Category(ies) of Dementia - over 65 years of age(18), old age, registration, with number not falling within any other category(44), of places Physical disability over 65 years of age(6). Lincoln House v233928 h57-h08 s35671 lincoln house v233928 230605 stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. The total number of persons that may be accommodated at any one time must not exceed 44. 2. As vacancies arise the numbers in the PDE categories will be reduced to 3. 3. The continued registration of this service past April 2007 is dependent upon the physical environment meeting standards. Date of last inspection 07 January 2005 Brief Description of the Service: Lincoln House is one of a number of care homes run by The Orders of St John Care Trust and provides care and accommodation for older people who may be suffering some dementia related illness, and/or physical disability. Local psychiatric services are available for guidance on treatment and support for staff. The home is due to be rebuilt in order to bring the building up to current spatial requirements and will remain close to the centre of Banbury. Lincoln House v233928 h57-h08 s35671 lincoln house v233928 230605 stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, lasting 6.5 hours, which took place on the 23rd June 2005.. The purpose of the visit was to see how the home is meeting the National Minimum Standards. The visit involved speaking to residents in order to ascertain their views upon the care and the services they receive at the home, the staff members and the care services manager, viewing care plans and assessments, whilst observing the general day to day operation of the home. At the time of inspection the service users were busy going about their daily activities and there was a calm relaxed atmosphere. The inspector was warmly welcomed, by both the staff and residents. Much of the inspection focused upon life from the service users’ point of view. What the service does well: What has improved since the last inspection? A new format for care planning and assessments has been put together to allow for a clearer consistent package of care for which staff have undertaken training as to the usage of these. This new format is now in use for all newly admitted residents whilst existing residents’ details are in the process of being transferred and updated. Lincoln House v233928 h57-h08 s35671 lincoln house v233928 230605 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. Lincoln House v233928 h57-h08 s35671 lincoln house v233928 230605 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 Lincoln House v233928 h57-h08 s35671 lincoln house v233928 230605 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 and 5 The home provides clear information to prospective service users to allow them to make an informed choice. No emergency admissions are taken, all residents undergo an assessment of needs, either in their own surroundings or at the home, prior to moving into the home to ensure the home can meet their needs. The assessment process encourages the support of family involvement with the resident’s consent. EVIDENCE: The home provides clear information about the home, the services available, and the staff working within the home to allow prospective service users to make an informed choice when deciding upon where they wish to live. Prospective service users, and family members, are invited to the home to undergo an assessment of needs, meet care staff and fellow residents and gain a ‘feel’ of the home. In instances where the prospective service user is unable to visit the home, an assessment is carried out in their own surroundings. Lincoln House v233928 h57-h08 s35671 lincoln house v233928 230605 stage 4.doc Version 1.30 Page 9 The inspector viewed five residents’ assessment of care needs and of these, three were found to be undated and failed to have either the resident’s or their representative’s signature to indicate that the resident had been involved in the process. Lincoln House v233928 h57-h08 s35671 lincoln house v233928 230605 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) 7,8,9 and 10 Residents are treated with care, dignity and respect at all times. A good rapport was seen to exist between the care staff and the residents. The care planning and review process is of poor standard and needs to be addressed to ensure residents’ needs are met fully. EVIDENCE: Staff were observed to knock upon residents’ doors before entering and treat them with dignity and respect. Residents within the home all have a plan of care generated from their initial assessment which, the inspector was informed, is reviewed regularly to address any further needs that may be present. However of the 5 viewed, one resident’s file contained no evidence of a risk assessment having been carried out, although the file clearly stated the resident uses a frame to aid mobility. The same resident’s file, along with a further two files, failed to contain a signature to show the resident and or their advocate/ representative had played a part in the drawing up of the care plan. A further plan of care, in which the resident is prone to falls, had a risk assessment undertaken in September 2004 and no further assessments Lincoln House v233928 h57-h08 s35671 lincoln house v233928 230605 stage 4.doc Version 1.30 Page 11 undertaken since, although the care plan stated clearly monthly reviews were to be undertaken. The same resident’s care plan was undated. Another plan of care failed to show any evidence of any risk assessment having been undertaken, although the resident has mobility problems and uses a frame to aid in walking. The inspector observed the medication round and found good practice taking place throughout. Photographs were found to be placed upon the medication administration records thereby reducing the risk of any potential accidents. Whilst good procedures were taking place during the medication round, the inspector did note on one resident’s MAR (Medication Administration Record) sheet that there was an omission, which had not been allocated an omission code or contain a signature. The same resident’s MAR sheet contained a signature in which the medication for that evening had been administered which clearly was not the case. Furthermore, whilst touring the home, it was noted that a service user’s MAR sheet was pinned to the inside of their wardrobe door. Clearly marked upon the MAR sheet was the instruction that a medication was to be administered twice a day, although it had only been administered once on 13/2/05 and no further administration had been undertaken. The inspector spoke to the staff member in charge, who informed the inspector that it would be dealt with immediately. The home enables residents to access specialist services when required; they telephone the service provider when a resident requires, to arrange a visit to the home. This includes chiropody, the hearing clinic and optician. A falls specialist is involved in the home, who gives training to staff members and works alongside the resident and their families to develop strategies in dealing with falls, and who also works with the occupational therapist in order to acquire any necessary aids that the resident may require. Lincoln House v233928 h57-h08 s35671 lincoln house v233928 230605 stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 14 and 15 The home needs to offer a wider range of activities to suit all the residents’ needs. The home encourages residents to maintain contact with their family and friends and assist the residents in exercising choice and control over their lives whilst in the home. EVIDENCE: Residents were very complimentary of the food offered at Lincoln House, informing the inspector that there is a choice available and should they not like the food offered, care staff will endeavour to provide an alternative. This was seen to be the case during the inspection. Lincoln House employs an activities co-ordinator who presently offers 6 hours a week. The home is presently advertising for an activities co-ordinator in order to enhance the daily activities offered at the home and enable more one to one quality time with the residents. The appointment of an activities co-ordinator will allow the residents more choice around their recreational interests and needs, thus a recommendation has been made within this report. There is a club room in the home in which the residents can enjoy watching videos, and a shop trolley where residents can purchase small items if required. Lincoln House v233928 h57-h08 s35671 lincoln house v233928 230605 stage 4.doc Version 1.30 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 has a clear procedure for complaints and concerns, which all residents are provided with and are familiar with. Residents are protected from any abuse and the home facilitates access to an advocacy service where the need arises. EVIDENCE: The complaints policy was seen to be placed upon the notice board within the home and can also be found in the Service Users Guide. Residents spoken to informed the inspector that they were aware of the procedure and would raise any issues if the need arose and felt that any concerns would be taken seriously and acted upon appropriately. The home facilitates access to an independent advocacy service, provided by Age Concern Oxfordshire if the need arises. Details of the service were viewed upon notice boards within the home. The care services manager informed the inspector that all staff had recently undergone abuse training, which was verified by staff members who were on duty during the inspection. Likewise staff have updated their skills and knowledge around manual handling. Lincoln House v233928 h57-h08 s35671 lincoln house v233928 230605 stage 4.doc Version 1.30 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, 21, 23, 25 and 26 The home presents as clean and well maintained, serving the residents’ needs appropriately. Residents have access to safe and well-maintained communal and private space whilst grab rails and aids were seen to be installed thereby meeting the needs of all the residents within the home EVIDENCE: Lincoln House has been targeted by The Orders of St John Care Trust as a home in need of complete redevelopment. It is planned that the new home will be built on an alternative site within Banbury. This new development will be fully compliant with environmental National Minimum Standards, and provide totally single accommodation with en suite facilities once a suitable site has been sought. There are sufficient bathrooms and lavatories to service the residents’ needs, all of which are within close proximity to the residents’ bedrooms. Hoists and assisted baths are available in the home. Lincoln House v233928 h57-h08 s35671 lincoln house v233928 230605 stage 4.doc Version 1.30 Page 15 Each resident is supplied with a call bell for use in an emergency or if assistance is required. Residents are able to bring into the home small pieces of furniture by agreement with the manager, to ensure that their accommodation is as homely as possible. Bedrooms viewed by the inspector presented as clean, tidy and contained personal memorabilia. The general feedback was that the residents found their bedrooms served their needs and were to their liking. Generally, on the whole the home presented as well maintained and clean, although one bathroom failed to contain any liquid soap or paper towels for the residents’ use. A further communal bathroom was found to contain a cleaning fluid in a readily accessible cupboard and a bar of soap. It is a requirement that hazardous cleaning fluids be stored appropriately and bars of soap remain in residents’ own rooms so as to prevent the possibility of cross infection. Lincoln House v233928 h57-h08 s35671 lincoln house v233928 230605 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, 28 ,29 and 30 Staffing levels were sufficient although a Manager is not yet appointed to manage the home and give support and guidance. A thorough recruitment procedure is followed to ensure, as far as is possible, the health, safety and well being of the residents in their care. EVIDENCE: The home was seen to be sufficiently staffed on the day of inspection and staff were observed to meet the needs of the residents appropriately. Whilst the home does not have an appointed manager at present, a care services manager offers support to the care leaders who ensures to visit the home 2 or 3 times a week and is always available via the telephone. There is a thorough recruitment procedure, based on equal opportunities and ensuring the protection of the service users is followed. All members of staff undergo induction training, upon appointment to their posts, and are offered ongoing training which equips them to meet the assessed needs of the residents within the home. A training matrix has been implemented to allow identification of staff who require their training to be updated. All staff spoken to informed the inspector that they undergo formal supervision on a 6 weekly basis and undergo a formal yearly appraisal. Lincoln House v233928 h57-h08 s35671 lincoln house v233928 230605 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) 31, 32 and 38 The home does not have a manager appointed at present and whilst a care services manager is in contact with the home daily and visits the home 2 or 3 times a week to offer support and guidance to the staff a manager should be appointed to ensure the home is managed appropriately. EVIDENCE: The care services manager was present during part of the inspection and informed the inspector that there are plans in place to fill the vacancy for a manager of the home. The inspector was informed that the staff receive considerable support from the organisation and care services manager to ensure the home runs smoothly in the interim and this was verified by the Care Leader on duty. Lincoln House v233928 h57-h08 s35671 lincoln house v233928 230605 stage 4.doc Version 1.30 Page 18 Whilst the health safety and welfare of the residents is promoted, as stated in the Health and Personal Care section of this report, risk assessments are not being undertaken regularly, thereby a potential risk to the health and safety of the residents and carers within the home. Lincoln House v233928 h57-h08 s35671 lincoln house v233928 230605 stage 4.doc Version 1.30 Page 19 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 3 x 2 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 x 14 3 15 3 COMPLAINTS AND PROTECTION 3 x 3 x 3 x 3 3 STAFFING Standard No Score 27 2 28 3 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 2 2 x x x x x 2 Lincoln House v233928 h57-h08 s35671 lincoln house v233928 230605 stage 4.doc Version 1.30 Page 20 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 7 Regulation 13(4c) Timescale for action The registered person must carry 23/06/05 out risk assessments to ensure any unnecessary risks to the health or safety of service users are identified and and as far as possible eliminated. The registered manager must 23/06/05 ensure to maintain and keep records up to date. Where a service user self administers medication, a risk assessment must be undertaken. The registered person must 23/06/05 ensure assessment of needs are dated and gain the service users/advocates signature to evidence their part in the process. All hazardous substances held in 23/06/05 the home must be stored safely. Requirement 2. 9 13 Sch 3 3. 3 14 4. 5. 38 13(4) 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 v233928 h57-h08 s35671 lincoln house v233928 230605 stage 4.doc Version 1.30 Page 21 Lincoln House 1. 2. 31 12 It is reccommended that a manager be sought as a matter of urgency. It is reccommended that there be an increase in hours reserved for activities to provide service users with an increased activities programme. Lincoln House v233928 h57-h08 s35671 lincoln house v233928 230605 stage 4.doc Version 1.30 Page 22 Commission for Social Care Inspection Burgner House, 4630 Kingsgate, Cascade Way, Oxford Business Park South, Cowley, Oxford. OX4 2SU 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 Lincoln House v233928 h57-h08 s35671 lincoln house v233928 230605 stage 4.doc Version 1.30 Page 23 - 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!