Inspection on 14/03/07 for Lincoln House Community Support Centre

This inspection was carried out on 14th March 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Lincoln House Community Support... 19/03/09

Lincoln House Community Support... 15/03/06

Lincoln House Community Support... 28/09/05

Lincoln House Community Support... 13/01/05

Lincoln House Community Support... 09/07/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Lincoln House Community Support Centre Samuel Street Crewe Cheshire CW1 3WH Lead Inspector Paul Ramsden Unannounced Inspection 14th March 2007 10:45 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 Lincoln House Community Support Centre DS0000036901.V323868.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. Lincoln House Community Support Centre DS0000036901.V323868.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Lincoln House Community Support Centre Address Samuel Street Crewe Cheshire CW1 3WH 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) 01270 580240 01270 501471 Http/www.cheshire.gov.uk Cheshire County Council Care Home 34 Category(ies) of Old age, not falling within any other category registration, with number (34), Physical disability (5) of places Lincoln House Community Support Centre DS0000036901.V323868.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. This home is registered for a maximum of 34 service users to include:* Up to 34 service users in the category of OP (Old age, not falling within any other category) * Up to 5 service users in the category of PD (Physical disability aged between 48 and 65 years) 15th March 2006 Date of last inspection Brief Description of the Service: Lincoln House is a two-storey community support centre that is owned and managed by Cheshire County Council. Clients are accommodated on the ground and first floors only. Access between floors is via the shaft lift or the stairs. The home is located near to the centre of Crewe, and is accessible to local facilities such as shops, pubs and post office. The main purpose of the home is to enable older people to remain living in the community by providing a diverse range of support. This includes respite care, day care and an intermediate care unit that provides rehabilitation for people discharged from hospital who are not yet ready to go home. Clients’ accommodation consists of 34 single bedrooms, two of which have ensuite facilities. These are arranged in four areas each with its own lounge and dining area. All lounges have drink and snack-making facilities. Lincoln House has an adequate number of toilets and a variety of bathrooms available. Aids to help independence are in evidence throughout the home; these include bath hoists, grab rails and an emergency call bell system. There are pleasant and attractive grounds for people to enjoy during good weather. Adequate car parking facilities are available to the front and side of the building. The fees payable in this home are based on a financial assessment of the individual. Lincoln House Community Support Centre DS0000036901.V323868.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. An unannounced visit took place on the 14 March 2007 and lasted 6 hours. Paul Ramsden, Inspector, undertook the visit. All of the key standards for older people were looked at. Unfortunately the home manager has recently passed away. Everyone who knew her; including the inspector is still coming to terms with this sudden loss; she is sadly missed. This visit was just one part of the inspection. Before the visit the home manager was also asked to complete a questionnaire in order to provide up to date information about services in the home. Questionnaires were made available for clients and families to find out their views and other information received since the last key inspection was reviewed. Nine client survey forms have since been returned During the visit various records and the premises were looked at. A number of clients, relatives and staff members were spoken with; they gave their views about the home and the service provided. What the service does well: What has improved since the last inspection? A new fire alarm system has been fitted. New kitchens with dishwashers have been fitted in two of the lounges. A number of areas within the home have been redecorated; this is an ongoing process. Lincoln House Community Support Centre DS0000036901.V323868.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Lincoln House Community Support Centre DS0000036901.V323868.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 Lincoln House Community Support Centre DS0000036901.V323868.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): 1, 3 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Information about the home is available and clients are assessed prior to admission to ensure that their needs can be met at the home. EVIDENCE: The home provides a range of information to clients; these include the Statement of Purpose and the Service User Guide. All of the information required under the Care Homes Regulations 2001 and Standard 1 of the National Minimum Standards for Older People is contained within these documents. Pre admission or care manager [usually the person’s social worker] assessments had been carried out for the three clients whose records were checked during this visit. Those seen as part of the case tracking process contained enough information for staff to be able to meet individual needs. Clients, relatives and other healthcare professionals are involved with the preadmission assessment. Clients only stay at Lincoln House for respite care Lincoln House Community Support Centre DS0000036901.V323868.R01.S.doc Version 5.2 Page 9 therefore some people have had a number of stays at the home. The carecoordinator will check that the assessment is still current prior to the stay. Due to the nature of the service provided by Lincoln House there are occasions when an emergency admission takes place without an accurate assessment of a client’s needs having been undertaken. Following such an admission an assessment is then carried out by the home’s staff in order ascertain possible future needs. Lincoln House currently has eight beds for intermediate care, which is provided in dedicated accommodation. It is understood that these are due to become respite beds from April. Lincoln House Community Support Centre DS0000036901.V323868.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 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The clients care plans seen provided sufficient information for staff members to be able to take appropriate action to meet an individuals needs. EVIDENCE: The care co-ordinator develops a care plan, known as a care programme from the assessment carried out before someone moves into the home. The five programmes seen as part of the case tracking process provided staff members with the necessary information for them to look after a person’s needs. The carers are expected to sign the plan after each time they deliver care or support to clients. Care programmes are kept in individual bedrooms, allowing access to it at all times. All personal care is carried out in the privacy of a client’s bedroom or one of the bathrooms. If a client has stayed at the home previously the care coordinator will update the care programme prior to admission if a person’s needs have changed. Lincoln House Community Support Centre DS0000036901.V323868.R01.S.doc Version 5.2 Page 11 The staff members at the care home monitor the service users’ health and emotional needs daily and there was evidence to show that clients were receiving appropriate support from health care professionals. This included GPs, community nurses, optician, dentist and chiropodist. The changing needs of individuals are discussed as and when required; the inspector was able to see this in practice during the visit. Clients staying at the home usually keep their own Doctor because they are not going to live permanently at Lincoln House, however if they are out of area the home registers the person temporarily at one of the local practises. Whilst no issues regarding this were noted during the visit one of the clients has written on a survey form that in their opinion medical assistance is difficult to arrange? The clients spoken with during the inspection all said that the standards of care provided were very good and that they had been able to express their opinions and wishes about their daily routines. When clients arrive for their stay they complete a preference sheet, which is placed in the care plan. It was also seen throughout the visit that clients were being treated with courtesy, respect and good humour by staff. Staff members spoken with had a good understanding of the people they were supporting and were able to meet their diverse needs Cheshire County Council has a written policy on the receipt, administration [including self-administration] safekeeping, handling, recording and disposal of medication within its homes. Service user medication is kept in a lockable cabinet in each bedroom. The arrangements for the administration of medication during the inspection were considered to be satisfactory. Lincoln House Community Support Centre DS0000036901.V323868.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 good. This judgement has been made using available evidence including a visit to this service. Clients spoken with were positive about the home and the support they received so they could maintain contact with friends and family and make choices about their daily lives. EVIDENCE: Clients were able to move around freely within the home and a choice of sitting areas was available. They confirmed that routines within the home were flexible and that they were able to make choices in many areas of daily living, for example times of rising and retiring, where to spend their time and with whom and participation in planned activities. Staff members were seen to knock on the door and to await permission before entering a client’s bedroom. Although clients confirmed during the visit that a variety of social and other activities were organised three clients have said on comment cards that they would like more activities to be arranged. Lincoln House Community Support Centre DS0000036901.V323868.R01.S.doc Version 5.2 Page 13 Meals can be taken in the dining areas or in the privacy of clients’ own rooms. There is a menu that has the flexibility to meet individual needs and choices. All of the clients that commented said the food was good and that choices were available. Special diets are prepared where necessary. Facilities for clients to make their own drinks are available. Lincoln House Community Support Centre DS0000036901.V323868.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. Clients and relatives are able to complain and action is taken to respond to their concerns. Adult protection training for staff is available to ensure the continued safety of clients. EVIDENCE: There is a clear complaints procedure for the home; information about complaints and the procedure that will be followed are available in the entrance area. This is also included in the information available to clients. The pre-inspection questionnaire indicates that two complaints have been received during the previous 12 months; these were responded to within the agreed timescale. The clients spoken with during the visit confirmed that they knew what to do if they were unhappy or wanted to make a complaint. The survey forms received also confirmed this. The home has an Adult Protection procedure (including Whistle Blowing), which complies with the Public Disclosure Act 1998 and the Department of Health Guidance ‘No Secrets’. Staff members receive training in this area. Lincoln House Community Support Centre DS0000036901.V323868.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, 23, 24, 25 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The clients live in a safe, homely, clean and comfortable home. EVIDENCE: A tour of the premises was undertaken; this included the lounges, communal areas and a number of bedrooms. Furnishings, fittings and lighting in the lounges and communal areas are of a good quality and are domestic in character. The home provides adaptations for use by clients with mobility problems: these include bath and toilet aids, hoists, grab rails and wheelchairs. The home was found to be clean and tidy on the day of the visit. The laundry is appropriately equipped and good systems are in place for the care of peoples’ clothes. Lincoln House Community Support Centre DS0000036901.V323868.R01.S.doc Version 5.2 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 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. Staff members work positively with clients and families to improve the quality of life of people living in the home. A robust staff recruitment process is in place in order to protect clients from possible harm. EVIDENCE: Staff on duty and rotas seen demonstrated that staffing levels and the skill mix of staff is adequate to meet the needs of the clients within the home. Staff members were cheerful and friendly. Clients spoken with were complimentary about staff attitude and competence. One of the clients said; “Its wonderful, staff, food, they will do anything for you. “I wish I could live here permanently”. A client has written on a comment card, “Couldn’t get any better if you tried”. The pre-inspection questionnaire shows that 13 of the 29 care staff members are qualified to NVQ level 2, a recognised qualification for staff involved in delivering care. During the visit some of the staff members spoken with said that they wanted to do their NVQ but were unable to due to a shortage of assessors. Upon checking it was found that this was an issue and that it was in the process of being addressed. Lincoln House Community Support Centre DS0000036901.V323868.R01.S.doc Version 5.2 Page 17 Whilst there was evidence that staff were receiving training in areas such as moving and handling, first aid and adult protection the records seen did not show when whether all training is up to date. It is therefore recommended that an audit of staff training be carried out in order to ensure that all of the staff team have attended the appropriate courses for their job and that the information contained within the database is up to date. The files for the two most recently appointed members of staff seen contained all of the required information and a robust recruitment procedure was in place for the protection of clients. Prospective staff members are checked against the POVA list before employment commences and CRB disclosures are obtained. A thorough induction procedure is available and all new staff members undertake this in order to ensure that they are suitably trained when starting work. Lincoln House Community Support Centre DS0000036901.V323868.R01.S.doc Version 5.2 Page 18 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 home is being well run and managed on a day-to-day basis. There are appropriate procedures in place to make sure that clients are safe. EVIDENCE: Unfortunately the home manager has recently passed away. Everyone, including the inspector is still coming to terms with this sudden loss and it is to the staff members credit that they have continued to provide the good quality of care to the clients using the service. Cheshire County Council have had to appoint a new manager and she had taken up her appointment two days earlier. The new manager is very experienced and will register with the Commission for Social Care Inspection. Lincoln House Community Support Centre DS0000036901.V323868.R01.S.doc Version 5.2 Page 19 All clients using the service are given a quality assurance form at the end of their stay. These are then collated centrally by social services and the findings are then passed to the home. This is an ongoing process. Clients’ personal allowances are being handled appropriately. Personal monies were being kept securely and those inspected had correct balances and accurate records. There is a comprehensive health and safety manual as well as policies and procedures in relation to safe working practices in place. All of the maintenance contracts seen were up to date. The fire precautions record book was up to date and demonstrated that checks of the alarm system, emergency lighting, fire drills and staff training were taking place. Monthly visits to comply with regulation 26 of the Care Homes Regulations are being carried out. Lincoln House Community Support Centre DS0000036901.V323868.R01.S.doc Version 5.2 Page 20 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 3 X 3 X X 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 X 3 X 3 3 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 Lincoln House Community Support Centre DS0000036901.V323868.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? No 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. 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 OP30 Good Practice Recommendations The registered person should undertake an audit of staff training. Lincoln House Community Support Centre DS0000036901.V323868.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT 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 Lincoln House Community Support Centre DS0000036901.V323868.R01.S.doc Version 5.2 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. 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