Inspection on 15/03/06 for Lincoln House Community Support Centre

This inspection was carried out on 15th March 2006.

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 Community Support... 19/03/09

Lincoln House Community Support... 14/03/07

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 Maureen Brown Unannounced Inspection 09:30 15 March 2006 th 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.V281806.R01.S.doc Version 5.1 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.V281806.R01.S.doc Version 5.1 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 Audrey Lloyd 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.V281806.R01.S.doc Version 5.1 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) The registered provider must, at all times, employ a suitably qualified and experienced manager who is registered with the Commission for Social Inspection Staffing must be provider to meet the dependency needs of the service users at all times and will comply with any guidance which may be issued through The Commission for Social Care Inspection 28th September 2005 2. 3. Date of last inspection Brief Description of the Service: Lincoln House is a two-storey community support centre providing respite care that is owned and managed by Cheshire County Council. 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, a weekend day centre and an intermediate care unit which provides residential rehabilitation for people discharged from hospital who are not yet ready to go home. The home is located near to the centre of Crewe, and is accessible to local facilities such as shops, pubs and post office. Lincoln House provides personal care and accommodation for up to 34 service users and up to eight beds for intermediate care, which is provided in dedicated accommodation. Service users accommodation consists of 34 single bedrooms, two of which have en-suite facilities. These are arranged in four areas each with its own lounge and dining area. All lounges have drink and snack-making facilities. Access between floors is via a passenger lift or the stairs. There are pleasant and attractive grounds for service users to enjoy during good weather. Adequate car parking facilities are available to the front and side of the building. Lincoln House Community Support Centre DS0000036901.V281806.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out on 15th March 2006 by Maureen Brown and lasted five hours. One hour was spent reading the previous inspection report and reviewing the service history of the home. The registered manager was on duty together with the agreed numbers of care and ancillary staff. Thirty people were living in the home at the time of the inspection. During the visit ten service users, the manager and staff on duty were spoken with. Records were examined and a tour of the premises was undertaken that included all communal areas and some bedrooms. Eleven out of forty-three standards were assessed and most were met. Feedback from the inspection was given to the manager at the end of the inspection. What the service does well: The home had an established staff team who were keen for high standards to be maintained at Lincoln House. The care plans showed that service users’ care needs have been identified and that these needs are met. During the visit staff were seen helping service users with personal care tasks such as eating and drinking. This was done in an appropriate and caring manner. Service users’ bedrooms and communal areas are maintained to a good standard. The décor and furniture are of a good standard and provide a warm and safe environment for service users. The manager and staff provide a high standard of care to service users. Relationships between service users and staff are good and service users are able to approach staff for help with personal and other needs. The home provides sufficient numbers of staff to meet service users needs and there is always a senior person on duty. Thirteen of thirty staff were qualified to NVQ level II or above and seven were currently undertaking this award. The home provides a good variety of relevant training and all staff have completed mandatory training. The home was clean with suitable and sufficient equipment is provided to meet the needs of the service users. Lincoln House Community Support Centre DS0000036901.V281806.R01.S.doc Version 5.1 Page 6 All of the service users spoken with made positive comments about the home and the staff members working there. These included “everyone is so kind”, “staff are very friendly” and “the care is excellent”. Service users said that routines within the home were flexible and that this gave them some control over their lives and enabled them to be more independent. Catering within the home appeared to be well managed and all service users said the food was good and they confirmed they were offered choices at mealtimes. After the meal service users commented, “the food was good” and “food is first class”. 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. Lincoln House Community Support Centre DS0000036901.V281806.R01.S.doc Version 5.1 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.V281806.R01.S.doc Version 5.1 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 the following standard(s): 1 Although sufficient information is provided for service users to make a decision about moving into the home, some details need amending. EVIDENCE: A statement of purpose and service user guide was available which showed the services offered by the home. These documents included general information about the home, a description of the facilities, the fees charged and details of the registered provider and staff. The copy of the complaints procedure needs amending to include the Commission and details of the registered manager also needs amending. A copy of the home’s service users guide was kept in each bedroom. Copies of the most recent inspection report were available in the office, reception area and on the noticeboards in each of the service user lounge areas. Lincoln House Community Support Centre DS0000036901.V281806.R01.S.doc Version 5.1 Page 9 See requirement Nos. 1 & 2. Lincoln House Community Support Centre DS0000036901.V281806.R01.S.doc Version 5.1 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 the following standard(s): 7&9 The service users health, personal and social care needs are met by the staff team who enable them to maintain their privacy and dignity. EVIDENCE: Three service users care records were seen during this inspection. These were comprehensive and well presented in individual files. Each contained sufficient information for staff to appropriately meet the needs of the service users. 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 programme provides staff members with the necessary information for them to look after a person’s needs. 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 service user’s bedroom or one of the bathrooms. Service users staying at the home usually keep their own Doctor because they are not going to live permanently at Lincoln House. Service users’ medication is kept in a lockable cabinet in each bedroom. An inspection of the medication systems demonstrated that the requirement made Lincoln House Community Support Centre DS0000036901.V281806.R01.S.doc Version 5.1 Page 11 at the previous inspection had been completed. A new record sheet had been developed and is used to ensure that medication entering and leaving the home is documented appropriately. The service users 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. Staff members were observed interacting with them in an appropriate, dignified and respectful way. Daily record sheets seen showed that day-to-day activities were recorded. This enabled staff and family members to see what a particular service user was undertaking during the day. They were written clearly, easy to follow and were signed by carers. However, it was noted that red pen is used for night care notes. This should be avoided, as it is distracting to the reader and difficult to read if photocopied. See recommendation No. 1. Lincoln House Community Support Centre DS0000036901.V281806.R01.S.doc Version 5.1 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 the following standard(s): 12 Routines at the home are flexible to suit service users’ individual preferences. Service users staying at Lincoln House are able to maintain contact with their family and friends and make choices regarding their own lives. EVIDENCE: Service users 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 and where to spend their time. Staff members were observed to knock on the door and to await permission before entering a service users bedroom. The service users spoken with made positive comments during the inspection and these included “staff are considerate and friendly” and “staff are courteous and supportive”. Meals can be taken in the dining areas or in the privacy of service users’ own rooms. There is a menu that has the flexibility to meet individual needs and choices. All of the service users that commented said the food was good and that choices were available. Special diets are prepared where necessary. Facilities for service users to make their own drinks are available. Lincoln House Community Support Centre DS0000036901.V281806.R01.S.doc Version 5.1 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 the following standard(s): 16 Service users are able to voice their opinions and are confident that appropriate action would be taken to address any problems or complaints. EVIDENCE: Service users are given a copy of Cheshire County Council’s complaint procedures leaflet in the “information pack” when they come to stay at the home. A printed complaints/compliments form is used to record and monitor complaints and receive comments about services. The service users spoken with were complimentary about the home and the quality of care routinely offered to them. They also said that they would inform staff members if they had a problem. The home or the Commission had not received any complaints about this service. Lincoln House Community Support Centre DS0000036901.V281806.R01.S.doc Version 5.1 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 the following standard(s): 19 & 26 The home provided a clean and comfortable environment for the people to live in. EVIDENCE: A tour of the home was undertaken and this included all the communal areas and a number of bedrooms. The home was furnished in a domestic style with additional equipment such as grab rails, raised toilet seats and hoists provided as necessary to meet the service users’ needs. A good standard of décor was evident throughout. The heating and lighting was sufficient throughout the home. The home both externally and internally is maintained to a good standard. The home was found to be clean, odour free and tidy on the day of inspection. Lincoln House Community Support Centre DS0000036901.V281806.R01.S.doc Version 5.1 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 28, 29 & 30 Staff are employed in sufficient numbers to meet service users’ needs. Appropriately trained and supervised staff care for service users. The recruitment and selection process is insufficient to protect the welfare of the service users. EVIDENCE: Staff on duty and rotas seen demonstrated that staffing levels and the skill mix of staff were adequate to meet the needs of the service users within the home. The staff members seen on the day were cheerful and friendly and service users were complimentary about staff attitude and competence. New staff members are routinely inducted through Cheshire County Council’s formal induction scheme to ensure that they are suitably conversant with core values, local authority policy and procedures and moving and handling. There are various in-house training programmes available for staff members. These include, adult protection, supervision, emergency aid, fire training, food hygiene, health and safety, medication, and moving and handling. The home provides on-going training for staff including NVQ in care, this will help staff further improve their skills in caring for service users. Thirteen out of thirty staff had achieved NVQ Level II or III, and seven staff were undertaking this award at present. Lincoln House Community Support Centre DS0000036901.V281806.R01.S.doc Version 5.1 Page 16 The recruitment procedure does not ensure that the staff are suitable to work with vulnerable people. Three staff files were examined and these showed that not all relevant pre-employment checks were carried out. The files contained a selection of application forms, references and health declarations. All staff had received Criminal Record Bureau checks. The staff files were difficult to access the information and reorganisation would be of benefit. See requirement No. 3 and recommendation Nos. 2 & 3. Lincoln House Community Support Centre DS0000036901.V281806.R01.S.doc Version 5.1 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 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33 & 35 Staff received support to enable them to meet service users’ needs. Service users views were used in the planning for the home. Decisions are influenced by the information obtained from the surveys and from conversations with service users. EVIDENCE: Quality standards questionnaires are used. These are sent out after the first visit a service user makes to the home and then annually. Comments from service users and families included “very impressed”, “staff very caring and helpful”, “my Mother received outstanding care” and “everyone so kind”. From discussions with the manager it was noted that an analysis of this information was not completed or shared with service users or other interested parties. However a matrix has been produced for the period January to December 2005 and this reflected service users views. Lincoln House Community Support Centre DS0000036901.V281806.R01.S.doc Version 5.1 Page 18 Some service users money is kept within the office safe. Also items such as keys or pieces of jewellery are kept in the safe, as requested. All this information is recorded on the one form. It was stated that a maximum of fifty pounds per person is preferred to be kept at the home. Four service users monies were tracked and it was noted that the records were not up to date. It is also recommended that weekly stock checks be undertaken. See requirement Nos. 4 & 5 and recommendation No. 4. Lincoln House Community Support Centre DS0000036901.V281806.R01.S.doc Version 5.1 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 X X X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X 3 X X X X X X 3 STAFFING Standard No Score 27 X 28 2 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 2 X 2 X X X Lincoln House Community Support Centre DS0000036901.V281806.R01.S.doc Version 5.1 Page 20 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. 1. Standard OP1 Regulation 4, 5 Requirement The registered person must ensure that the registered managers’ name is changed in the Statement of Purpose and Service Users Guide. The registered person must ensure that the registered managers name and details of the Commission are included in the Complaints Procedure. The registered person must ensure that all pre-employment checks are carried out prior to new staff being employed. The registered person must ensure that an analysis is produced from the Quality Assurance process and that this is shared with service users and other interested parties. The registered person must ensure that service users money records are kept up to date. Timescale for action 30/04/06 2. OP1 4, 5 30/04/06 3. OP29 19 30/04/06 4. OP33 24 30/09/06 5. OP35 17 30/04/06 Lincoln House Community Support Centre DS0000036901.V281806.R01.S.doc Version 5.1 Page 21 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. 3. 4. Refer to Standard OP7 OP28 OP29 OP35 Good Practice Recommendations The registered person should ensure that red pen is avoided in the service users daily log sheets. The registered person should produce a plan to show how 50 of staff will be qualified to NVQ level II or above by 2008. The registered person should ensure that the staff files are re-organised for ease of access. The registered person should ensure that weekly checks are made of cash and other valuables held within the home. Lincoln House Community Support Centre DS0000036901.V281806.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT 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 Community Support Centre DS0000036901.V281806.R01.S.doc Version 5.1 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. 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