Inspection on 28/09/05 for Lincoln House Community Support Centre

This inspection was carried out on 28th September 2005.

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

The inspector 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... 15/03/06

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 28th September 2005 12:35 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.V260304.R01.S.doc Version 5.0 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.V260304.R01.S.doc Version 5.0 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 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.V260304.R01.S.doc Version 5.0 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 aged between 48 and 65 years in the category of PD (Physical disability under the age of 65 years) The registered provider must, at all times, employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection 13th January 2005 2. 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. Access between floors is via a passenger lift or the stairs. 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 residents, these are currently registered to provide care for up to 34 older people, five adults with a physical disability aged between 48 to 65 years and up to eight beds for intermediate care, which is provided in dedicated accommodation. Residents 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. Lincoln House has an adequate number of toilets and a variety of bathrooms available for residents. The home provides various aids to help maintain independence; these include bath hoists, grab rails and an emergency call bell system. The main kitchen and laundry are on the ground floor. There are pleasant and attractive grounds for residents to enjoy during good weather. Lincoln House Community Support Centre DS0000036901.V260304.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out on 28 September 2005 and lasted for three hours and fifteen minutes. The senior carer was on duty together with the agreed numbers of care and ancillary staff. Thirty people, five of whom were in the intermediate care unit were living in the home at the time of the inspection. During the visit twelve residents, two visiting family members, a social worker from the intermediate care team and four of the staff on duty were spoken with. A range of care, health and home records were examined and a tour of the premises, including all lounges, other shared areas and a number of bedrooms, was undertaken. Comment cards for use by residents and relatives were left at the home. Eight resident and one relative card have been returned to the CSCI. What the service does well: What has improved since the last inspection? Lincoln House Community Support Centre DS0000036901.V260304.R01.S.doc Version 5.0 Page 6 This was not discussed with the senior carer on duty during this inspection visit. 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.V260304.R01.S.doc Version 5.0 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.V260304.R01.S.doc Version 5.0 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): 3 and 6 Although the majority of residents are assessed prior to admission in order to ensure that the home will be able to meet their needs there are occasions when an emergency admission is made without an assessment having been carried out. EVIDENCE: Pre admission or care manager [usually the person’s social worker] assessments had been carried out for the five residents whose records were inspected. Those seen contained enough information for staff to be able to meet individual needs. Residents, relatives and other healthcare professionals are involved with the pre-admission assessment. 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 the resident’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 provides eight beds for intermediate care, which is provided in dedicated accommodation. The staffing levels have been increased to accommodate the extra dependency of residents, and the rehabilitative nature Lincoln House Community Support Centre DS0000036901.V260304.R01.S.doc Version 5.0 Page 9 of their stay at the home. There are a number of hours per week of specialist staff allocated, such as occupational therapists and physiotherapists, who provide treatment according to the assessed needs of residents. Specialist equipment is provided, where necessary. The aim of the unit is, following a period of rehabilitation to return people to their own home. The social worker fro the intermediate care team spoken with during the inspection visit made a number of positive comments about the quality of care provided to the people staying in the unit. Lincoln House Community Support Centre DS0000036901.V260304.R01.S.doc Version 5.0 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, 8, 9 and 10 All residents have a care plan that shows how their individual needs are being met. The systems used to identify and meet an individual residents needs are good. The procedures for the administration of medicines require improvement. 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 programme provides 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 residents. Five residents plans were looked at as part of the case tracking process, following the care delivered to them. 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 resident’s bedroom or one of the bathrooms. Residents staying at the home usually keep their own Doctor because they are not going to live permanently at Lincoln House. Residents’ medication is kept in a lockable cabinet in each bedroom. An inspection of the medication systems demonstrated that a number of areas Lincoln House Community Support Centre DS0000036901.V260304.R01.S.doc Version 5.0 Page 11 need attention; whilst a record is made that medication is leaving the home the actual amounts are not being recorded. It was also noted that for one residents PRN medication it stated that one or two could be administered, the actual number given was not recorded. These were discussed with the senior carer on duty. See requirement No 1. The residents 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; they were seen to address residents appropriately according to their recorded wishes. Lincoln House Community Support Centre DS0000036901.V260304.R01.S.doc Version 5.0 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, 13, 14 and 15 Routines at the home are flexible to suit residents’ individual preferences. Residents staying at Lincoln House are able to maintain contact with their family and friends and make choices regarding their own lives. EVIDENCE: Residents 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 resident’s bedroom. The residents and visitors spoken with made wholly positive comments during the inspection; these included “Staff are great, nothing is too much trouble”. The eight resident and one-relative/visitor comment cards received also contained positive comments about the home. When residents arrive for their stay they complete a preference sheet, which is placed in the care plan. Meals can be taken in the dining areas or in the privacy of residents’ own rooms. There is a menu that has the flexibility to meet individual needs and choices. All of the residents that commented said that the food was good and that choices were available. Special diets are prepared where necessary. Facilities for residents to make their own drinks are available. Lincoln House Community Support Centre DS0000036901.V260304.R01.S.doc Version 5.0 Page 13 Lincoln House Community Support Centre DS0000036901.V260304.R01.S.doc Version 5.0 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Residents are able to voice their opinions and are confident that appropriate action would be taken to address any problems or complaints. Policies, procedures and staff training are in place to protect residents from abuse. EVIDENCE: Residents 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 comment about services. The residents 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 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 are routinely offered training in adult protection procedures. The authority and the home’s written philosophy promote the rights and dignity of residents. Lincoln House Community Support Centre DS0000036901.V260304.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 The environment within the home is good, providing residents with a pleasant place to stay. EVIDENCE: A tour of the premises was undertaken; this included communal areas and a number of bedrooms. The home both externally and internally is maintained to a good standard. The home was found to be clean and tidy on the day of inspection. The laundry is appropriately equipped and good systems are in place for the care of peoples’ clothes. Lincoln House Community Support Centre DS0000036901.V260304.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 Staff members were seen to be working positively with residents, families and visiting professionals to improve the quality of life of people living in the home. 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 residents within the home. The staff members seen on the day were cheerful and friendly and residents 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. Lincoln House Community Support Centre DS0000036901.V260304.R01.S.doc Version 5.0 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): 31 and 38 The home is being well run and managed on a day-to-day basis. The home has an experienced and competent management team. EVIDENCE: Lincoln House Community Support Centre DS0000036901.V260304.R01.S.doc Version 5.0 Page 18 There is a comprehensive health and safety manual as well as policies and procedures in relation to safe working practices in place. All staff members are supervised on a continuous basis; in addition they will all receive formal supervision regularly. There was evidence that staff were receiving training in areas such as moving and handling, first aid and fire safety. 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.V260304.R01.S.doc Version 5.0 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 X X 3 X X 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 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 X X X X X X 3 STAFFING Standard No Score 27 3 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X X X X 3 Lincoln House Community Support Centre DS0000036901.V260304.R01.S.doc Version 5.0 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 OP9 Regulation 13 Requirement Suitable arrangements for the recording and disposal of medication are made. Timescale for action 30/11/05 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 Lincoln House Community Support Centre DS0000036901.V260304.R01.S.doc Version 5.0 Page 21 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.V260304.R01.S.doc Version 5.0 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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