Inspection on 16/10/07 for Lindau Retirement Home

This inspection was carried out on 16th October 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

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

CARE HOMES FOR OLDER PEOPLE Lindau Retirement Home 104 Littlestone Road Littlestone New Romney Kent TN28 8NH Lead Inspector Wendy Mills Key Unannounced Inspection 16th October 2007 10:00 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 Lindau Retirement Home DS0000069722.V343164.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. Lindau Retirement Home DS0000069722.V343164.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Lindau Retirement Home Address 104 Littlestone Road Littlestone New Romney Kent TN28 8NH 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) Care Excellence Limited Mr Stephen Wayne Cooper Care Home 26 Category(ies) of Old age, not falling within any other category registration, with number (0) of places Lindau Retirement Home DS0000069722.V343164.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: 2. Old age, not falling within any other category (OP). The maximum number of service users to be accommodated is 26. Date of last inspection Brief Description of the Service: Lindau is a residential home providing care and support for up to twenty-six people over the age of sixty-five. The home is newly registered as it came under new ownership in May 2007. Care Excellence Ltd owns the home and the registered manager is Mr Steven Cooper. The company owns another home in the area and also has homes further away. Lindau is situated on a main road, near the seafront at Littlestone. The small town of New Romney is about a mile away. There are good local facilities including a post office, shops, pubs, restaurants and a library. Wider facilities are available at the towns of Hythe, Folkestone and Ashford, which are approximately a half hour drive away. The home has good communal facilities that include a large open-plan lounge/dining area, a quiet room/library and a large, safe and accessible rear garden. There is parking space to the front of the home and on-street parking nearby. The weekly fees for this home range between £313 and £430 Further information about this service can be obtained by telephoning the registered manager, on 01797364371. Lindau Retirement Home DS0000069722.V343164.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This visit was unannounced. It formed part of the inspection process of the Commission for Social Care Inspection (CSCI) under the regulations of the Care Standards Act 2000. This report has been complied using information gained during this visit and information supplied prior to the visit from a variety of sources such as relatives, visiting health and social care professionals, and the home itself. During the visit in-depth discussion was held with the registered manager. Residents, their relatives and staff were spoken to in private and during a tour of the home. A tour of the home was made and documentation, including staff files and care plans, was examined. Both direct and indirect observation was used throughout the visit. Currently there is ongoing work in the home to improve the standard of accommodation throughout. This is being very well managed and disruption for the residents has been kept to a minimum. Occupancy has been kept low in order to allow work to take place. The company, the registered manager and all staff are commended for the way they have maintained standards of care throughout the disruption that renovation work can cause. Residents and their relatives said that the care in the home is very good. They said that the staff are kind and caring and that everyone tries hard to meet their needs. Staff said that they like working in the home and are given support to improve their knowledge. Many of the staff have worked at the home for several years. The residents, their relatives, staff and the registered manager are all thanked for the welcome they gave and their assistance throughout this visit. What the service does well: Lindau Retirement Home DS0000069722.V343164.R01.S.doc Version 5.2 Page 6 The home is well managed. There is a good organisational structure that helps all staff to be clear about their roles and responsibilities. Staffing levels and staff training are good and staff turnover is low. Staff say that their morale is high now. This is reflected in their positive approach to the residents. The residents are well cared for. They are treated with respect and their privacy and dignity is preserved. There is a committed and caring staff team. There is a low staff turnover and staff morale is now good. One resident said, “We have a lot of good people (staff) here”. There is a very pleasant and welcoming environment. The accommodation is now well maintained and is very clean and sweet smelling. What has improved since the last inspection? What they could do better: Lindau Retirement Home DS0000069722.V343164.R01.S.doc Version 5.2 Page 7 Whilst it is accepted that the way care planning is recorded can present a challenge for staff, more attention to detail is needed. Staff should be diligent in ensuring that every entry they make in any record is signed and dated. As many of the residents have lived in the home for some years, it is recommended that staff undertake specialist training in the various effects of aging. For example, it would be helpful if staff were trained to recognise the early stages and effects of conditions such as dementia, diabetes and arthritis. 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. Lindau Retirement Home DS0000069722.V343164.R01.S.doc Version 5.2 Page 8 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 Lindau Retirement Home DS0000069722.V343164.R01.S.doc Version 5.2 Page 9 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides the residents, their relatives and supporters, with the information they need in order to make a decision about moving into the home Appropriate pre-admission assessments are made. This ensures that only those residents who are suited to the home and whose needs can be met are admitted to the home. EVIDENCE: This ensures that only those residents whose needs can be met by the home are admitted to the home. Lindau Retirement Home DS0000069722.V343164.R01.S.doc Version 5.2 Page 10 A ten percent sample of care plans, including those of the most recently admitted residents, was examined during this visit. Comprehensive preadmission assessments were noted to be in place. Residents said that they had been invited to visit the home before making a decision about whether the home was right for them. However, some said that they had asked their relatives or supporters to do this on their behalf. The home does not provide intermediate care. On occasions residents are admitted for planned respite care. Lindau Retirement Home DS0000069722.V343164.R01.S.doc Version 5.2 Page 11 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 & 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home promotes the health and well being of the residents. EVIDENCE: Residents and their relatives said that they are very well cared for. Both direct and indirect observation showed that the staff treat the residents with respect and that they respect their privacy and dignity. They were seen to knock on doors, speak kindly to the residents and give personal care in a discrete and gentle manner. Infection control and nutrition in the home have significantly improved. Environmental improvements, described in more detail later in this report in Lindau Retirement Home DS0000069722.V343164.R01.S.doc Version 5.2 Page 12 the outcome area for the environment, have meant that it is easier and more rewarding for staff to ensure cleanliness. There is a new care planning process that is clearer about every aspect of care. This means that staff have clearer information about how they should provide care for the residents. This care planning system includes better ways of monitoring nutrition, dependency levels and medication. This care planning system includes a nutritional assessment – the Malnutrition Universal Screening Tool (MUST), recommended by the National Institute for Clinical Excellence (NICE), and a dependency assessment. Senior staff were receiving training in the use of this care planning system on the day of this visit. Inspection of these new care plans showed that the transition from the old system to the new one has been, for the most part, carefully completed. However, there were some omissions of signatures and dates. It is important that staff are diligent in signing and dating every entry made in the care plans. District nurses said that they had always found the personal care given by the home to be of a high standard. They said that communications with the home are now much better. Residents and relatives said that the staff at the home are good and kind. One resident said, “We have a lot of good people (staff) here”. Other residents said that the staff are, “kind and helpful”. Relatives and visitors said that they could “not fault the staff”. Direct and indirect observation showed that not only are staff were kind and respectful but there was a friendly and pleasant atmosphere in the home despite the disruptions by the carpet fitters and an unannounced visit from the CSCI. The alterations in the home have improved the safety of the storage of medicines and also made the atmosphere more homely as trolleys are no longer placed in the communal areas of the home. There are sound policies and procedures for the management and administration of medicines within the home. There is good liaison with local GPs and other health and social care professionals. Arrangements are made for a medicines review for all new residents to ensure that they are receiving appropriate medication. Arrangements are made for those residents who wish to self medicate. At present some chose to administer their own creams and this is recorded appropriately. The staff are commended for the way they care for the residents. Lindau Retirement Home DS0000069722.V343164.R01.S.doc Version 5.2 Page 13 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 &15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are supported to make informed choices and to lead fulfilling and interesting lives. EVIDENCE: Social and emotional needs are identified in the care plans. Residents said that they can choose how they spend their time. Some said that they prefer to spend time in their rooms with their newspapers and television whilst others prefer to spend time in the lounge. Visitors said that they are always made welcome and that they can have privacy if they wish. Some residents like to take an interest in the safe and pleasant garden and like to spend time there. There are plans to further improve this area in the coming year. Lindau Retirement Home DS0000069722.V343164.R01.S.doc Version 5.2 Page 14 Staff spend time with residents, chatting, playing chess and doing puzzles. Entertainers visit the home regularly although not all residents wish to join in this type of activity. Religious needs are met. Arrangements are made for residents to receive Holy Communion in the home and a church group visits regularly. At present there are no residents from ethnic minorities in the home but information is available about the cultural and religious needs of people from a variety of religious, cultural and ethnic backgrounds. The dining area has recently been extended, redecorated and refurbished. Meals can be taken in the dining room or in the residents’ own rooms. There is a varied and nutritious menu and residents are offered a choice of menu. Staff were observed to spend time with each resident, offering them appropriate choices and helping them decide on what they would like to eat and what they would like to do. The home uses seasonal foods as much as possible. The main meal is served at lunchtime. The new owners have significantly improved the quality of food. The registered manager has now been given control of budgets for the day-today running of the home. This includes food purchase. As a result, the quality of food at the home has improved significantly. Food at the home is now both plentiful and of good quality. The cook said that she is very pleased with the way things have improved. Residents and staff praised the cook for her cooking, especially her baking. They said they really like her home made cakes. Residents also said that they enjoy their meals and that they always have plenty to eat. The new owners, the registered manager and the cook are commended for the way in which they have worked together to make these important improvements. Lindau Retirement Home DS0000069722.V343164.R01.S.doc Version 5.2 Page 15 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 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are sound policies and procedures for the management of concerns and complaints and for the protection of vulnerable adults (POVA). The home listens to the concerns of residents, their supporters and staff and acts upon them. EVIDENCE: The complaints procedure is included in the Service User Guide. The complaints policy clearly identifies timescales for responding to any concerns or complaints. Residents and relatives said that they know how to complain but said that they had not felt the need to make a formal complaint. Residents said that they can speak to staff or the manager is they have any concerns. One relative said that he felt he could always talk to the manager if he has any concerns. A record is kept of complaints. The manager said that day-to-day complaints are sorted out immediately. Sound Adult Protection policies and procedures are in place. Staff have recently received Adult Protection training. Criminal Record Bureau (CRB) Lindau Retirement Home DS0000069722.V343164.R01.S.doc Version 5.2 Page 16 Disclosures are applied for as part of the recruitment process and there was good evidence that all staff at the home have received satisfactory CRB checks. All staff spoken with during this visit were clear about their responsibility to report any concerns in respect of protection of the residents from abuse. They said that the manager is very approachable and has an “open door” policy. They said that they would have no hesitation is reporting any suspicion of abuse immediately. Lindau Retirement Home DS0000069722.V343164.R01.S.doc Version 5.2 Page 17 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, 20, 23, 24, 25 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Despite the renovation work in progress, the environment is safe, sweet smelling and well maintained. This now gives the residents a pleasant place in which to live. EVIDENCE: Since taking on the home in the spring of this year, the new owners, Care Excellence Ltd, have made great strides in improving the environment. They left several rooms vacant so that the work could be carried out without disturbing the residents too much. The main lounge and dining areas have been completely redecorated, refurbished and decluttered. All the old furniture has been disposed of and all Lindau Retirement Home DS0000069722.V343164.R01.S.doc Version 5.2 Page 18 the furniture is new. Residents said that the new chairs are much more comfortable and the area is much lighter. A library has been created in the quiet lounge upstairs. The dining area has been extended and is now much pleasanter and lighter and a new staff office has been created in a corner of the large communal area. Mealtimes are much more closely monitored and senior staff are able to ensure that those who need help at mealtimes are given this is a discrete and appropriate manner. Staff said that this is a great improvement and that they feel their role is valued and appreciated. Eleven bedrooms have been completely redecorated. They have new carpets and curtains and furniture as standard but residents are encouraged to personalise their rooms as much as possible. Furniture and furnishings can be brought from home if residents wish, providing they meet health and safety standards. New industrial machines have been provided in the laundry and this has improved both efficiency and infection control in respect of laundry management. New flooring has been laid in the kitchen and new carpets provided in the communal areas. On the day of this visit, new carpet was in the process of being laid on the upstairs landing. Fire precautions have been reviewed and improved. Cleaning throughout the home is of a higher standard and staff say that they are pleased and proud to be working at the home. Care Excellence and the registered manager are commended for the timely way in which these improvements have been carried out and for the minimal disruption to the residents. Lindau Retirement Home DS0000069722.V343164.R01.S.doc Version 5.2 Page 19 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 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staffing levels, staff training, and staff recruitment procedures are all good. Consequently staff morale is high and there is a low staff turnover. This means that the residents receive consistent care from a cheerful and well qualified staff team EVIDENCE: Staff rosters show that there are good staffing levels at present. The home is only sixty percent full. The CSCI was informed that a decision was made to keep staffing at the same level as for full occupancy to make sure that there would be as little disruption as possible during the renovation process. A sample of staff files was examined. This showed very good evidence that staff are taking the training opportunities offered to them. Staff have recently completed training in Adult Protection. Whilst specialist training is being undertaken, it is recommended that all staff undertake training in all relevant specialist areas such as dementia care and diabetes so that their awareness of the signs of these conditions are enhanced. Lindau Retirement Home DS0000069722.V343164.R01.S.doc Version 5.2 Page 20 Staff files also show that all appropriate pre-employment checks are made. These include a minimum of two references and a Criminal Records Bureau (CRB) check. Staff interviewed said that they are very happy working in the home. They said that they are well supported by the manager. They said that their views are listened to and acted upon. They confirmed that there are staff meetings and individual supervision. Care Excellence Ltd is commended for the way in which they have supported good staffing levels and staff training. This means that there is a very committed and motivated staff team. Lindau Retirement Home DS0000069722.V343164.R01.S.doc Version 5.2 Page 21 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, 32, 33, 35 &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 well managed and run in the best interests of the residents. EVIDENCE: Since the last inspection the home has been taken over by Care Excellence Ltd. The assistant manager has retired and the registered manager is now employed full time at the home. This has created a much more positive approach to the way the home is managed. Lindau Retirement Home DS0000069722.V343164.R01.S.doc Version 5.2 Page 22 The registered manager holds the National Vocational Qualification (NVQ in Management and Care at Level 4. He has increased his hours of employment and now has more time to make improvements. Communication within the home, with staff and residents, and with external agencies, such as health care professionals and local suppliers have all improved. The registered manager is commended for his perseverance and diligence in working to improve the home. Residents, their relatives and staff said that they could talk to the manager at any time and that he listens to their views and acts upon them. They said that there is an open door policy and that their ideas and concerns are taken seriously. The home does not act as appointee for any of the residents. The home holds small amounts of spending money for some residents and this is appropriately accounted for. Health and safety in the home has improved significantly. Infection control is better, there are new fire precautions including a fire plan and a snatch roll containing essential details of all residents in case of fire. The COSHH cupboard has been reviewed and made safer. The home has taken every precaution to ensure that the home is safe during the renovation work. No health and safety hazards were noted during a tour of the home. Lindau Retirement Home DS0000069722.V343164.R01.S.doc Version 5.2 Page 23 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 N/A 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 X 3 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 3 3 X 3 X X 3 Lindau Retirement Home DS0000069722.V343164.R01.S.doc Version 5.2 Page 24 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 2 Refer to Standard OP7 OP30 Good Practice Recommendations All entries in the care plans and other documentation should be signed and dated by the member of staff making that entry. Staff should undertake training in dementia care in order to increase their awareness of the signs and symptoms of early dementia in residential care service users. Lindau Retirement Home DS0000069722.V343164.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Lindau Retirement Home DS0000069722.V343164.R01.S.doc Version 5.2 Page 26 - 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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