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Inspection on 02/06/06 for Lindisfarne

Also see our care home review for Lindisfarne for more information

This inspection was carried out on 2nd June 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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 found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home has very good documentation available to introduce new residents to the home. These had been reviewed and updated and the Commission for Social Care Inspection sent the up-to-date versions. The manager and senior staff work very positively with the Commission for Social Care Inspection and regularly inform them of matters arising in the home. There are regular unannounced visits to the home by Walsingham personnel and the Commission is also informed of these. Good recruitment procedures are in place and a comprehensive staff training and development programme available. There are well-developed links established between the home and health and social care personnel. Very positive comments were received by the inspector from one of the feedback cards that stated `I have great admiration for the staff and their determination to provide a high quality of life`. The home uses photographic and symbols in a very imaginative way to further involve residents in their everyday lives. The manager and staff are very committed and focussed in their provision of care and do this in a sensitive, encouraging and kindly manner. Staff feel very supported in their work and receive regular supervision.

What has improved since the last inspection?

The home continues to ensure that the identified needs of people in the home are met. They involve the expertise and guidance of other personnel in order that the most appropriate outcomes are achieved for people and are diligent in doing this on an ongoing basis. The requirement made at the previous inspection regarding the ventilation in the bathroom areas had been completed. A review of the sound levels from this is being attended to.

What the care home could do better:

The wear and tear in the living areas although identified for attention now needs to be upgraded and the decoration work that has commenced should be completed. The outside area also needs some attention with regard to the garden areas. The availability of staff should continue to be monitored so that the comprehensive needs of people in the home are consistently met.

CARE HOME ADULTS 18-65 Lindisfarne Greenvale Court Frizington Cumbria CA26 3SZ Lead Inspector Cath Wilson Unannounced Inspection 2nd June 2006 10:00 Lindisfarne DS0000022679.V289381.R01.S.doc Version 5.1 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 Lindisfarne DS0000022679.V289381.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 Adults 18-65. 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. Lindisfarne DS0000022679.V289381.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Lindisfarne Address Greenvale Court Frizington Cumbria CA26 3SZ 01946 813402 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) Walsingham Miss Pamela Brannon Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Lindisfarne DS0000022679.V289381.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The home is registered for a maximum of 6 service users to include: up to 6 service users in the category of LD (Learning disabilities) The service should at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. 1st December 2005 Date of last inspection Brief Description of the Service: Walsingham are the Registered Company for Lindisfarne. They have similarly registered homes in Cumbria and throughout the Country. Lindisfarne is located in the village of Frizington on the West Coast of Cumbria. There is a large enclosed garden and patio area. Car parking is available and there is level access into the home. Lindisfarne is on a lower level to the nearby residential court of flats and houses and the incline to the home is graduated. Accommodation is on one level and the corridor and door entrances are designed for people who may use wheelchairs. There is a kitchen, dining room, lounge, office and utility room, with private bedrooms situated off the two corridors leading from the entrance hall. Toilets and bathrooms are specially equipped and designed. At the time of this inspection the fees for a person accommodated at the home were £1172.25p to £2458.90p. Lindisfarne DS0000022679.V289381.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place during the morning and early afternoon period. During the inspection I met service users and staff and the deputy manager. The registered manager had completed the pre-inspection questionnaire and service user relatives and the inspector received professional comments. A tour of the home was made and records and administration documents were assessed. What the service does well: The home has very good documentation available to introduce new residents to the home. These had been reviewed and updated and the Commission for Social Care Inspection sent the up-to-date versions. The manager and senior staff work very positively with the Commission for Social Care Inspection and regularly inform them of matters arising in the home. There are regular unannounced visits to the home by Walsingham personnel and the Commission is also informed of these. Good recruitment procedures are in place and a comprehensive staff training and development programme available. There are well-developed links established between the home and health and social care personnel. Very positive comments were received by the inspector from one of the feedback cards that stated ‘I have great admiration for the staff and their determination to provide a high quality of life’. The home uses photographic and symbols in a very imaginative way to further involve residents in their everyday lives. The manager and staff are very committed and focussed in their provision of care and do this in a sensitive, encouraging and kindly manner. Staff feel very supported in their work and receive regular supervision. Lindisfarne DS0000022679.V289381.R01.S.doc Version 5.1 Page 6 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. Lindisfarne DS0000022679.V289381.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Lindisfarne DS0000022679.V289381.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4 and 5 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to the home, meeting with staff, information from relatives and professionals and assessing the home’s documentation. The home has good procedures and paperwork in place to ensure appropriate referrals and that they accept people whose needs they can meet. EVIDENCE: The information available to prospective residents, their family or representatives is well documented. The manager is fully informed of the criteria for needs led assessments and incorporates this information comprehensively in individual plans of care. People are able to visit the home prior to admission and this is achieved with the existing resident’s needs taken into consideration. People are provided with choice and being provided with opportunities to visit the home allows an informed and supported decision to be made. The Statement of Purpose and Service User Guide are regularly reviewed and appropriately updated and these are forwarded to the Commission for Social Care Inspection. Both documents are accessible and available to family and representatives also. The home’s use of photographic and symbols in their documentation is very good. This further involves residents in everyday events in their life and positively includes them in this. Lindisfarne DS0000022679.V289381.R01.S.doc Version 5.1 Page 9 Each resident is provided with a written contract on the terms and conditions of their placement. Lindisfarne DS0000022679.V289381.R01.S.doc Version 5.1 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 8, 9, and 10 Quality in this outcome is good. This judgement has been made using available evidence including a visit to this home. The manager and staff are very focussed on achieving the individual outcomes for people. This is carefully monitored through a developed system of care planning. Risk taking is well managed and a good balance is achieved between promoting independence and ensuring the well-being and safety of people in the home. EVIDENCE: The manager and staff have developed individual care plans for people in the home. Individual ways of communicating are included and staff are constantly seeking ways of furthering people’s involvement in their daily lives. Good use is made of photographs and symbols both in the care plans and daily information sheets. Information is kept up-to-date with the use of staff meetings and daily records. The information is regularly monitored and assessed and reviews appropriately held. This is also includes multi disciplinary reviews so that comprehensive information is shared and appropriate actions undertaken. In order to further strengthen the care planning used in the home the method of recording outcomes is to be further considered. The manager and senior staff are diligent in monitoring peoples individual plans of care and this is very good practice. Lindisfarne DS0000022679.V289381.R01.S.doc Version 5.1 Page 11 Risk assessments have been undertaken and are integrated into the everyday life experiences of people. This allows people to be appropriately supported to be included in events in their lives in a safe, manageable and balanced manner. Lindisfarne DS0000022679.V289381.R01.S.doc Version 5.1 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 15, 16, and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service, meeting with residents, staff and information from inspection feedback cards. People’s rights are very much promoted and their individuality respected. Meal times are also catered for on an individual basis and fully takes into account choice and balance. EVIDENCE: People are encouraged and supported to have contact with family and friends. Arrangements are in place for family to visit and they do so regularly and feel welcomed and involved. Relatives regarding staff changes and ensuring that enough staff will be available to meet the needs of residents expressed comments. There had been a number of staff changes and the manager and senior staff constantly monitor this. The core staff group continue to be vigilant in maintaining the philosophy of the home and placing people and their needs first. People are involved in community facilities and their religious wishes are attended to. People’s rights and responsibilities are promoted by the positive attitude of staff and they are involved in a range of interests, and activities in the community. Lindisfarne DS0000022679.V289381.R01.S.doc Version 5.1 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Quality in this outcome area is good. This judgement has been made using evidence including a visit to the home, assessing documentation and medicines arrangements and talking with staff. Health care matters are well managed and documented. Medicines management is generally good but a review of the administration records would ensure entries are recorded consistently. EVIDENCE: Staff are very knowledgeable of peoples needs including their health care arrangements. The staff team work very positively with the local health care professionals to offer a responsive and supportive approach in assisting people to maintain and receive the right attention. Specialist assistance and guidance is incorporated into the home’s approach and practices and actions regularly reviewed. Training has been provided to staff regarding medicines management in the home and this is under review. The records assessed at this inspection were generally very good but there was an inconsistency in the administration record. Policies and procedures for medicines handling are in place and are appropriate for the home. Records indicate there is much work being achieved in supporting people in their health care needs and individuality is sensitively attended to ensure people’s dignity is upheld. Lindisfarne DS0000022679.V289381.R01.S.doc Version 5.1 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the home. The home’s systems for safely managing people’s financial arrangements is in place and is monitored regularly by both the manager and senior personnel from Walsingham. The home has a satisfactory complaints system. EVIDENCE: Information is available regarding complaints and relatives or representatives have access to this. Advocacy is available and staff informed regarding the process with this so that people can be supported as much as possible. Staff are informed of the policies and procedures relating to adult protection matters and how to safeguard the health and welfare of people in the home. Protecting vulnerable adults is integrated into the training and development plan for each member of staff. The manager and staff are familiar with the multi-disciplinary guidance and include arrangements for training to be appropriately renewed. Lindisfarne DS0000022679.V289381.R01.S.doc Version 5.1 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27, 28, 29 and 30 Quality in this outcome is adequate. This judgement has been made using available evidence including a visit to this home. People benefit from living in a comfortable environment that is generally well maintained and safe. Areas for upgrading or improvement had been identified such as paintwork to doors and walls. EVIDENCE: Arrangements are in place for the health and safety of people in the home and for their environment. Guidelines are followed regarding environmental health and fire safety. Specialist equipment is regularly serviced and the home has access to advice and guidance regarding environmental matters. Each resident has their own bedroom and arrangements are in place to upgrade and replace furnishings and the décor when needed. There are parts of the outside area to the home that are unkempt. The requirement made at the previous inspection regarding ventilation in the bathroom areas has been completed. The noise level from these is under review. Lindisfarne DS0000022679.V289381.R01.S.doc Version 5.1 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 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, 32, 34, 35 and 36 Quality in this outcome is good. This judgement has been made using available evidence including a visit to the service, assessing staff records and meeting with staff. Staff are well trained and have a comprehensive training and development programme. Recruitment procedures are good and aimed at protecting residents and that staff have the right qualities. EVIDENCE: The home provides each member of staff with a comprehensive training and development programme. Training matters in key subjects are kept up-todate along with staff involvement in NVQ qualifications. All new staff had undergone a period of induction and all appropriate checks and references had been undertaken prior to commencing work. A number of staff had left the home and it is with the diligence of the remaining staff that enough staff had been able to ensure appropriate levels of support are available for service users. However, this has limited effectiveness. The manager and the organisation are constantly monitoring this situation, and it is a matter that relatives have also commented upon. The staff that are employed in the home are very clear about their roles and responsibilities and are well informed of the individual and comprehensive needs of residents. Staff feel they are very well supported in their work and have very regular supervision. They meet regularly to discuss their provision and quality of care they are providing. Lindisfarne DS0000022679.V289381.R01.S.doc Version 5.1 Page 17 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 40, 41 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the home, assessing the home’s procedures and meeting with staff. People in the home benefit from an organised and well ran home that places their care and overall welfare first. EVIDENCE: There are health and safety policies and procedures available in the home and staff are well informed of these matters. The records assessed on the day of the inspection were organised, up-to-date, accessible and confidentially stored. The deputy manager who was present during this inspection is very clear about her role and responsibilities and the systems that are organised in the home. Arrangement in the home were very focussed on meeting the needs and wishes of residents. It is evident that the manager and staff are constantly seeking ways to improve the quality of people’s lives and enlist the help of fellow professionals and colleagues to do so. Lindisfarne DS0000022679.V289381.R01.S.doc Version 5.1 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 4 2 4 3 4 4 4 5 4 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 2 29 3 30 3 STAFFING Standard No Score 31 4 32 3 33 3 34 4 35 3 36 4 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 2 X 4 3 3 3 3 3 3 Lindisfarne DS0000022679.V289381.R01.S.doc Version 5.1 Page 19 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA24 Regulation 23 Requirement The bathroom must be provided with appropriate ventilation. Timescale for action 31/08/06 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 Lindisfarne DS0000022679.V289381.R01.S.doc Version 5.1 Page 20 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith Cumbria CA11 9BP 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 Lindisfarne DS0000022679.V289381.R01.S.doc Version 5.1 Page 21 - 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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