Inspection on 15/12/05 for Lindisfarne Care Home

This inspection was carried out on 15th December 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

Lindisfarne Care Home 13/11/08

Lindisfarne Care Home 28/06/07

Lindisfarne Care Home 14/06/06

Similar services:

Turret Villa Retirement Home

Moor House

Mendip House

Beaconsfield Court Care Home

Little Sisters Of The Poor

Manor House

Middleton Hall Ltd

Middlesbrough Intermediate Care Centre

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

CARE HOMES FOR OLDER PEOPLE Lindisfarne Care Home Masefield Road Hartlepool TS25 4JY Lead Inspector Michaela Griffin Unannounced Inspection 15th December 2005 10.0 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 Lindisfarne Care Home DS0000062328.V274392.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. Lindisfarne Care Home DS0000062328.V274392.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Lindisfarne Care Home Address Masefield Road Hartlepool TS25 4JY 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) 01429 244020 Gainford Care Homes Ltd Care Home 53 Category(ies) of Dementia (5), Dementia - over 65 years of age registration, with number (48) of places Lindisfarne Care Home DS0000062328.V274392.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection First Inspection Brief Description of the Service: Lindisfarne is a purpose built, 53 bed residential care home, owned by Gainford Care Homes Ltd. It has bedrooms on two floors and further facilities, including an activity room and a hairdressing salon, on a lower ground floor. The home is situated on Rift House housing estate, on the outskirts of Hartlepool, and is on a major bus route with small, local shops and community facilities nearby. The home opened in August 2005 and currently has thirteen permanent residents and another person who spends two days a week in the home. Lindisfarne Care Home DS0000062328.V274392.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The manager and the director, with overall responsibility for the home, gave information about the service for the inspection. Five more members of staff were interviewed and three people who live in Lindisfarne, and three visitors, talked about the service. Four relatives and a service user also filled in comment cards, and so did a health professional who visits the home. What the service does well: 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 Care Home DS0000062328.V274392.R01.S.doc Version 5.1 Page 6 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 Lindisfarne Care Home DS0000062328.V274392.R01.S.doc Version 5.1 Page 7 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 5 People are not admitted to the home, until a full assessment has been carried out and they have had visited the home and agreed that it can meet their needs. EVIDENCE: Three case files were examined and two of these three service users, and the wife of the third, were interviewed. The files showed that the home had collected full information, including a care manager’s assessment, about each service user, before they were offered a place. The manager, a qualified nurse, had visited each person and carried out an assessment, before offering a place on a trial basis. People confirmed that they had been invited to visit and look round the home, before making the decision to move in. Lindisfarne Care Home DS0000062328.V274392.R01.S.doc Version 5.1 Page 8 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 Service users’ needs are detailed in care plans, which ensure that staff, who, provide health care, have the appropriate knowledge and training. People feel that they are treated with consideration and respect. EVIDENCE: Case files were examined and service users and/ or their relatives were interviewed. Each person’s file contained a full care plan, which detailed their health, personal and social care needs. They were written in a way that was clear and understandable. These plans were based on discussions with service users, about how they preferred their needs to be met. And, service users signed the care plans, to show that they agreed with them. The files also included personal histories and pen pictures, of the people who live in the home, which family members helped to write. These histories help remind everyone that each individual, is a whole person, who has led a full life. and made a contribution to society. They explained that each person has worked very hard for their family and community, is a citizen and has the right to be treated with great respect, even if they are now dependent on the help of others. This personal information is particularly helpful, when people are no Lindisfarne Care Home DS0000062328.V274392.R01.S.doc Version 5.1 Page 9 longer able to communicate their likes and dislikes, and what is important to them, clearly. When the staff interviewed talked about the people they care for, they showed them respect. People who live in the home confirmed that all the staff work together and help each other, to make sure that people’s needs are met, in the way that they like. The staff also ensure that people get the health care and medical attention they need and promote their health and well being. Visits by health practitioners and clinical assessments and instructions are clearly recorded. Skin condition is assessed and monitored, and nutritional and dietary needs are carefully screened and action taken when required. Extra staff are brought in to accompany service users, to hospital appointments, when needed. The files showed that the spinal injury nurse had assessed the needs of two people and, as well as visiting them regularly, has drawn up a physio-therapy plan, which is carried out in the home. One lady described how the staff, at the home, have had training, so that they know how to exercise her legs every day. The wife of another service user described how the home was acting on advice they had sought from a dietician, in preparing special meals and monitoring her husband’s weight. On the day of the inspection, a district nurse and a chiropodist both visited people who live in the home. Records of medical device alerts are kept on file and the nurses sign to show they have read then. This protects service users from the inappropriate use of medical devices and equipment. People are also encouraged and assisted to care for themselves, as far as they are able and this is set out in the care plans. Every one has their own room, with en-suite toilet facilities. Residents and relatives confirmed that staff treat the people who live in the home, with respect and consideration. One person, who returned a comment card, wrote ‘I am very happy with the care of my husband in this home. A service user commented ‘I have had a bad year with my health, but I am happy in here. The care is so good and they do their very best.’ The manager of the home is currently reviewing the home’s policies and procedures for the safe administration of medication. She is in discussion with a representative of the pharmacy that supplies the home, about introducing a single, consistent system for dispensing and recording medication. At present, the qualified nurse on duty supervises the administration of medication to all residents, and none handle their own. Some care staff have already had training in the safe handling of medication. Lindisfarne Care Home DS0000062328.V274392.R01.S.doc Version 5.1 Page 10 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 The home does not yet offer a structured programme of activities for its small group of residents. Staff are working hard to develop and strengthen links with the local community, and family and friends are encouraged to participate in the life of the home. EVIDENCE: The home has the use of a mini bus. And, in the summer, outings were organised for residents, to the coast and for a pub lunch. However, the mini bus has been away for repair for some weeks and so no outings or shopping trips have been offered before Christmas. The new manager is currently organising a trip to the pantomime. The home has separate lower ground floor accommodation, which the management hope to develop as a day care service, for people living in their own homes. If this service does develop, residents of the home will be able to join in the activities offered, if they want to. The home also hopes to offer hairdressing and bathing services to local people, this would improve opportunities for contact between residents and people outside the home. The home does not currently employ an activities’ organiser, but intends to recruit one, to ensure that a wider range of interests are provided for as the number of residents increases. There is not a programme of activities yet, but Lindisfarne Care Home DS0000062328.V274392.R01.S.doc Version 5.1 Page 11 the manager and staff arrange activities and social events on a regular basis, wherever possible, involving relatives and the local community. Service users and relatives described a carol service that had taken place the day before, which was led by local school children and well attended by neighbours and families. In a more informal way, staff encourage residents to play board games, dominoes and jig saws. One resident explained that she does not like to mix much and prefers to stay in her own room watching television and reading. However, she is looking forward to going on outings, when the weather improves. The manager is trying to develop links with local churches and religious organisations. She hopes to invite clergy to hold services and get involved with meeting the spiritual needs of residents. One lady described how a lay visitor, from her church, visits to give her communion. Everyone interviewed said that all visitors are made welcome and that the atmosphere is always warm and friendly. Two people confirmed that they visit everyday. The home has a very pleasant dining room, together with a small kitchen area where visitors can prepare drinks and snacks. People are also able to eat in their rooms, when they prefer to. When the home opened, the chef prepared four-week menus, offering a choice at each of three cooked meals a day. However, while the numbers of residents have remained small, he has tried to cater more individually for residents’ preferences, preparing meals that people have requested. One relative likes to help feed her husband and often tastes the meals, which she said are ‘beautiful.’ A service user remarked ‘If there is something that I don’t like, they always find an alternative.’ Another said ‘the food is fair and they try to give me the things I like.’ Lindisfarne Care Home DS0000062328.V274392.R01.S.doc Version 5.1 Page 12 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 The home has a complaints procedure that is easy to understand and follow. Service users and their relatives feel that they are consulted by the manager and that their concerns are taken seriously. EVIDENCE: The home has a complaints policy and procedure, which is written in understandable language and displayed on the notice board. It also has a more accessible version, which is illustrated with diagrams for people who are not fluent in written English. The home has not received any formal complaints so far, but the manager said that service users or relatives have occasionally expressed concerns that have been resolved by the care or nursing staff they have approached. Service users and visitors were aware that they could make complaints, but said that they did not have anything to complain about. However, they did have suggestions for small improvements to the service and said that they found both the original and the new manager approachable, and easy to talk to. The new manager intends to arrange regular consultation meetings, with service users and relatives and the first one is already planned for the new year. The company that runs this home, is also in the process of developing a Newsletter and the manager of this home hopes to encourage and enable some of people who live there to contribute items. Lindisfarne Care Home DS0000062328.V274392.R01.S.doc Version 5.1 Page 13 Some of the staff at the home have had training in the protection of vulnerable adults; all those interviewed felt that they would know what to do if they suspected abuse had occurred. The manager has a copy of the Teeswide InterAgency strategy, which she can consult if she has any suspicions or receives information that a vulnerable adult has been abused. The home is currently revising its policies and procedures, to ensure that they meet the requirements of the Inter-Agency Strategy. The home should also ensure that all staff have basic training in recognising and responding to the signs and symptoms of abuse. Lindisfarne Care Home DS0000062328.V274392.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): 19,21, 23,25 and 26 This new, purpose built, home provides a well-furnished and decorated, clean and comfortable environment. EVIDENCE: The home was purpose built, to the standards required by the Care Home Regulations and the Care Standards Act 2002. And, it has only been open a few months. It is suitably and comfortably furnished, the décor and soft furnishings are attractive and the layout of the wide hall ways and the lounges and dining room, gives it a light and airy appearance. The home looks clean, has a pleasant smell and communal areas are tidy and free from hazards and obstacles. There is a programme of regular decoration and replacement of furniture and equipment, for all the homes run by this company, together with an allocated budget, managed centrally. A handyman has recently been employed, to help with routine maintenance and small decorating jobs. Each person has their own room, with en-suite toilet and hand basin, however they are not supplied with fixed mirrors for residents, who may want to do their own personal grooming. Paper towels are not provided in residents’ bathrooms, for the use of staff. People are able to personalise their own rooms Lindisfarne Care Home DS0000062328.V274392.R01.S.doc Version 5.1 Page 15 and some have brought their own furniture, along with televisions. There are ample bathing facilities, properly equipped, to offer a choice of baths or showers. There is also a hairdressing salon, run by a qualified hairdresser. Only one domestic assistant is employed at present, and residents remarked on how hard she works to keep the communal areas and bedrooms clean and tidy, at all times. The manager has plans to employ a part time laundry assistant also. The home has recently had some work carried out, on the advice of the fire officer, to ensure that residents and staff can be safely evacuated in the event of a fire. All the staff have had fire training and are aware of fire safety issues and evacuation procedures. The home has policies and procedures for the control of infection. Because the home has a small number of residents at present, they all live on one floor. The people, whose needs are for general nursing care, are looking forward to eventually moving to rooms they have picked on the first floor, where they will have views of open countryside or the sea. Lindisfarne Care Home DS0000062328.V274392.R01.S.doc Version 5.1 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): 27,28,29 and 30 The numbers and skill mix of staff are appropriate to the current numbers and needs of the residents. EVIDENCE: Staff numbers and the skill mix of staff is appropriate, to meet the needs of the small number of service users who currently live in the home, for routine care. There is one nurse and three carers on duty, during the day, and one nurse and one carer at night. They are employed fairly flexibly at present, to respond to people with both general nursing and residential care needs, who currently all have bedrooms on the ground floor The manager intends to employ an extra member of staff for the mornings, when the home is busiest and people may want more help to engage in activities. The staffing situation will continue to be reviewed, as more people move in to the home, needs change and people with general nursing needs move to rooms on the first floor. The home has a training programme to provide induction and core training and to meet the particular needs of individual members of staff. The home currently employs five qualified nurses and seven care staff. The national minimum standard recommended has been achieved, because over fifty per cent of the care staff are already suitably qualified. Four out of seven care staff already have National Vocational Qualifications in Care at Level two or above. The manager holds the D32/33 City and Guilds assessors award, and so is qualified to help staff to progress with their NVQs Lindisfarne Care Home DS0000062328.V274392.R01.S.doc Version 5.1 Page 17 Staff files showed that the home had followed rigorous recruitment procedures, in the appointment of staff, ensuring that enhanced police checks were carried out and written and verbal references provided. The people interviewed felt that that they receive the training and support they need to do their jobs. Lindisfarne Care Home DS0000062328.V274392.R01.S.doc Version 5.1 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32, 33, 35 and 38 The home does not yet have a registered manager. The recently appointed manager is suitably, qualified and experienced to apply for registration. The continuous and consistent leadership of a manager is required to develop this service and to lead this staff team, to their full potential. EVIDENCE: The manager has recently been appointed, but had been deputising in the role, when the previous manager left suddenly. She has worked at the home, since it opened in August and is a qualified nurse, with six years supervisory experience in care homes, for older people. Certificates held on her file showed that she has kept renewing her knowledge and learning new skills, since qualifying as a general nurse.Relevant courses have provided her with training in staff supervision and appraisal. She intends to enrol for the registered managers award once she feels established and confident in her new post. She is accountable to the company directors, but also receives the support of a mentor, who is the experienced manager of another, similar home. Lindisfarne Care Home DS0000062328.V274392.R01.S.doc Version 5.1 Page 19 The smooth running of the home is also assisted by a full time administrator, who deals with routine paper-work and correspondence, as well as staff pay roll and time sheets. Her employment in the home, since it opened, has helped maintain some continuity in the organisational arrangements. The home only handles small amounts of pocket money, on behalf of service users. The administrator keeps records of all financial transactions, including money deposited for the safe keeping of the home and money withdrawn, these were available for inspection. The new manager is in the process of setting up a programme of individual supervision for all staff, as they have not been provided routinely since the home opened. She also intends to hold regular staff meetings, although communication has not been a problem within the small staff team. Staff have thus far met regularly, but informally, to support each other and share information, during the period when they were unclear about future management arrangements. Relationships within the home, between all the staff, and including the new manager and non-care staff, are said to be very strong. One staff member explained ‘The staff have all stuck together, the day shift and the night shift too, all support each other.’ The trust between staff and their sense of responsibility, to each other and to the people who live in the home, contribute to the warm and caring atmosphere the service users and their visitors appreciate. The original staff team was disappointed when their first manager left. However, they have confidence in the new manager, because she was already a respected member of this team, and hope to support her in her new role. As one person put it : ‘We are happy with the new manager, we are behind her all the way.’ The manager is also developing a quality assurance system, which includes questionnaires for referring agencies, visiting professionals and relatives. She has also introduced a residents’ and carers’ forum, which will meet in January. Lindisfarne Care Home DS0000062328.V274392.R01.S.doc Version 5.1 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable Lindisfarne Care Home DS0000062328.V274392.R01.S.doc Version 5.1 Page 21 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 3 x 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 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 2 3 x 3 x 3 x 3 3 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 2 3 x 3 x x 3 Lindisfarne Care Home DS0000062328.V274392.R01.S.doc Version 5.1 Page 22 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 OP12 Regulation 16 Requirement The home must introduce a programme of regular activities, based on consultation with service users about their interests and preferences. The home must provide all staff with training on the Protection of Vulnerable Adults and the home’s own policy and procedure. The responsible individual must appoint a suitably qualified and experienced person as manager and that person should satisfy the CSCI that she is a fit person to be the registered manager. Timescale for action 01/08/06 2 OP18 12 01/07/06 3 OP31 9 01/07/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No 1. OP32Refer to Standard Good Practice Recommendations The Responsible Individual should ensure consistency in the future management arrangements for the home. Lindisfarne Care Home DS0000062328.V274392.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Darlington Area Office No. 1 Hopetown Studios Brinkburn Road Darlington DL3 6DS 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 Care Home DS0000062328.V274392.R01.S.doc Version 5.1 Page 24 - 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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