Inspection on 02/02/07 for Lindisfarne Residential Home

This inspection was carried out on 2nd February 2007.

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 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 Residential Home 04/12/07

Lindisfarne Residential Home 02/11/05

Lindisfarne Residential Home 12/05/05

Lindisfarne Residential Home 08/03/05

Lindisfarne Residential Home 14/09/04

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

CARE HOMES FOR OLDER PEOPLE Lindisfarne Residential Home Whitehall Park Chester Le Street Durham DH2 2EP Lead Inspector Denise Huscroft Unannounced Inspection 2nd February 2007 11:00 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 Lindisfarne Residential Home DS0000007487.V327210.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. Lindisfarne Residential Home DS0000007487.V327210.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Lindisfarne Residential Home Address Whitehall Park Chester Le Street Durham DH2 2EP 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) 0191 3883717 0191 3882808 Walker.Hanson@btopenworld.com Gainford Care Homes Ltd Sylvia Andrew Care Home 30 Category(ies) of Dementia - over 65 years of age (30) registration, with number of places Lindisfarne Residential Home DS0000007487.V327210.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 2nd November 2005 Brief Description of the Service: Lindisfarne residential home provides care for up to 28 service users with dementia. The home is built over two floors with lift access; the home is situated within a housing estate in Chester-le-street, which is a town close to Durham. The home is part of the Gainford Care Home Group. Fees charged are between £370.00 and £398.50 per week Lindisfarne Residential Home DS0000007487.V327210.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced. It took place over 5 hours and included a site visit, 3 resident file inspections, 3 staff file inspections and interviews with 3 staff, 2 residents and 3 relatives. A pre inspection questionnaire, resident and relative surveys were received before the site visit. The manager of the home was present during the inspection. What the service does well: The home offers a pleasant environment in which to live. Downstairs there is a very airy communal lounge/dining room which opens out into a large conservatory with French doors overlooking lovely gardens. Residents from both floors can enjoy sitting out in the summer. The bedrooms have many personal possessions in evidence including pictures, photos and furniture. The bathrooms and toilets were all clean and fresh. A district nurse said “Lindisfarne is one of the better homes for cleanliness” and a relative said “the bedroom’s lovely”. The home provides good information for prospective residents, carries out a full assessment and offers a trial visit before any decision is made. This is done in a sensitive manner at the residents pace. One relative said “staff were marvellous with us when we were making the decision”. Residents and families are involved in writing detailed individual care plans which include life history. This ensures staff get to know residents’ likes and dislikes as well as their care needs. The home has a dedicated activities co-ordinator who provides activities, arranges for entertainment to be brought into the home and organises trips out into the community. One to one support is also provided for residents who want to go for walks or shopping. Although the manager has worked in the home for many years she only became manager last year. Staff have described her as “approachable” and “supportive”. One relative said “The manager has a lovely manner. If you’ve got a problem she’ll sort it out” and a resident said she was “very nice, good as gold”. Lindisfarne Residential Home DS0000007487.V327210.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Lindisfarne Residential Home DS0000007487.V327210.R01.S.doc Version 5.2 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 Lindisfarne Residential Home DS0000007487.V327210.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is, good. This judgement has been made using available evidence including a visit to this service. The needs of residents are fully assessed to make sure they can be met before they move in to the home. The home does not provide intermediate care EVIDENCE: Prospective residents have an assessment by a local authority social worker and are then offered the opportunity to have a look around the home. They receive a service user guide, the homes’ Statement of Purpose and a colour pictorial brochure. A pre admission assessment is carried out by the manager together with the resident, a relative or a previous carer. If the home feels it can meet the residents’ needs a trial stay can be arranged before a permanent decision is made. One relative said “Staff were marvellous with us when we were making the decision”. Lindisfarne Residential Home DS0000007487.V327210.R01.S.doc Version 5.2 Page 9 A requirement of the last inspection was that assessments must be fully completed for all service users. The files examined showed detailed assessments which meets this requirement. Lindisfarne Residential Home DS0000007487.V327210.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Each resident has an individual care plan outlining their needs and how they will be met. The health care needs of residents are fully met. The home has clear policies and procedures for the safe storage and administration of drugs. The right to privacy and respect of residents is maintained. EVIDENCE: The organisation have decided to use standardised documentation across all homes. As this has only recently been implemented both the new and old files of 3 residents were examined. The new files were easy to read and contained detailed information of residents’ needs in all areas including: safety/risk, personal cleaning and dressing, communication and vision, dietary Lindisfarne Residential Home DS0000007487.V327210.R01.S.doc Version 5.2 Page 11 requirements, emotional enrichment/wellbeing, elimination, social activities and spiritual needs, moving and handling and sexuality. In addition there was evidence of good quality life story work which gave a good insight into the resident concerned. A requirement of the last inspection was that care plans must be in place for all areas of residents’ health care needs. The new documentation ensures all areas are addressed. Each resident remains registered with their own G.P wherever possible. They also have access to specialist provision including a Chiropodist every 3 months, Optician every 6 months and support from the district nursing service when required. Families confirmed they had been involved in writing care plans and all relative surveys said they were satisfied with the overall care in the home. A district nurse said there were “no problems at all, the level of care is quite good”. The home has policies and procedures in place regarding the administration and storage of medication. A selection of residents’ records were examined and found to be in order. The manager carries out a monthly audit of the residents’ medication. The home uses the Monitored Dosage System. Any unused drugs are returned to Boots monthly. The disposal of controlled drugs is signed for by 2 nurses and for other drugs 1 nurse must sign. A requirement of the last inspection was that the registered person must ensure that medicines are recorded, handled and safely administered in line with prescribers instructions at all times. This requirement has now been met. There are no registered nurses employed by the unit so any medical procedures are carried out by district nurses. A district nurse said “Staff are very professional. They always ask what procedure has been carried out so that they can record it in the residents’ records”. During the inspection the residents all seemed happy and well cared for. Staff treated residents with respect and gave them choices as to what they wanted to eat/drink and where they wanted to be, either in the lounge with the others or in their bedroom. In discussion with staff they said they gave residents dignity, and respected their privacy in several ways including noting if they prefer a male or female carer in their care plan, minimising intervention and therefore promoting independence, knocking on bedroom and bathroom doors and keeping the shower curtain drawn as much as possible during bathing. Lindisfarne Residential Home DS0000007487.V327210.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Activities are provided within the home to make sure the social, religious and recreational interests of the residents are addressed. Contact with family, friends and the local community is encouraged. Residents are encouraged to make choices in all areas as far as they are able. There is a varied balanced diet provided within the home which the residents enjoy. EVIDENCE: The home has an activities co-ordinator who provides a programme of different social activities in the home every morning and afternoon. There is an outing arranged every week to local pubs, parks, shops and the coast. Residents also get one to one support from the activities co-ordinator to go shopping or for walks. 1 resident goes for a walk every afternoon with staff. Lindisfarne Residential Home DS0000007487.V327210.R01.S.doc Version 5.2 Page 13 The home feel it is important to incorporate different things into the programme to keep both mind and body stimulated. Carers offer help to those who can’t manage but only as much as is necessary. The co-ordinator has weekly meetings with the manager to discuss the weeks programme. Activities are planned for 1 year in advance and records of activities and who has taken part are kept on individual files. Church services are held in the home followed by a coffee morning as well as private communion for those who want it. The salvation army also visits the home to provide entertainment. The home encourages residents to maintain contact with friends, relatives and the local community. They have a policy of open visiting which can be in the lounge, conservatory or in private bedrooms. For those families who find transport a problem a minibus is provided on a rota basis to bring them into the home. Comments from relatives include “You’re always made very welcome”. And “Always get a cup of tea, they’re very nice”. Residents are given choices in as many ways as possible. This can be in day to day things such as what to eat, staff ask each resident before 10.00am what they want for lunch, as well as which activities they want to take part in. The manager has devised a selection of pictorial prompts which are displayed around the home e.g. “do you want a bath or a shower” and “Do you want a hot drink or a cold one”. One resident said she “Chose to watch T.V. because she enjoyed the company”. Another said “Staff are very considerate you can go to bed whenever you feel like it”. The home provide a three week menu which includes a choice of hot food at each meal. If residents don’t like what is on offer they can have an alternative. There is also fresh fruit always available for residents to help themselves to and drinks and snacks served each morning, afternoon and evening. For those residents who require liquidised food the meal is made keeping the food groups separate so that individual tastes are maintained. Staff also liquidise cakes and snacks when they are served to the other residents. The meals are made in the nursing home on site and brought to the residential home on a hot food trolley. The temperature of food is checked and recorded and it is then served by kitchen staff. Residents can choose to eat in the dining room or in their own bedrooms. On the day of the inspection the meals looked hot and smelled good. The residents all ate well and said they enjoyed the meal. The last inspection made a requirement that menus must be reviewed with feedback from residents. The residents get a questionnaire every 6 months which they fill in alone or with support from staff or relatives which asks what they think of the food. Comments were mostly positive and included “Food’s very good. They keep changing the menu”. Relatives said “The food looks Lindisfarne Residential Home DS0000007487.V327210.R01.S.doc Version 5.2 Page 14 lovely, dad especially likes bacon and eggs in the morning”. Another had eaten in the home with her mother at social events and said it had been lovely. Lindisfarne Residential Home DS0000007487.V327210.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 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a complaints procedure that residents and families are confident of which is provided in written and pictorial formats. The home has policies and procedures in place to make sure the residents are protected from all types of abuse. EVIDENCE: The home has a complaints procedure which is found in the service user guide and also displayed in the unit. The procedure is also given in an easy to read pictorial version. Surveys showed that relatives and residents were aware of the procedure and those spoken to during the inspection felt confident that any complaint would be acted upon. The complaints recording showed any complaints are monitored and the outcome recorded. A complaint which is currently being investigated showed the procedure was being followed correctly. One resident was able to point out exactly where the procedure was in the corridor and a relative who had had cause to complain said she was very happy with the way it had been handled. The home has policies and procedures in place to protect residents from abuse. Training records confirmed that staff have training to make sure they are Lindisfarne Residential Home DS0000007487.V327210.R01.S.doc Version 5.2 Page 16 aware and understand the procedures. Those spoken to during the inspection agreed they understood the training which included POVA and whistle blowing. Lindisfarne Residential Home DS0000007487.V327210.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 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can be confident the home is safe and well maintained. The home is kept clean, pleasant and hygienic. EVIDENCE: The pre inspection questionnaire showed that all maintenance checks were carried out within appropriate timescales. A selection of records and certificates were examined during inspection and found to be in order. The manager and the maintenance staff carry out a monthly environmental safety audit of the unit which includes checking the condition of floors, doors, water temperatures, and emergency lighting. Lindisfarne Residential Home DS0000007487.V327210.R01.S.doc Version 5.2 Page 18 A tour of the building, upstairs and down, showed it was clean and well maintained. Downstairs there is a very airy communal lounge/dining room which opens out into a large conservatory with French doors overlooking lovely gardens. Residents from both floors can enjoy sitting out in the summer. The bedrooms had many personal possessions in evidence including pictures, photos and furniture. The bathrooms and toilets were all clean and fresh. A district nurse said “Lindisfarne is one of the better homes for cleanliness” and a relative said “the bedroom’s lovely”. Lindisfarne Residential Home DS0000007487.V327210.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 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The number and skills of staff meet the residents needs. Residents are safe in the home. The home has efficient recruitment procedures to protect and support residents. Training and support is provided to make sure staff can do their jobs effectively. EVIDENCE: The home has six staff on duty on morning shift, five staff on afternoons and three staff on night shift. There is also an activities co-ordinator who works 9.00am to 5.00pm.Some relatives felt that if there were more staff then the residents could get out and about a bit more but they understood the limitations. Almost all relative surveys said there was always sufficient numbers of staff on duty. A requirement of the last inspection was that staff induction and training must be kept up to date with accurate records maintained. Lindisfarne Residential Home DS0000007487.V327210.R01.S.doc Version 5.2 Page 20 The manager provided the training matrix which operates in the organisation to make sure staff have regular training. All new staff have induction training which includes First Aid, Moving and Handling and POVA training. Currently 87 of care staff have a National Vocational Qualification of level two or above and 80 hold a current First Aid certificate. Staff spoken to felt the training was of a good quality, particularly the dementia training which includes dealing with challenging behaviour and has helped them to do their jobs. The home has recruitment policies and procedures in place to ensure residents are supported and protected including Criminal Record Bureau checks, Protection of Vulnerable Adult checks and two written references. The application form also asks for a full employment history but those files examined did not have exact dates of former employment and therefore were not following the procedures correctly. The manager is aware of this and it will be a recommendation of this inspection that future applicants supply these details. Lindisfarne Residential Home DS0000007487.V327210.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): 31,33,35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can be confident the home is run by a person fit to do so. The home has systems in place to ensure it is run in the best interests of the residents. The home protects the residents’ financial interests. The home protects the health, safety and welfare of residents and staff. EVIDENCE: The registered manager, who came into post last year, has 9 years experience working within the private sector and with residents having mental health Lindisfarne Residential Home DS0000007487.V327210.R01.S.doc Version 5.2 Page 22 needs. She is completing a Registered Managers Award and has NVQ level 3, a Safe Handling of Medication Certificate and Supervisory Development Certificate. The manager was present throughout the inspection and was able to provide all the documentation required to show the minimum standards were being met. She appeared to have good relations with staff, residents and visitors alike. Staff receive regular supervision from the manager and described her as “approachable” and “supportive”. One relative said “The manager has lovely manner. If you’ve got a problem she’ll sort it out” and a resident said she was. “very nice, good as gold”. A recommendation of the last inspection was that staff should receive regular supervision which staff files that were examined and staff spoken to confirmed is now taking place. The views of residents and relatives play an important part in the homes’ quality assurance systems. Relative and resident questionnaires are sent out every 6 months. There were evidence of lots of replies on file. Most of the comments were positive although the home also welcome suggestions of how things could be better. Regulation 26 visits were all recorded and any actions recommended have been carried out. The residents financial interests are protected through the recording of their income and outgoings which is audited monthly by the manager and separately by the company administrator. An inspection of a selection of resident’s records found them all to be in order. Social services handle the financial affairs of four residents and carry out an annual audit which found records to be accurate. A requirement of the last inspection was that the registered person must ensure that water temperature checks are carried out in the absence of the maintenance man and that a record of these temperatures is maintained. All health and safety checks must be recorded. The manager was able to provide signed records of all safety checks including water temperatures, fire alarm tests and weekly fire drills. Lindisfarne Residential Home DS0000007487.V327210.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 x 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 x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 x x 3 Lindisfarne Residential Home DS0000007487.V327210.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 Refer to Standard OP29 Good Practice Recommendations The manager should ensure all future job applicants provide exact dates of previous employment. Lindisfarne Residential Home DS0000007487.V327210.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Darlington Area Office No. 1 Hopetown Studios Brinkburn Road Darlington DL3 6DS 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 Lindisfarne Residential Home DS0000007487.V327210.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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