Inspection on 04/12/07 for Lindisfarne Residential Home

This inspection was carried out on 4th December 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

Lindisfarne Residential Home 02/02/07

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 Tanya Newton Unannounced Inspection 4th December 2007 09:30 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.V351883.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.V351883.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 CLS@gainfordcarehomes.co.uk 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.V351883.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 2nd February 2007 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 £431.00 per week Lindisfarne Residential Home DS0000007487.V351883.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Mrs Newton and Mrs Lowther carried out the inspection on the 4th December between the hours of 9:30 and 12:30. A tour of the building was taken and the inspectors spent time talking to people living and working at the home, as well as visitors and staff. Many of the comments received during the inspection have been included within the report. The provider of the home has been asked to complete an annual assessment, which provides the Commission with information about the home. This information had not been received prior to the report being issued. What the service does well: What has improved since the last inspection? What they could do better: The home should develop a tool to monitor pain and include this within the care plan. Input from specialist support teams such as McMillan nurses should also be recorded within the plan of care. The home must ensure that prescriptions are received on time, where they have difficulties with getting these they should seek advice from the Primary Care Trust (PCT). The home must ensure that items such as Calogen are dated on opening and stored in the fridge. Some of the carpets in the home need replacing, as there were odours present in some of the bedrooms. The Regulation 26 visits must be carried out by the Lindisfarne Residential Home DS0000007487.V351883.R01.S.doc Version 5.2 Page 6 provider each month and a report must be held in the home. An up to date electrical wiring certificate must also be available, a copy of this should be sent to the Commission following the inspection. It is recommended that staff receive training on the Mental Capacity Act. 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.V351883.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.V351883.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&6 People who use the service experience good quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to this service. Assessments continue to be well managed and the home does not admit people whose needs cannot be met. EVIDENCE: People are assessed before being admitted to the home. Assessments form the basis from which the care plan will be written. This describes how the home will meet individual needs. The assessments viewed contained detailed information The home does not admit people for intermediate care. Lindisfarne Residential Home DS0000007487.V351883.R01.S.doc Version 5.2 Page 9 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 People who use the service experience good quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to this service. People’s care needs are well managed by the home. Systems to administer medication are in the main good, but the home must seek action to address problems such as prescriptions running out. People living at the home are treated well. EVIDENCE: The health and personal care which a person receives is based on their individual needs. What is identified during the assessment process is put into the plan of care and agreed by the person being admitted to the home or by their advocate. Care is delivered in accordance with the care plan, with privacy, dignity and personal choice being maintained and promoted at all times. The care plans include risk assessments so that people can continue to take reasonable risks in a safe manner. Lindisfarne Residential Home DS0000007487.V351883.R01.S.doc Version 5.2 Page 10 Nutritional screening, falls risk assessment, pressure care and moving and handling needs are all assessed on an ongoing basis. Care plans are evaluated and reviewed monthly. The home should implement a tool to monitor and record pain and this should include possible triggers to be aware of. Whilst the manager said that they would contact the Macmillan nurses where this was required, this information should also be recorded within the care plan. Medication systems were viewed, one person had not received their Digoxin medication for three days as it had run out, and the home was waiting for a prescription from the G.P. On another occasion, someone had been out on social leave and had not been given their medication. Calogen must be dated on opening and stored in the fridge. There were clear records of all medicines being received and administered. The home carries out weekly stock checks. The home must ensure that prescriptions are received on time, where they have difficulties with getting these they should seek advice from the Primary Care Trust (PCT). During the inspection the people accommodated seemed happy and well cared for. The interactions between people living at the home and members of staff were good. We observed the ways in which staff were treating people with respect, offering them choices as to what they wanted to eat/drink and what they wanted to do. Staff said that they respect people’s dignity and privacy in several ways including noting if they prefer a male or female carer in their care plan and by knocking on bedroom and bathroom doors before entering. Lindisfarne Residential Home DS0000007487.V351883.R01.S.doc Version 5.2 Page 11 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 People who use the service experience good quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to this service. The home provides a range of varied activities. Relatives are made welcome and encouraged to visit the home. People living at the home are encouraged wherever possible to make choices within all aspects of daily living. There is a varied menu and people likes and dislikes are well catered for. EVIDENCE: The people living at Lindisfarne were busy making Christmas decorations during our visit. There was good interaction between people taking part in the tasks and the staff supporting the activity. There is a varied activity programme within the home. This includes weekly PAT dogs, monthly church services and a varied programme in house, which is led by the home’s activity co-ordinator. There are outings on the home’s minibus each week and people go out with staff to the shops. The home encourages people 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. Lindisfarne Residential Home DS0000007487.V351883.R01.S.doc Version 5.2 Page 12 People are encouraged to make choices wherever possible. This could include a choice of meals, drinks and activities or where someone would like to be. 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”. The home provides a three-week menu, which includes a choice of hot food at each meal. If people don’t like what is on offer they can have an alternative. There is also fresh fruit available and drinks and snacks are served each morning, afternoon and evening. 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 kitchen staff then serve it. People can choose to eat in the dining room or in their own bedrooms. On the day of the inspection the meals looked appetising and smelled good. People said that they enjoyed their food. Lindisfarne Residential Home DS0000007487.V351883.R01.S.doc Version 5.2 Page 13 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 People who use the service experience good quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to this service. Complaints and adult protection matters are supported by clear guidance and training. EVIDENCE: The home has a complaints procedure in place, which is displayed throughout the home. The complaints procedure is also available in a pictorial format to aid people’s understanding. No complaints had been received since the last inspection. Staff are trained to recognise and prevent abuse. The home has a clear adult protection procedure which links with the local authority procedure for safeguarding adults. The home also has an active whistleblowing policy. All staff spoken with said that they would have no hesitation in whistle blowing (telling someone) if there was a problem. Information on how to report abuse is publically displayed for relatives, people living in the service and staff to follow. Staff are also trained to manage challenging behaviours and deescalate situations. Lindisfarne Residential Home DS0000007487.V351883.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 People who use the service experience adequate quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to this service. Although the environment in the main is kept clean and tidy, there were some odours present. New carpets or flooring may be required in some of these rooms. EVIDENCE: A tour of the home was taken, new tables and chairs have been purchased for the dining room and some chairs have been bought for the lounge. Communal areas are spacious and people have room to move around without being crowded. Furnishings are comfortable. The garden is well kept and used as a resource for people who require time out in a quiet space. Bird feeders provide added interest. Bedrooms are not en suite but the warmth of the atmosphere somewhat compensates for less luxurious facilities. Lindisfarne Residential Home DS0000007487.V351883.R01.S.doc Version 5.2 Page 15 There were some odours in some of the bedrooms. Carpets may need replacing in some of these rooms. An alternative floor covering may be considered providing that the person and/or their family or care manager are in agreement. Some bedrooms were personalised to reflect individual taste, some people choose not to have personal items within their rooms. Bathrooms and toilets are fitted with aids and adaptations to meet the needs of people using the service. Lindisfarne Residential Home DS0000007487.V351883.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 People who use the service experience good quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to this service. Staffing numbers, recruitment systems and training, support and protect people living and working at the home. EVIDENCE: Staff rotas were looked at. The number of staff on duty is sufficient to meet the needs of the people living within Lindisfarne care home. Comments about the staff included “All the staff are canny”, “The girls are very nice and I think that I am well looked after” and “I think I am well cared for”. Staff recruitment files contained sufficient information to protect people. This included a police check and two references. The home has also introduced a policy on Equality and Diversity. All staff have read and signed a copy of the policy to say they understand it and this is kept in their personnel file for future reference. All staff had completed a long distance training course on Equality and Diversity. Induction is provided for all new staff. Training files were also looked at. Some staff had gaps in their mandatory training this has been booked. Mandatory training includes First Aid, Fire, Manual handling, H&S, protection of vulnerable adults (POVA) and food hygiene. Lindisfarne Residential Home DS0000007487.V351883.R01.S.doc Version 5.2 Page 17 Other training included NVQ’s, dementia awareness, and infection control, challenging behaviour and crisis intervention. It is recommended that staff receive training on The Mental Capacity Act. Comments from staff were positive and included “This is the best home that I have worked in, staff are all kind friendly and approachable” and “we have enough staff 99 of the time, it’s a good friendly environment”. Eighteen of the twenty staff employed had an NVQ at level 2 or above. Lindisfarne Residential Home DS0000007487.V351883.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 People who use the service experience good quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to this service. The home has a registered manager who is able to provide clear leadership and support at Lindisfarne. The home does have systems to monitor quality, which seek the views of relatives and other professionals. Health and Safety systems ensure the safety and well being of those living in the home as well as staff. EVIDENCE: The day to day operations of the home are well managed by the registered manager. There are clear lines of accountability within the home. Staff said that they are well supported by the manager. The views of people living at Lindisfarne and their relatives play an important part in the home’s quality assurance systems. Questionnaires are sent out Lindisfarne Residential Home DS0000007487.V351883.R01.S.doc Version 5.2 Page 19 every 6 months. There was evidence of lots of replies on file. The proprietor normally completes a regulation 26 visit monthly, however this had not been done since September. The home has also sent out satisfaction surveys and has received a number of responses. The manager should summarise the information within these surveys and include any action which is being carried out. People’s financial interests are well managed and accurate records are maintained. Health and safety systems were looked at. Safe working practises are maintained in line with current regulations and appropriate risk assessments are available. All safety checks for maintenance are carried out by external contractors as designated by law. All accidents are recorded and reported appropriately. Safety procedures are posted and explained during the staff induction process. Accident statistics are audited monthly and care plans amended where required. The homes electrical wiring certificate was not available. A copy of this certificate must be sent to CSCI following the inspection. Lindisfarne Residential Home DS0000007487.V351883.R01.S.doc Version 5.2 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 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 3 X X X X X X 2 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 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 X 2 X 3 X X 3 Lindisfarne Residential Home DS0000007487.V351883.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP9 Regulation 13 (2) Requirement Timescale for action The home must ensure that prescriptions are received on 15/01/08 time, where they have difficulties with getting these they should seek advice from the Primary Care Trust (PCT). The home must ensure that items such as Calogen are dated on opening and stored in the fridge. Carpets need replacing where there are odours present in bedrooms. Regulation 26 visits must be conducted on a monthly basis and a report held at the home. 28/02/08 2 OP26 23 (2) d 3 OP33 26 30/12/07 Lindisfarne Residential Home DS0000007487.V351883.R01.S.doc Version 5.2 Page 22 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 OP8 Good Practice Recommendations The home should develop a tool to monitor pain and include this within the care plan. Input from specialist support teams such as Macmillan nurses should also be recorded within the plan of care A copy of the home’s electrical wiring certificate should be sent to the Commission. 2. OP38 Lindisfarne Residential Home DS0000007487.V351883.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection St Nicholas Building St Nicholas Street Newcastle upon Tyne NE1 1NB 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.V351883.R01.S.doc Version 5.2 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. 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