Inspection on 26/10/05 for Lindley Grange Nursing Home

This inspection was carried out on 26th October 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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

Lindley Grange Nursing Home 05/09/07

Lindley Grange Nursing Home 13/09/06

Lindley Grange Nursing Home 20/06/05

Lindley Grange Nursing Home 09/09/04

Lindley Grange Nursing Home 20/05/04

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

CARE HOMES FOR OLDER PEOPLE Lindley Grange Nursing Home Acre Street Lindley Huddersfield West Yorkshire HD3 3EJ Lead Inspector Cathy Howarth Unannounced Inspection 26th October 2005 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Lindley Grange Nursing Home DS0000001118.V260498.R01.S.doc Version 5.0 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. Lindley Grange Nursing Home DS0000001118.V260498.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Lindley Grange Nursing Home Address Acre Street Lindley Huddersfield West Yorkshire HD3 3EJ 01484 460557 01484 659336 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) BUPA Care Homes (GL) Ltd Mrs Carol Ann Bottrill Care Home 45 Category(ies) of Dementia - over 65 years of age (45) registration, with number of places Lindley Grange Nursing Home DS0000001118.V260498.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Can provide accommodation and care for three named service users under 65 years of age. 20th June 2005 Date of last inspection Brief Description of the Service: Lindley Grange provides nursing care and accommodation for up to 45 older people with dementia type illnesses. The accommodation is on two floors and all the bedrooms have ensuite facilities. Each floor also has lounge and dining room facilities. The home is a stone, purpose built nursing home set in its own grounds. It is approximately two miles from Huddersfield and is on a main bus route. Lindley village, with all its amenities, is located within a short walk. There is a safe garden for service users and ample parking to the front and side of the building. Lindley Grange Nursing Home DS0000001118.V260498.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place over a four-hour period on the day. Inspectors observed care practices over the lunch period, spoke with service users, staff and the deputy manager. Records held within the home were also examined. Not all core standards were assessed on this visit as many core standards had been assessed at the previous visit. Please refer to the previous report for information regarding these standards. Overall the service was found to be good but some important improvements need to be made in the interests of the well being of service users. The inspectors would like to thank service users and staff for their welcome on this visit. What the service does well: What has improved since the last inspection? What they could do better: Care plans should be updated to make sure they reflect the needs of service users. Meals are of a good quality but attention needs to be paid to how they are served. Service users are not adequately protected at present. Improvements need to be made in training and staff deployment to ensure all service users are kept safe from harm. Lindley Grange Nursing Home DS0000001118.V260498.R01.S.doc Version 5.0 Page 6 Complaints need to be recorded fully and available for inspection. Staff supervision needs to improve to meet National Minimum Standards. 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. Lindley Grange Nursing Home DS0000001118.V260498.R01.S.doc Version 5.0 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 Lindley Grange Nursing Home DS0000001118.V260498.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): This section was not assessed on this visit. Please refer to previous report. EVIDENCE: Lindley Grange Nursing Home DS0000001118.V260498.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 9 Each service user has a care plan, however two of the 4 care plans examined did not reflect the current health care needs of the service users. Policies and procedures are in place to ensure the safe administration of medication. EVIDENCE: Each service user has a care plan. The care plan identifies the areas of personal and health care in which the service user requires assistance from staff. Four service users’ care files were examined. There were risk assessments in place for such things as moving and handling, nutrition and skin integrity. Some of these had been reviewed monthly. It is recommended that all care documentation is reviewed on a monthly basis with the involvement of the service user or their family. The care files inspected also had a dependency rating score which determined the level of dependency for each service user. These had been completed by the staff on a monthly basis. On checking one of these it was found that the scoring did not reflect the current health care needs of one of the service Lindley Grange Nursing Home DS0000001118.V260498.R01.S.doc Version 5.0 Page 10 users. One service user who had recently been admitted to the home had an incomplete care plan. Problems which had been identified on the pre-admission assessment had not been formulated into a care plan. Qualified nursing staff are responsible for the administration of medication. The stock balances of four service users’ medication was checked and the balances tallied with the medication administration records held by the home. It was noted that medication prescribed for one service user had been refused at regular intervals. The staff informed the Inspector that the service user’s GP had been made aware of this but there was no record made by the staff to say that he had been informed. Staff were advised to record in the service user’s care file that the GP had been made aware of any medication which has been refused. Lindley Grange Nursing Home DS0000001118.V260498.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,14, 15 A good range of recreational and social opportunities are provided. Service users can exercise choices but may need staff support to do so. Meals are of a good quality but attention needs to be paid to how they are served. EVIDENCE: The home has two large main communal areas, one on each floor of the home. There are also smaller lounges available for people to meet with relatives or watch TV. There is an activity timetable where it was seen that there was a good range of activities on offer over the week for people to join in if they wish. Service users who spoke with the inspector had some difficulties remembering any of the activities they may have enjoyed or participated in. This may simply be a reflection of the service user group at the home however. There was evidence of service users’ preferences being taken into account in the care plans and indications that staff try to organise activities to meet specific needs. As part of the inspection, lunchtime on the ground floor was observed. There was evidence of staff taking time and assisting those people that required help Lindley Grange Nursing Home DS0000001118.V260498.R01.S.doc Version 5.0 Page 12 to feed in a discreet and sensitive manner and the food was of a good quality, which service users appeared to enjoy. Unfortunately because so many people needed assistance, some people had to wait for their lunch. It was noted however that all the meals were served at the same time. This meant that, for those people who were waiting, their meal was cold before they received it. A recommendation is made that this arrangement is altered to ensure that all service users receive their meals while they are hot. The inspectors observed staff taking time checking out with service users to ensure they understood their choices. Lindley Grange Nursing Home DS0000001118.V260498.R01.S.doc Version 5.0 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 Service users can make complaints but the records for these need to be available. Service users are not adequately protected at present. EVIDENCE: On this visit the manager was on leave and the staff on duty were unable to locate the detailed records of complaints. There was evidence however that complaints had been received that were logged. It was not however logged who had made these or what the complaints were about. The complaints log should be detailed and records of complaints should be available for inspection at all times. The procedure is displayed and clearly some people have used the system. The home also keeps letters complimenting the service from relatives and service users. On this visit, inspectors were concerned to find that a recent incident highlighted a lack of awareness of procedures around the protection of vulnerable adults. Records for one service user revealed a series of incidents of aggression towards other service users and staff, some involving injuries and unacceptable sexual behaviour. These incidents had been ongoing for some time without any referral to adult protection. The manager should look at how such incidents are dealt with and make referrals where there are clear risks to service users. All staff should revisit the procedures around adult Lindley Grange Nursing Home DS0000001118.V260498.R01.S.doc Version 5.0 Page 14 protection to ensure that they respond appropriately to these types of occurrences. In discussion with staff, it was clear that there are staffing issues to be considered in keeping people safe. On the ground floor in particular, staff were indicating that there are potentially volatile situations on a regular basis. Recently, staffing has been reduced on some shifts and this may leave service users vulnerable where two are staff are working and have to leave the main communal area. See further details in the section on staffing. Lindley Grange Nursing Home DS0000001118.V260498.R01.S.doc Version 5.0 Page 15 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): 21, 26 There are adequate toilet and washing facilities for service users. The home is maintained in a clean and tidy manner. EVIDENCE: The home has suitable and sufficient facilities for washing and toilet requirements. There are toilet facilities close to communal areas for service users to use during the daytime. On the day of this inspection the home was found to be clean and tidy and free from offensive odours. Lindley Grange Nursing Home DS0000001118.V260498.R01.S.doc Version 5.0 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, 29 Attention needs to be paid to deployment of staff to ensure service users are kept safe. Staff recruitment procedures serve to protect service users. EVIDENCE: During this inspection staff rotas were examined. Inspectors were informed that recently staff had been informed that there would be a reduction in staffing due to the fact that three service users had been assessed as needing residential rather than nursing care. While staffing numbers were seen to be within appropriate levels, the deployment of staff caused some concern, particularly on the ground floor where this may result in service users being unattended at times. Staff reported that this group can be fairly volatile and there have been incidents of aggression and unacceptable behaviour between service users. Inspectors were concerned also about the extensive use of agency nurses within the home, to cover shortfalls in the rota. Given some of the problems being experienced by staff with some service user this may contribute to increased risks for service users. Staff need to be deployed so that the welfare of service users is protected at all times. Working practices within the staff team may need to be reviewed to achieve this. Staff recruitment files for three recently employed staff were examined. These were found to be satisfactory. Lindley Grange Nursing Home DS0000001118.V260498.R01.S.doc Version 5.0 Page 17 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): 36 Staff supervision needs to improve to meet National Minimum Standards. EVIDENCE: On this visit, staff supervision records were examined. These showed that staff were not receiving supervision at the recommended frequency of six times a year. Given some of the challenges facing the staff, this is important and needs to improve. There is an appraisal system in place and some staff had participated in this. Lindley Grange Nursing Home DS0000001118.V260498.R01.S.doc Version 5.0 Page 18 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 X X X X HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 X 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 1 17 X 18 1 X X 3 X X X X 3 STAFFING Standard No Score 27 1 28 X 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X X 2 X X Lindley Grange Nursing Home DS0000001118.V260498.R01.S.doc Version 5.0 Page 19 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. 2 Standard OP16 OP18 Regulation 17 (3) 13(6) Requirement Records of complaints must be kept at the home and available for inspection at all times. The procedures for referring to adult protection should be used for the protection of service users. Staff should receive refresher training in identifying and responding to abuse. There must be suitably qualified and experienced staff in sufficient numbers on each shift to protect the welfare of service users. Timescale for action 30/11/05 31/10/05 3 3 OP18 OP27 13(6) 18(1) 30/11/05 26/11/05 Lindley Grange Nursing Home DS0000001118.V260498.R01.S.doc Version 5.0 Page 20 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard OP7 OP15 OP36 Good Practice Recommendations Care plans should be reviewed monthly to ensure they reflect the current needs of service users. The arrangements for serving hot meals should be reviewed to ensure that all service users receive meals while they are hot. All staff should receive supervision a minimum of 6 times per year. Lindley Grange Nursing Home DS0000001118.V260498.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Brighouse Area Office Park View House Woodvale Office Park Woodvale Road Brighouse HD6 4AB 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 Lindley Grange Nursing Home DS0000001118.V260498.R01.S.doc Version 5.0 Page 22 - 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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