Inspection on 31/01/06 for Lindsay Hall Nursing Home

This inspection was carried out on 31st January 2006.

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

Lindsay Hall Nursing Home 12/11/08

Lindsay Hall Nursing Home 13/12/06

Lindsay Hall Nursing Home 08/06/05

Lindsay Hall Nursing Home 07/01/05

Lindsay Hall Nursing Home 27/07/04

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

CARE HOMES FOR OLDER PEOPLE Lindsay Hall 128 Dorset Road Bexhill On Sea East Sussex TN40 2HT Lead Inspector Andy Denness Unannounced Inspection 31st January 2006 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 Lindsay Hall DS0000014014.V280325.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. Lindsay Hall DS0000014014.V280325.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Lindsay Hall Address 128 Dorset Road Bexhill On Sea East Sussex TN40 2HT 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) 01424-219532 Galleon Care Homes Limited Lynda Foster Care Home 38 Category(ies) of Dementia (38), Mental disorder, excluding registration, with number learning disability or dementia (38) of places Lindsay Hall DS0000014014.V280325.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Only service users who have a dementia type illness and /or mental disorder are to be accommodated. Service users should be aged sixty (60) years or over on admission That no more than thirty eight (38) service users are to be accommodated 8th June 2005 Date of last inspection Brief Description of the Service: Lindsay Hall is a Care Home providing nursing and personal care and accommodation for 38 older people with dementia. It is owned by Galleon Care Homes, who also own two other homes in the area. The home is situated in a quiet residential area of Bexhill-on-Sea close to local shops, churches, pubs and other community facilities. The building is a large, spacious home, providing a light and airy positive environment for its residents. There is a lift in the premises to reach all three floors and has assisted bathing equipment and hoists to assist transfer. There is a large garden to the rear which is accessible to service users and car parking for visitors at the front of the building Lindsay Hall DS0000014014.V280325.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced Inspection took place over a morning and afternoon in January and lasted 4 ½ hours. To help gather evidence on how the home is performing the Inspector sat and ate a meal with service users, met with staff and the home’s manager, examined a range of records and written information and undertook an inspection of the premises. Discussions took place with several service users and the relatives of one service user who were visiting at the time of the inspection. 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. Lindsay Hall DS0000014014.V280325.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 Lindsay Hall DS0000014014.V280325.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): 1,2,3,4,5 & 6. Preadmission arrangements are good and ensure that service users move into a home that is suitable to meet their assessed needs. EVIDENCE: Written information in the form of a statement of purpose and a service user’s guide are in place; these documents provide information for prospective service users about Lindsay Hall and the service provided; both documents were examined, they were of a good quality and contained all required information including a copy of the report of the last inspection of the home and details of the latest consultations with the relatives of service users of how they think the home is performing. The manager undertakes assessments of service users’ needs prior to them moving in; since the last inspection improvements have been made to the recording tool used in this process. The recorded assessments of the last two service users admitted were examined; they were of a good quality and covered all necessary areas. All service users or their relatives are issued with a contract detailing the terms and conditions of their stay at Lindsay Hall, a copy of this was examined in contained all required information. The relatives of one service user who were visiting during Lindsay Hall DS0000014014.V280325.R01.S.doc Version 5.1 Page 8 the inspection said they had the opportunity to look around the home before the decision for their relative to move in was made. Intermediate or rehabilitative care is not provided. Lindsay Hall DS0000014014.V280325.R01.S.doc Version 5.1 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): 7,8,9 & 10 Procedures and practices in the home regarding meeting service users’ needs in relation to health, personal care and medication are good and ensure that staff provide them with the appropriate level of help and support. EVIDENCE: Using the initial assessment of need undertaken by the manager as a starting point individual plans of care are compiled for each service user; these identify amongst other things what support they need from staff to meet their day to day needs in relation to health, personal care and mental health needs. The plans for the two newest and the two most needy service users were examined; they were of a good quality and provided detailed guidance for staff. From observations made, discussions with staff and service users and records examined it was evident that needs identified in the plans were being appropriately met by staff. Records examined confirmed that a range of health care professionals are regularly accessed to support staff in meeting service users’ needs, these include GPs, Dentists, Physiotherapists, and speech therapists (to advise over eating problems). Care plans also contained falls risk assessments, nutritional details and pressure sore risk assessments. All plans were reviewed regularly. Because of their mental health needs, service users Lindsay Hall DS0000014014.V280325.R01.S.doc Version 5.1 Page 10 do not manage their own medication, staff do this for them; an easily monitored system is used, storage and records were examined and found to be in order. Records examined clearly described the importance of staff ensuring service users privacy and dignity; observations confirmed that staff upheld these principles in the way they interacted with service users, by for example knocking on doors and awaiting an answer before entering. Lindsay Hall DS0000014014.V280325.R01.S.doc Version 5.1 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): 12,13,14, & 15. Arrangements regarding social and recreational needs and meals are good ensuring variety and choice for service users. Service users have choices in most areas of their lives and arrangements ensure that they remain in contact with friends and relatives. EVIDENCE: The Inspector was told that an activities organiser is employed to work five days a week with service users. Records examined confirmed that a range of activities are provided; because of service users mental health needs these are mainly one to one activities which include reminiscing, reading to them, discussing books, listening to music, outings and help with writing letters. Records examined confirmed that regular contact is kept with service users’ relatives, informing them of issues in their care. Relatives who were visiting during the inspection confirmed that this is the case. The manager said that it is often difficult for service users to make choices because of their mental impairment, however staff do give them choices that they can make decisions over including for example what time to get up or a choice between wearing two items of clothing. The Inspector sat and ate lunch with service users, the meal was well prepared and obviously enjoyed by service users; their comments about meals included “ good” and “oh yes the meals are good” records examined confirmed that a varied and wholesome menu is provided. Lindsay Hall DS0000014014.V280325.R01.S.doc Version 5.1 Page 12 The majority of service users’ required help to eat their meals; staff provided support in a caring and respectful manner. Lindsay Hall DS0000014014.V280325.R01.S.doc Version 5.1 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, 17 & 18 Arrangements regarding complaints and adult protection are good and uphold service users and others right to complain and help ensure the protection of service users from abuse. EVIDENCE: The home has detailed complaints procedure in place, this document was examined it was of a satisfactory standard and records examined confirmed that the manager investigates complaints in line with the written procedures; relatives said that they thought that their concerns, if they had any, would be listened to and acted on. A written procedure is in place regarding adult protection matters and records examined confirmed that most staff are trained in the subject. At the last inspection it was recommended that guidance was sought regarding assessing the mental ‘capacity’ of service user’s ability to make decisions and who should be involved in discussions around working in somebody’s best interests, this is still being investigated by the owners of the home. Lindsay Hall DS0000014014.V280325.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, 20,21,22,23,24,25 & 26. Physical standards and accommodation throughout the home are good and ensure that service users live in a comfortable, well-maintained and safe environment. EVIDENCE: Lindsay Hall is an adapted building with accommodation on three floors; a shaft lift is fitted to assist access for those with mobility problems. An inspection of most areas of the home took place; all areas were well maintained and decorated and furnished to a good standard. Communal facilities consist of only one lounge/dining room; there is insufficient space and seating for all 38 service users; this does not comply with the size requirements for new care homes however national minimum standards clearly state the if a care home was in existence before 2002, as this is the case, then a requirement cannot be made to provide additional communal space. However the owners of the home should keep in mind that the current arrangements are not ideal and should consider providing additional facilities. The lounge/dining room was decorated and furnished in a comfortable homely Lindsay Hall DS0000014014.V280325.R01.S.doc Version 5.1 Page 15 style. The home has sufficient bathrooms, showers and WCs to meet service users’ needs. Most baths are fitted with hoists or are special baths to assist those with mobility problems. Other aids and adaptations including hoists, special beds, grab rails etc are in place to assist staff with transferring service users. Bedroom accommodation is provided in 18 single rooms and 10 double rooms. All bedrooms were decorated and furnished to a good standard, service users are able to bring some of their own furniture with them, many have done so which results in pleasant personalised rooms. The home is fitted with a central heating system with guarded radiators in all areas. Tests confirmed that hot water is delivered to baths and wash hand basins at a safe temperature. The laundry was suitably equipped and records examined confirmed that staff are trained in infection control. A very high standard of cleanliness and hygiene was found in all areas of the home; the cleaners are to be commended for this. Lindsay Hall DS0000014014.V280325.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 Staffing arrangements are good and ensure that service users’ needs are met by sufficient numbers of skilled and motivated staff. EVIDENCE: Staffing numbers on the day of the inspection were sufficient to meet service users needs; an examination of records confirmed that this is the case at all other times, this includes trained nurses on duty 24 hours per day, care staff and ancillary staff. Observations made during the inspection confirmed that staff are caring and respectful in their interactions with service users and that they manage sometimes-difficult situations linked to service users mental health needs with calmness and professionalism. Some service users were able to give their views of staff, their comments included “good people”, “I get on well with staff” and “they do their best to help you”. Training records examined confirmed that staff have received training in a number of subjects including, first aid, fire prevention, moving and handling, dementia, medication and adult protection. Currently 50 of staff have not completed the required national level training course. An examination of records confirmed that generally correct recruitment procedures are followed when new staff are employed, this includes the use of application forms, following up of references, CRB checks, POVA checks and identity checks. However in the instance of a new member of staff only one reference, rather than the required two, had been obtained, action has been required to address this. Lindsay Hall DS0000014014.V280325.R01.S.doc Version 5.1 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): 31, 32, 33, 35, 36, 37, & 38. Management and administration systems are good and support staff in providing an excellent quality of care for service users. EVIDENCE: The manager is a trained nurse and has undertaken her required management training. Throughout the inspection she demonstrated a clear understanding of the needs of the service users living at Lindsay Hall. Observations and discussions with staff confirmed that she is respected, approachable and provides clear leadership. Records examined confirmed that the home has developed an excellent system for assessing the quality of the service that they provide. This includes regular consultations with relatives and staff to gain their views of the service, an annual quality audit and the development of improvement plans and strategies. The results of these assessments are included in the home’s service user guide. The manager and the owners of the home are to be commended for this quality work. The manager explained that Lindsay Hall DS0000014014.V280325.R01.S.doc Version 5.1 Page 18 she holds no money on behalf of service users and that should items be purchased for service users then their relatives of representatives are billed. Discussions with staff confirmed that they receive the regular one to one support sessions from management as is required. Records examined confirmed that required policies and procedures were in place. A selection of other records required by regulation was examined, these were in order and stored securely. A selection of health and safety records was examined including risk assessments and training records, these were in order. All staff are trained in the required subjects related to safe working practices. The home is fitted with a full fire protection system records examined confirmed that this is tested regularly and staff are trained in fire protection matters. The manager demonstrated a clear understanding of health and safety matters. Lindsay Hall DS0000014014.V280325.R01.S.doc Version 5.1 Page 19 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 3 3 3 3 3 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 3 18 3 3 3 3 3 3 3 3 4 STAFFING Standard No Score 27 3 28 2 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 4 3 3 3 3 3 Lindsay Hall DS0000014014.V280325.R01.S.doc Version 5.1 Page 20 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 OP28 OP29 Regulation 18(1)(a) 19(1)(b) Requirement That 50 0f staff are trained to NVQ level 2. That a second reference is obtained for the member of staff discussed and that in future two references are obtained before new staff start work. Timescale for action 31/07/06 31/01/06 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. Refer to Standard OP17 Good Practice Recommendations That the home obtains up to date information and guidance from the Department of Health regarding assessing capacity, consent and working in peoples best interests. Lindsay Hall DS0000014014.V280325.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection East Sussex Area Office Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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 Lindsay Hall DS0000014014.V280325.R01.S.doc Version 5.1 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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