Inspection on 31/07/07 for Lindum House

This inspection was carried out on 31st July 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

Similar services:

Snydale Care Home

Abbey The

Larchfield Manor

Hawkhills

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

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

CARE HOMES FOR OLDER PEOPLE Lindum House 1 Deer Park Way Lincoln Way Beverley East Yorkshire HU17 8RN Lead Inspector Eileen Engelmann Key Unannounced Inspection 31st July 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 Lindum House DS0000069345.V347311.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. Lindum House DS0000069345.V347311.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Lindum House Address 1 Deer Park Way Lincoln Way Beverley East Yorkshire HU17 8RN 01482 886090 01482 869910 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) Barchester Healthcare Homes Ltd Mrs Janet Burns Care Home 64 Category(ies) of Dementia - over 65 years of age (10), Old age, registration, with number not falling within any other category (64), of places Physical disability (3), Physical disability over 65 years of age (64), Terminally ill (6) Lindum House DS0000069345.V347311.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service Users in the category PD, must be aged 55 or over and require nursing care. New service Date of last inspection Brief Description of the Service: Lindum House provides purpose-built accommodation for up to 64 older people requiring nursing and personal care. Care for individuals with dementia needs and physical disabilities can all be cared for in this environment. The home has two floors and the bedrooms, most of which have en-suite facilities, are on both levels. There are well-tended gardens, easily accessible to people using the service and there is car parking at the front of the building. Lindum House is set in a residential area, less that a mile from the centre of Beverley, with its good transport links. Information about the home and its service can be found in the statement of purpose and service user guide, both these documents are available from the manager of the home, and copies are on display in the entrance hall of the home. The latest inspection report for the home is available from the manager on request. Information given by the manager during this visit indicates the home charges fees from £90.00 a night for respite care and all other accommodation is £630.00 a week plus the nursing band fees, where applicable. People will pay additional costs for optional extras such as hairdressing, private chiropody treatment, toiletries and newspapers/magazines. Information on the specific charges for these is available from the manager and can be found in the Service User Guide. Lindum House DS0000069345.V347311.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced visit was carried out with the manager, staff and people living at Lindum House. The visit took place over 1 day and included a tour of the premises, examination of staff and people’s files and records relating to the service. Informal chats with a number of people and staff took place during this visit; their comments have been included in this report. Information was gathered from a number of different sources before we visited the home. Questionnaires were sent out to a selection of relatives, people using the service and staff and their written response to these was poor. We received 0 back from relatives (0 ) although some individuals did assist the person using the service to complete their form, 4 from staff (25 ) and 7 from people using the service (47 ). The surveys did go out late, but extra time was allowed for them to be returned and information from some was gathered after the site visit. The manager completed an Annual Quality Assurance Assessment and returned this to the Commission within the given timescale. Since the home was re-registered there has been one safeguarding of adults referral made to the South Holderness and Minster Adult Care Management Team. This was investigated by the team and is now resolved. The manager of the home is aware of her responsibilities in reporting safeguarding issues and outcomes areas such as health care, staff supervision, staff training, complaints and safeguarding of adults have been looked at as part of this visit. What the service does well: The home has an enthusiastic team of people working within the service, who like doing their jobs and learning more about how to do it well. The people working in the home want to make sure that the people who live in the home receive good care. People living in the home said they are offered a good choice of meals and they enjoyed the quality of food. Specific wishes are catered for and they have plenty to eat and drink throughout the day. People in the home are provided with a warm, safe and comfortable environment that welcomes visitors and makes them feel at home. The home is clean and staff work hard to make sure the building is odour free. People said they are happy with their bedrooms and can bring in their own possessions, making it feel more like home. Lindum House DS0000069345.V347311.R01.S.doc Version 5.2 Page 6 Relatives of the people living in the home said that they are made to feel welcome by the people working in the home and that they can visit when they please. 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. Lindum House DS0000069345.V347311.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 Lindum House DS0000069345.V347311.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): 1, 2, 3, 4 and 6. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The homes statement of purpose and service user guide are good, providing people using the service and prospective people with details of the services the home provides, enabling an informed decision about admission to the home. EVIDENCE: The statement of purpose and service user guide is on display in the entrance hall and copies are available from the manager. Each of the documents is produced in a clear print version, and these are very in-depth and informative. Given the wealth of information in the documents and the different abilities of the people using the service, we queried how many of the people living in the home are able to take in and use the information provided. It is recommended that the home consider producing more appropriate formats that use innovative methods to make the information they give meaningful and interesting, for example using photographs, leaflets, visual or audio versions. Lindum House DS0000069345.V347311.R01.S.doc Version 5.2 Page 9 Information from the surveys shows that the majority of people received sufficient information to make an informed choice about the service before accepting the placement offer. These individuals have also received a contract/statement of terms and conditions from the home. A significant number of residents within the home are self-funding and their files show that information about fees and fee increases is sent out to the person responsible for each individuals finances and sufficient notice of changes to the prices is given in writing. People using the service have their own personal files and four of these were looked at in detail. Three people had been assessed as private payers and the home had completed a detailed needs assessment from which a comprehensive care plan was produced. The fourth person is funded by the Local Authority and, despite searches by the manager, no needs assessment by the authority could be found, although the home had completed its own and drawn up an appropriate plan of care. The responsible individual must make sure that an assessment of need is obtained from the Care Management team (where applicable) before a placement is offered to a prospective client. Staff members on duty were knowledgeable about the needs of each person they looked after and had a good understanding of their specific problems/abilities and the care given on a daily basis.Discussion with people showed that they were satisfied with the care they receive and have a good relationship with the staff. Comments from the surveys said ‘ the staff are professional, helpful and friendly and my relative is well looked after’. The home employs seven staff from overseas countries including Poland and the Philippines. People living in the home said they liked meeting individuals from different cultures; sometimes there are slight communication difficulties but nothing that cannot be worked out. One person living in the home told us that she likes to keep in touch with staff who have moved back to their native countries and she enjoys receiving letters from these individuals. People using the service are able to make a choice of staff gender when deciding whom they would like to deliver their care, as the home has 7 male care staff for day time duties and 2 for night duties. Discussion with five people indicated that they have a good relationship with the staff and are comfortable in asking for specific individuals to deliver their personal care. Preferences for staff gender when giving personal care are documented in the individual care plans. The staff training files and the training matrix show that new staff go through an induction before starting work and that the home has a training programme in place. Information from the files and matrix indicates that the majority of staff are up to date with their basic mandatory safe working practice training, and have access to a range of more specialised subjects that link to the needs Lindum House DS0000069345.V347311.R01.S.doc Version 5.2 Page 10 of the people using the service, including customer care, strokes and visiting mum. Information from the Annual Quality Assurance Assessment and discussion with the people using the service indicates that all of the people are of white/British nationality. The home does accept people with specific cultural or diverse needs and everyone is assessed on an individual basis. Discussion with the manager indicated that the home looks after a number of people from the local community, although placements are open to individuals from all areas. The home does not accept intermediate care placements so standard six is not applicable to the service provided. Lindum House DS0000069345.V347311.R01.S.doc Version 5.2 Page 11 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. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health, personal and social care needs of people using the service are clearly documented and are being met by the service and staff. Improvements to the staff performance around recording within the medication system must be made, to ensure the peoples’ health and welfare are protected. EVIDENCE: Staff said that individuals are able to input to their care plans as they are being written and people using the service sign these to say they agree with the contents. Relatives of those with dementia are asked to assist with information for the plans. There is little evidence that people are consulted on an ongoing basis about their care, especially when staff are completing the monthly evaluations. This was discussed with the manager and she said she would look at how staff could use a variety of different and creative methods to help people using the service to contribute to their own care plan. Lindum House DS0000069345.V347311.R01.S.doc Version 5.2 Page 12 Individual care plans are in place for all the people using the service and the four examined set out the health, personal and social care needs identified for each person. The plans looked at have been evaluated on a monthly basis and any changes to the care being given is documented and implemented by the staff. Risk assessments were seen to cover pressure sores, nutrition, moving/handling and activities of daily living. Information about the person’s social interests, likes and dislikes, spiritual needs and wishes regarding death and dying are included within the individuals care plan. The funding authorities are carrying out yearly reviews of the care plans and the minutes of these meetings show that people have input to this process (where possible), and family/representatives are also invited to the reviews with the person’s permission. This process of review is carried out by the home, for self-funding people. Information from the surveys indicates that the majority of people who responded are satisfied that the staff give appropriate support and care to those living in the home. People said they are able to make their own decisions about their daily lives most of the time; that staff treat them well and listen and act on what they say. One person commented that ‘I understand that if there is a slight delay in staff coming to assist me, that this is due to them being busy at the time’. One relative said ‘Staff are at all times pleasant, friendly and helpful when discussing my mothers needs’. Two people told us that ‘the staff are extremely good; they promote our independence and respect our wishes regarding care. People have good access to their GP’s, chiropody, opticians and other external services. Responses to the surveys indicated that people and their relatives are satisfied with the level of medical support given to the people living at the home. Entries in the care plans specify where individuals have dietary needs, including supplement drinks and pureed diets. The staff weighs everyone on a regular basis and evidence in the plans show that dieticians are called out if the home has particular concerns about an individual. A senior nurse is the designated tissue viability person, who has an excellent knowledge base of wound care and has developed good working relationships with the local GP’s and external bodies. This individual cascades information down to other members of staff to ensure continuity of practice and gives staff regular training to update and maintain their skills. Pressure areas are monitored carefully and proactive measures include risk assessments and special mattresses and seat cushions. Information from the Annual quality assurance assessment and discussion with the manager indicates that there have been six people admitted with pressure sores to the home in the past twelve months, their wound care is documented in their care plan and treatment is given as appropriate. Evidence in the care plans show staff are being successful in healing these areas. Lindum House DS0000069345.V347311.R01.S.doc Version 5.2 Page 13 Relatives commented that they are kept informed of their relative’s wellbeing by the staff; they are regularly consulted (where appropriate) on their care and feel involved in their lives. Checks of the medication show the home is using a blister pack system of medication supplied by a local pharmacy. Observation of the medication records show that there are some areas of practice that need to improve and these include • • There are a number of missing signatures where staff who have given out medication, have not signed on the record sheet. One person, whose care was being tracked, was seen to be taking a 7day course of antibiotics. The signatures on the sheet indicated that there should be 4 tablets left, but when checked there were 6 in the packet. This means that staff have been signing and not giving the medication, which is detrimental to the health of the person who should have received them. Where staff are hand writing medication onto the sheets (transcribing), they are not following best practice. Staff must include the amounts of medication received or brought forward, and have two staff sign the entry to indicate they have both witnessed that the information on the sheet is correct. It was noted that medication already held in the home when a new medication sheet is started is not added to the supplies on the medication record sheets. This should be done so as to ensure a running total is available at all times and an audit of stock is easy to carry out. Staff are not always entering the amount of medication received from the pharmacy onto the record sheet, so making auditing difficult. • • • Checks of the controlled drugs and register showed that these are up to date, accurate and well managed. The nurses are carrying out spot checks on the medication systems and the manager said she would speak to the individuals concerned, as they had not picked up on the issues raised during this visit. People and relative comments show they are very satisfied with the care and support offered by the staff. Chats with people using the service revealed that they are happy with the way in which personal care is given at the home, and they feel that the staff respect their wishes and choices regarding privacy and dignity. Observation of the service showed there is good interaction between the staff and people, with friendly and supportive care practices being used to assist people in their daily lives. Lindum House DS0000069345.V347311.R01.S.doc Version 5.2 Page 14 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. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are provided with choice and diversity in the meals and activities provided by the home. Individual wishes and needs are catered for and people have the option of where, when and how they participate in both eating and leisure activities. EVIDENCE: Discussion with a group of five people indicates that they enjoy the activities on offer within the home and they were looking forward to the next day’s events where they were going to celebrate ‘Yorkshire Day’ with special menus, a raffle and entertainment. The home has an activities co-ordinator who organises and runs a weekly programme of social events; information about this is on display in the reception area and given out to people each week in a letter format. Meetings for people using the service and their relatives are held every 6 months; these are used as an opportunity for individuals to express their ideas of what activities and trips out they want and to give their feedback on events that have taken place. Comments from the surveys indicate that people and their Lindum House DS0000069345.V347311.R01.S.doc Version 5.2 Page 15 relatives also appreciate the fact they can talk to the manager on a daily basis if they wish to. There are a number of people in the home who are partially sighted and these individuals are able to access talking books, watches and magnifying glasses from the Royal National Institute for the Blind. Discussion with people living in the home indicated that they have access to a minibus two to three times each week and can go out on regular trips; they also take part in Quizzes and other group activities. Records are kept of all the social interactions going on in the home and evidence seen at this visit indicates that people are encouraged to celebrate Christian events such as Birthdays, Easter and Christmas. There are monthly in-house church services, one week it is Methodist, another week is the Latimer Church and the next it is Church of England. The Catholic priest will visit anyone wishing to take Communion on request. Discussion with the people living in the home indicates that they have good contact with their families and friends. Everyone said they were able to see visitors in the lounge or in their own room and they could go out of the home with family or staff would take them into the town. Visitors were seen coming and going during the day, staff were observed making them welcome and there clearly was a good relationship between all parties. Relatives and visitors to the home are very positive about the service and the staff. Written and verbal comments given to us showed a high level of satisfaction. Individuals said that the home helped their relatives/friends stay in touch with them. One person said ‘I am phoned when important things affecting my relative take place’ another commented that ‘ the staff make time for me, answer my questions and help me through what is a difficult time’. Information about advocacy services is on display in the home and discussion with the manager indicated that no one at the home is currently using an advocacy service, although these have been accessed in the past. Five people spoken to were well aware of their rights and said that they had family members who acted on their behalf and took care of their finances. People spoken to are satisfied that they can access their personal allowances when needed. People said that the home encouraged them to bring in small items of furniture and personal possessions to decorate their bedrooms. There are six-monthly meetings where the viewpoints and opinions of those living in the home can be expressed and the management team will listen and take action were needed. Visitors said they are kept informed of any important issues affecting their Lindum House DS0000069345.V347311.R01.S.doc Version 5.2 Page 16 friend/relative and felt that staff did a good job of supporting people to live the lives they choose. Observation of the lunchtime meal showed that people were offered a good choice of food, and it was nicely presented. Individuals spoken to said ‘ the food is lovely, it looks good and tastes even better’ and ‘ meals have improved lately’. Two or three individuals felt that the teatime menu still needs some work to develop it further. Comments made were ‘the meal is unappetising and relies on unhealthy snacks such as sausage rolls and cake’ and ‘the meal is rushed as staff do not always have sufficient time to feed everyone’. The manager said that the home has internal resources from within the company to assist the Chef develop the menus and this would be looked at. Lindum House DS0000069345.V347311.R01.S.doc Version 5.2 Page 17 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. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has a good complaints system with some evidence that peoples’ views are listened to and acted upon. Visitors and people using the service are confident about reporting any concerns and the manager acts quickly on any issues raised. EVIDENCE: Checks of the complaints records in the home showed that the manager has dealt with fifteen minor complaints in the last six months. The manager responded to each one and they are now all resolved. The home has a complaints policy and procedure that is included in the statement of purpose and service user guide. It is also on display within the home. People’s survey responses showed individuals have a clear understanding about how to make their views and opinions heard and those people spoken to said ‘the manager comes round every day to see us and will discuss any problems at this time’. Relatives are aware of the complaints procedure and are confident of using it if needed. Those who responded to the surveys said that the manager was Lindum House DS0000069345.V347311.R01.S.doc Version 5.2 Page 18 efficient and effective in answering queries and they were satisfied with her actions. There has been one safeguarding of adults referral made in the past 12 months and this was following on concerns raised with the Commission for Social Care Inspection about the behaviour of a staff member at the home. The South Holderness and Minster Care Management Team handled the referral and a full investigation took place. As a result of the investigation the home has improved how it responds to any allegations made and the manager and staff are aware of their role and responsibilities in reporting any concerns they may have regarding the safety of the people using the service. The home has policies and procedures to cover adult protection and prevention of abuse, whistle blowing, aggression, physical intervention and restraint and management of resident’s money and financial affairs. The staff on duty displayed a good understanding of the safeguarding of adults procedure. Information in the staff training files showed that staff have access to Safeguarding of Adults training and that it is part of the homes rolling programme of mandatory training. Lindum House DS0000069345.V347311.R01.S.doc Version 5.2 Page 19 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, 22 and 26. People who use the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides an extremely high standard of environment, which offers people a safe, comfortable and attractive place to live. EVIDENCE: We walked around the building and found it satisfactory and suitable to meet the needs of the people using the service. The home has an ongoing maintenance and refurbishment programme and the manager was able to show us the work that has been completed in the past six months and discuss work that is planned for this year. Lindum House is a purpose built home that has been open for the past fourteen years. The décor is hotel standard, with lots of pictures and soft lighting, and a number of different seating areas. Lindum House DS0000069345.V347311.R01.S.doc Version 5.2 Page 20 Since the last visit to the home all corridors have been repainted and had new carpets fitted. Lounges have been repainted and had new furniture supplied and the downstairs bathroom has been refurbished with new décor and flooring. Ten bedrooms have been upgraded with new carpets, curtains and bed linen. The home is warm and welcoming and offers people a safe, comfortable and well-designed place to live. Individuals commented that the staff pride themselves on providing an extremely high standard of cleanliness within the home and that they could not fault the service. People have easy access to a number of outdoor areas, including a sensory garden and raised flowerbeds. Time and effort have gone into producing a wonderful display of flowers, shrubs and lawns that are enjoyed by everyone in the home. Flat walkways around these areas assist those with mobility problems to get out and about. Inspection of the home showed that it has been designed and built to meet the needs of disabled individuals. Doorways to bedrooms, communal space and toilet/bathing facilities are wide enough for wheelchairs, and corridors are spacious enough for people in wheelchairs or with walking frames to move along comfortably. The home is built on two floors and the upper floor is accessible by a passenger lift and/or stairs. There are flat walkways inside and out, providing safe and secure footing for people with limited mobility. Discussion with the staff and manager indicates that there is a wide range of equipment provided to help with the moving and handling of people and to encourage their independence within the home. This includes mobile hoists, stand aids, slide sheets, moving and handling belts and handrails. One person has had additional handrails fitted to their bedroom to aid their independence and discussion with this individual showed that this was extremely important to them. Another person has had a life line fitted that links to the nurse call system, as they are unable to use the normal call bell this enables them to summon help if needed. Bathrooms are fitted with rise and fall baths or fixed hoists, and shower rooms are designed for disabled access. Twelve specialist nursing beds are provided where people have an assessed need, and these aid staff in caring for these people and make life more comfortable for individuals who spend a lot of time in bed. The manager said these are being purchased on a regular basis and the hope is that eventually all the beds in the home will be replaced. The home and the community teams provide pressure relieving mattresses and cushions, where people are deemed at risk of developing pressure sores. Lindum House DS0000069345.V347311.R01.S.doc Version 5.2 Page 21 People can access a wheelchair friendly green house and the quadrangle has raised beds for those people who wish to do any gardening from a wheelchair or seated position. The environment is clean, warm and comfortable and no malodours were present. Comments from the day of this visit indicate that the people using the service find the home to be spotlessly clean and they are satisfied with the laundry service provided by the home. The laundry on site is spacious and a separate room is available for storage of clean clothes and linen until it goes back out to the bedrooms. Staff have a good understanding of infection control and demonstrated its use during their care practices, such as hand washing, use of anti-bacterial gel and wearing of protective clothing. Lindum House DS0000069345.V347311.R01.S.doc Version 5.2 Page 22 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. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The standards of recruitment, induction and training of staff are good with appropriate employment checks being carried out and staff demonstrating a clear understanding of their roles, ensuring that people are protected from risk and looked after by motivated and knowledgeable people. EVIDENCE: Comments from the people using the service and relatives are on the whole very positive about the staffing levels within the home, and individuals feel that there is a good standard of care being given to the people living in the home. Survey responses said ‘the staff are warm, welcoming and friendly’. At the time of this visit there were 54 people living in the home and staffing levels are as follows. In a morning (7am to 2.15 pm) there are two nurses and 10 care staff In the afternoon (2pm to 9.15pm) there are two nurses and 6 care staff At night (9pm to 7am) there are two nurses and 3 care staff. Observation of the staff showed that the home is busy, but well organised. Information from the annual quality assurance assessment and the staff rotas about the number of staffing hours provided, and information gathered during the inspection about the dependency levels of the people using the service, Lindum House DS0000069345.V347311.R01.S.doc Version 5.2 Page 23 was used with the Residential Staffing Forum Guidance and showed that the home is meeting the recommended guidelines. Staff said that they feel supported within the home and that the manager works hard to keep staff updated with any changes and motivates individuals to attend training to develop their skills and knowledge base. Overseas staff are encouraged to attend better English classes if their communication techniques are not as good as they could be. The company has achieved City and Guild training status and staff members are undertaking their NVQ 2/3 with the homes training officers. At the moment 13/46 care staff employed at the home (30 ) have achieved an NVQ 2 or 3 and three more staff are working towards this qualification. The home has an equal opportunities policy and procedure. Information from the staff personnel and training records and discussion with the manager, shows that that this is promoted when employing new staff and throughout the working practices of the home. The home has a recruitment policy and procedure that the manager understands and uses when taking on new members of staff. Checks of four staff files showed that police (CRB) checks, written references, health checks and past work history are all obtained and satisfactory before the person starts work. Nurses at the home undergo regular registration audits with the Nursing and Midwifery Council to ensure they are able to practice. The home provides a mandatory staff-training programme and this includes some more specialised training to help staff develop their skills and knowledge around customer care, strokes and safeguarding of adults. The manager said that training in Equality and Diversity issues is being looked at and it is hoped this will become part of the rolling programme of staff development. Lindum House DS0000069345.V347311.R01.S.doc Version 5.2 Page 24 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, 36 and 38. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management of the home is satisfactory overall and the home reviews aspects of its performance through a programme of audits and consultations, which includes seeking the views of residents, staff and relatives. EVIDENCE: Mrs Janet Burns is the registered manager of Lindum House; she has been in post since 1997 and is a Registered Nurse and has an active registration with the Nursing and Midwifery Council. She has achieved her Registered Managers Award and has access to training and support from the Barchester managers training programme. Lindum House DS0000069345.V347311.R01.S.doc Version 5.2 Page 25 The home has achieved the local council’s quality award (QDS) parts one and two. Continuous monitoring and assessment of the home and its practice/service by the Council’s Quality Assurance Team is an essential part of the process leading to the awards being reaffirmed year after year. Meetings for people using the service are held on a regular basis and minutes are circulated to people living in the home. Staff have meetings with the manager and everyone is encouraged to join in with discussions and voice their opinions. People and staff agreed that they are able to express ideas; criticisms and concerns without prejudice and the management team will take action where necessary to bring about positive change. Policies and procedures within the home have been reviewed and updated to meet current legislation and good practice advice from the Department of Health, local/health authorities and specialist/professional organisations. The manager completes in-house audits of the home and its service on a monthly basis, and the registered individual does spot checks and completes the regulation 26 visits. A copy of the monthly visit is sent to the commission. Checks of the finance systems within the home found that computerised records are kept for people’s personal allowances; the administrator on a daily basis up dates these. Information from the Annual Quality Assurance Assessment indicates the majority of people have their families looking after their financial affairs, and checks of the system show their relatives top up the person’s individual allowance account on a regular basis. People who have asked the home to look after their personal allowances are able to access their money on request, and receipts are kept for any transactions. All monies are kept safe and secure within the home and only the administrator or manager has access to the funds. Staff files show that individuals are not receiving regular formal supervision from the manager or their line manager. Discussion with the manager indicated that informal supervision is taking place, but there is a need to improve the level of recording and input to staff practice. The responsible individual must make sure that regular formal supervision is undertaken to ensure staff receive the support and direction they need, to maintain the high standards of care expected by the people who use the service. Maintenance certificates are in place and up to date for all the utilities and equipment within the building. Accident books are filled in appropriately and regulation 37 reports completed and sent on to the Commission where appropriate. Staff have received training in safe working practices and the manager has completed generic risk assessments for a safe environment within the home. Risk assessments were seen regarding fire, moving and handling, cot sides and daily activities of living. Lindum House DS0000069345.V347311.R01.S.doc Version 5.2 Page 26 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 2 3 X N/A 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 4 X X 4 X X X 4 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 4 X 3 2 X 3 Lindum House DS0000069345.V347311.R01.S.doc Version 5.2 Page 27 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 OP3 Regulation 14(1)(b) Requirement The responsible individual must make sure that a needs assessment is obtained from the local authority before offering a placement to a person who is receiving funded care. To make sure the person is confident that the home can meet their needs before accepting the placement. Accurate records must be kept of all medications, received, administered, leaving the home or disposed of to ensure there is no mishandling. To make sure people receive their medication correctly and their health and safety is not put at risk. Care staff must receive formal, structured supervision at least six times a year. So staff can receive feedback and support around their work practices and career development needs, and people using the service receive care from competent and experienced Lindum House DS0000069345.V347311.R01.S.doc Version 5.2 Page 28 Timescale for action 01/12/07 2. OP9 17(1)(a) 01/11/07 3. OP36 18(1)(2) 01/12/07 people who understand their roles and responsibilities. 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 OP1 Good Practice Recommendations The home should consider producing the statement of purpose and service user guide in more appropriate formats, which make the information within them meaningful and interesting for the people using the service. The manager should consider how staff could use a variety of different and creative methods to help people using the service to contribute to their own care plan. The manager should make sure that where staff are hand writing medication onto the sheets (transcribing), they include the amounts of medication received or brought forward, and have two staff sign the entry to indicate they have both witnessed that the information on the sheet is correct. Staff should ensure that medication already held in the home when a new medication sheet is started is added to the supplies on the medication record sheets. This should be done so as to ensure a running total is available at all times and an audit of stock is easy to carry out. 50 of care staff should achieve an NVQ 2 by the end of June 2008. 2. 3. OP7 OP9 4. OP9 5. OP28 Lindum House DS0000069345.V347311.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Hessle Area Office First Floor 3 Hesslewood Country Office Park Ferriby Road Hessle HU13 0QF 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 Lindum House DS0000069345.V347311.R01.S.doc Version 5.2 Page 30 - 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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