Inspection on 11/07/05 for Lindum Park House

This inspection was carried out on 11th July 2005.

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 found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Lindum Park House 12/02/07

Lindum Park House 11/09/06

Lindum Park House 30/11/05

Lindum Park House 28/02/05

Lindum Park House 13/09/04

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

CARE HOME MIXED CATEGORY MAJORITY ADULTS 18-65 Lindum Park House 1-2 Lindum Road Lincoln LN2 1NN Lead Inspector Doug Tunmore Unannounced 11 July 2005 0930 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 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 and Care Homes for Adults 18 – 65*. 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 Park House C53 CO4 S2377 Lindum Park House V237999 110705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Lindum Park House Address 1-2 Lindum Road Lincoln LN2 1NN Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01522 545099 United Health Limited Mrs C A Kirkham Care Home 17 Category(ies) of Mental Disorder, excluding learning disability or registration, with number dementia (MD) - 12 of places Mental Disorder, excluding learning disability or dementia o over 65 years of age (MD(E)) - 5 Lindum Park House C53 CO4 S2377 Lindum Park House V237999 110705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 28 February 2005 Brief Description of the Service: Lindum Park House is a large three stoery, semi-detached, Georgian, grade 2 listed building, which has been adapted to provide accommodation and services for seventeen residents with mental health needs. The home has single bedrooms and a self-contained flat on the top floor, two lounges and a large dining room. Unitied Healthcare Ltd owns the home and provides support through the companies Operations Manager. The home is situated in the centre of the city of Lincoln with all the local facilities available to the residents. The local bus and railway stations are close by and the home is within easy reach of all the citys main shopping areas. Although the home is close to the city centre, it has a small garden and yard, which is used by the residents. Lindum Park House C53 CO4 S2377 Lindum Park House V237999 110705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and started at 9.50 am. The main method of inspection used was called case tracking, which involved selecting two residents and tracking the care they receive through the checking of their records, discussion with them, the care staff and observations of care practice. The manager, staff and residents were very open to the inspection and made it a very pleasant experience for the inspector. A partial tour of the premises took place. What the service does well: What has improved since the last inspection? What they could do better: The home must now involved residents in the undertaking of risk assessments, which should be signed and agreed between residents and the home. The home must organise its administration with files, policies and procedures and adult protection information being easily available, with the manager knowing where documentation is and being aware of what has been updated. Lindum Park House C53 CO4 S2377 Lindum Park House V237999 110705 Stage 4.doc Version 1.40 Page 6 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. Lindum Park House C53 CO4 S2377 Lindum Park House V237999 110705 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home Individual Needs and Choices Lifestyle Personal and Healthcare Support Concerns, Complaints and Protection Environment Staffing Conduct of Management of the Home Scoring of Standards Statutory Requirements Identified During the Inspection Adults 18 – 65 (Standards 1–5) (Standards 6-10) (Standards 11–17) (Standards 18-21) (Standards 22–23) (Standards 24–30) (Standards 31–36) (Standards 37-43) Older People (Standards 1–5) (Standards 7, 14, 33 & 37) (Standards 10, 12, 13 & 15) (Standards 8-11) (Standards 16-18 & 35) (Standards 19-26) (Standards 27-30 & 36) (Standards 31-34, 37 & 38) Lindum Park House C53 CO4 S2377 Lindum Park House V237999 110705 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 (Adults 18 – 65) and Standards 1 – 5 (Older People) are: 1. 2. 3. Prospective service users have the information they need to make an informed choice about where to live. (OP NMS 1) Prospective users’ individual aspirations and needs are assessed. No service user moves into the home without having been assured that these will be met. (OP NMS 3) Prospective service users’ know that the home that they choose will meet their needs and aspirations. Service Users and their representatives know that the home they enter will meet their needs. (OP NMS 4) Prospective service users’ have an opportunity to visit and “test drive” the home. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitablity of the home. (OP NMS 5) Each service user has an individual written contract or statement of terms and conditions with the home. Each service user has a written contract/statement of terms and conditions with the home. (OP NMS 2) 4. 5. The Commission considers Standard 2 (Adults 18-65) and Standards 3 and 6 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2 Progress has been made by the home to improve the admission procedure. The homes policies and procedures have not been updated to reflect the change in practice regarding admission procedures. EVIDENCE: The home has introduced a prospective residents admission form, which, assesses the care needs of residents coming into this home. Residents files seen showed that one resident was admitted prior to the Care Standards being introduced with the second resident being case tracked being admitted in 2005. This residents file had a comprehensive assessment undertaken by a social worker. This assessment was reflected in the homes care plan, which was drawn up with the resident the home manager and the social worker and signed and dated. A letter was also sent to the residents confirming that the home could meet his needs. Both residents stated that they had visited the Lindum Park House C53 CO4 S2377 Lindum Park House V237999 110705 Stage 4.doc Version 1.40 Page 9 home prior to admission. Both residents had either been accompanied to the home by a social worker, a relative or a support worker. Both residents stated that they were ‘happy with this home’ and ‘get on with them’ other residents and staff. The visiting social worker confirmed that she visited with her client prior to admission and they had been made welcome. The homes policies and procedures do not reflect the current practice of the manager or other staff undertaking assessments of care needs prior to the admissions of residents. Lindum Park House C53 CO4 S2377 Lindum Park House V237999 110705 Stage 4.doc Version 1.40 Page 10 Individual Needs and Choices The intended outcomes for Standards 6-10 (Adults 18-65) and Standards 7, 14, 33 & 37 (Older People) are: 6. Service users know their assessed and changing needs and personal goals are reflected in their Individual Plan. The Service Users health, personal and social care needs are set out in an individual plan of care. (OP NMS 7) Service users make decisions about their lives with assistance as needed. Service Users are helped to exercise choice and control over their lives. (OP NMS 14) Service users are consulted on, and participate in, all aspects of life at the home. The home is run in the best interests of service users. (OP NMS 33) Service users are supported to take risks as part of an independent lifestyle. The service users health, personal and social care needs are set out in an individual plan of care. (OP NMS 7) Service users know that the information about them is handled appropriately and that their confidences are kept. Service Users rights and best interests are safeguarded by the home’s record keeping, policies and procedures. (OP NMS 37) 7. 8. 9. 10. The Commission considers Standards 6, 7 and 9 (Adults 18-65) and Standards 7, 14, and 33 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7 & 9 Service user individual needs were promoted and documented appropriately. EVIDENCE: Each service user had an individual detailed care plan. Both care plans were reviewed and signed and dated by the residents. The care plans seen reflected the changing needs of the residents. Residents commented that they were aware of their care plans and felt that they could comment about their care. Risk assessments were also available in files, which addressed the areas of risk in residents care plans. However, residents have not been involved in their risk assessments and these had not been signed by residents agreeing to the risk identified and how this might affect their daily living. The Commission has Lindum Park House C53 CO4 S2377 Lindum Park House V237999 110705 Stage 4.doc Version 1.40 Page 11 received eleven residents comment cards with ten showing that they feel well cared for, with one commenting sometimes. One relatives/visitors comment card was also received which showed that they were kept informed of important matters. Lindum Park House C53 CO4 S2377 Lindum Park House V237999 110705 Stage 4.doc Version 1.40 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 (Adults 18-65) and Standards 10, 12, 13 & 15 (Older People) are: 11. Service users have opportunities for personal development. Service Users find the lifestyle experiencd in the home matches their expectations and preferences and satisfies their social, cultural, religious and recreational interests and needs. (OP NMS 12) Service users are able to take part in age, peer and culturally appropriate activities. 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. (OP NMS 12) Service users are part of the local community. Service users maintain contact with family/ friends/ representatives and the local community as they wish. (OP NMS 13) Service users engage in appropriate leisure activities. 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. (OP NMS 12) Service users have appropriate personal, family and sexual relationships and maintain contact with family/friends/representatives and the local community as they wish. (OP NMS 13) Service users’ rights are respected and responsibilities recognised in their daily lives. Service users feel they are treated with respect and their right to privacy is upheld. (OP NMS 10) Service users are offered a (wholesome appealing balanced) healthy diet and enjoy their meals and mealtimes. Service users receive a wholesome appeaing balanced diet in pleasing surroundings at times convenient to them. (OP NMS 15) 12. 13. 14. 15. 16. 17. The Commission considers standards 12, 13, 15, 16 and 17 (Adults 1865) and Standards 10, 12, 13 and 15 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11, 13, 15 & 17 Social activities are available to residents and they are supported in visiting their family and friends. Meals are well managed and residents are empowered to make choices of the type of food they prefer. Lindum Park House C53 CO4 S2377 Lindum Park House V237999 110705 Stage 4.doc Version 1.40 Page 13 EVIDENCE: Family and friends were encouraged to visit at any reasonable time. Service users were supported to maintain contact through visits, telephone calls and letters. Staff provided appropriate guidance and support to service users with regards to managing their finances personal relationships within and outside of the home. The social worker stated that she was aware that in house activities take place with dominoes and cards are played regularly with staff joining in with residents. It was seen during the inspection that both residents and staff were playing board games and sitting outside under the shade of the trees talking in a relaxed and friendly atmosphere. Care plans seen identified those residents who are independent and visit relatives or friends using public transport for their journeys. One resident is in full time employment and receives support from the staff when required. One visitor spoken to said that he is made welcome when he visits the home and sees his friend in the privacy of one of the lounges. He commented that his friend ‘is very pleased now he’s got a room of his own’. The inspector joined residents for lunch and found that the food served was well cooked and residents enjoyed the meal. A staff member commented that residents get a wide choice of meals and they sign a menu card as to the choice they wish for on a given day. Residents’ feedback cards recorded that they all liked the food on offer at this home. Residents confirmed that four went to Great Yarmouth for a caravan holiday in April 2005 and enjoyed it very much. Lindum Park House C53 CO4 S2377 Lindum Park House V237999 110705 Stage 4.doc Version 1.40 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 – 21 (Adults 18-65) and Standards 8 – 11 (Older People) are: 18. 19. 20. Service users receive personal support in the way they prefer and require. Service users feel they are treated with respect and their right to privacy is upheld. (OP NMS 10) Service users’ physical and emotional health needs are met. Service users’ health care needs are fully met. (OP NMS 8) Service users retain, administer and control their own medication where appropriate and are protected by the home’s policies and procedures for dealing with medicines. Service users, where appropriate, are responsible for their own medication and are protected by the home’s policies and procedures for dealing with medicines. (OP NMS 9) The ageing, illness and death of a service user are handled with respect and as the individual would wish. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. (OP NMS 11) 21. The Commission considers Standards 18, 19 and 20 (Adults 18-65) and Standards 8, 9 and 10 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 & 20 Service users received personal and health care in line with their needs and independence in all areas is encouraged. EVIDENCE: One resident in the home takes her own medication which she receives directly from her G.P, her medication is monitored by a community nurse on a weekly basis. At the last visit on 22/06/05 the pharmacist report showed that administration records were good and storage, stock control and disposal was good. A relatively new member of staff confirmed that he had not undertaken medication training within the home. The homes accident book was seen and showed that accidents to residents are recorded appropriately and are in line with the homes policies and procedures. Lindum Park House C53 CO4 S2377 Lindum Park House V237999 110705 Stage 4.doc Version 1.40 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22-23 (Adults 18-65) and Standards 16, 18 & 35 (Older People) are: 22. 23. Service users feel their views are listened to and acted on. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted on. (OP NMS 16) Service users’ are protected from abuse, neglect and self-harm. Service users legal rights are protected. (OP NMS 17) Also Service users are protected from abuse. (OP NMS 18) Also Service users financial interests are sageguarded. (OP NMS 35) The Commission considers Standards 12, 13, 15, 16 and 17 (Adults 1865) and Standards 16, 18 and 35 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 & 23 The home takes the issue of addressing complaints very seriously and has a comprehensive complaints policy. Staff are aware of how to respond to a complaint or an adult protection allegation. EVIDENCE: No complaints have been received by the home since the last inspection. The homes service users guide was seen which gave information to residents and relatives concerning making a complaint. The service users guide now needs to be amended to reflect the change in the name to the Commission for Social Care Inspection. There were appropriate policies and procedures in place regarding the protection of vulnerable adults and staff had received training in May 2005. Discussion with staff showed that they had a clear understanding of the procedures. Residents’ feedback cards showed that ten of the eleven resident felt safe in the home and one did not. This was relayed to the manager. Lindum Park House C53 CO4 S2377 Lindum Park House V237999 110705 Stage 4.doc Version 1.40 Page 16 Environment The intended outcomes for Standards 24 – 30 (Adults 18-65) and Standards 19-26 (Older People) are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users live in a safe, well-maintained environment (OP NMS 19) Also Service users live in safe, comfortable surroundings. (OP NMS 25) Service users’ bedrooms suit their needs and lifestyles. Service users own rooms suit their needs. (OP NMS 23) Service users’ bedrooms promote their independence. Service users live in safe, comfortable bedrooms with their own possessions around them. (OP NMS 24) Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Service users have sufficient and suitable lavatories and washing facilities. (OP NMS 21) Shared spaces complement and supplement service users’ individual rooms. Service users have access to safe and comfortable indoor and outdoor communal facilities. (OP NMS 20) Service users have the specialist equipment they require to maximise their independence. Service users have the specialist equipment they require to maximise their independence. (OP NMS 22) The home is clean and hygienic. The home is clean, pleasant and hygienic. (OP NMS 26) The Commission considers Standards 24 and 30 (Adults 18-65) and Standards 19 and 26 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 27 & 30 The home is well maintained, the standard of the environment and its facilities are appropriate and safe for the needs of residents. EVIDENCE: A resident showed the inspector around the home, taking in the bedroom, toilets, bathrooms, showers and communal areas. Not all of the bedrooms were seen as some service users were out and others did not want them to be seen. Those seen were large and had been personalised by the occupants. All residents have single room accommodation and they expressed satisfaction Lindum Park House C53 CO4 S2377 Lindum Park House V237999 110705 Stage 4.doc Version 1.40 Page 17 with their rooms. Residents comment cards showed that ten out of the eleven felt that their privacy was respected and one said sometimes. The tour of the environment found that all toilets, were in working order and bathrooms and showers had clean non- slip bath mats. The home was found to be clean and no offensive odours were detected. Some residents look after their own rooms and carryout all of the cleaning tasks required to maintain a good level of cleanliness. The home employs a cleaner who works twenty hours a week. Lindum Park House C53 CO4 S2377 Lindum Park House V237999 110705 Stage 4.doc Version 1.40 Page 18 Staffing The intended outcomes for Standards 31 – 36 (Adults 18-65) and Standards 27 – 30 & 36 (Older People) are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported and protected by the home’s recruitment policy and practices. (OP NMS 29) Service users are supported by competent and qualified staff. Service users are in safe hands at all times. (OP NMS 28) Service users are supported by an effective staff team. Service users needs are met by the numbers and skill mix of staff. (OP NMS 27) Service users are supported and protected by the home’s recruitment policy and practices. Service users are supported and protected by the home’s recruitment policy and practices. (OP NMS 29) Service users’ individual and joint needs are met by appropriately trained staff. Staff are trained and competent to do their jobs. (OP NMS 30) Service users benefit from well supported and supervised staff. Staff are appropriately supervised. (OP NMS 36) The Commission considers Standards 34 and 35 (Adults 18-65) and Standards 27,29 and 30 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) These outcomes were not looked at during this inspection. EVIDENCE: Lindum Park House C53 CO4 S2377 Lindum Park House V237999 110705 Stage 4.doc Version 1.40 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 (Adults 18-65) and Standards 31-34, 37 & 38 (Older People) are: 37. Service users benefit from a well run home. 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. (OP NMS 31) Service users benefit from the ethos, leadership and management approach of the home. Service users benefit from the ethos, leadership and management approach of the home. (OP NMS 32) Service users are confident their views underpin all self-monitoring, review and development by the home. The home is run in the best interests of service users. (OP NMS 33) Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users rights and best interests are safeguarded by the homes record keeping, policies and procedures. (OP NMS 37) Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. Service users rights and best interests are safeguarded by the homes record keeping policies and procedures. (OP NMS 37) The health, safety and welfare of service users are promoted and protected. The health, safety and welfare of service users and staff are promoted and protected. (OP NMS 38) Service users benefit from competent and accountable management of the service. Service users are safeguarded by the accounting and financial procedures of the home. (OP NMS 34) 38. 39. 40. 41. 42. 43. The Commission considers Standards 39 and 42 (Adults 18-65) and Standards 33,35 and 38 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 41 &42 The home is poorly organised in respect to its administration with files, policies and procedures not updated. EVIDENCE: Lindum Park House C53 CO4 S2377 Lindum Park House V237999 110705 Stage 4.doc Version 1.40 Page 20 During the inspection it was found that documentation relating to the keeping of policies and procedures up to date is not undertaken. The manager confirmed that the organisation of the office is lacking at the present time and that she needs adequate space and cupboards to help facilitate an organised office. Risk assessments were seen on residents files relating to hazards posed by the homes environment for individual residents. Risk assessments are also available for the risk posed by radiators, which do not have thermostatic controls nor radiator guards. Water temperatures, fires drills, fire alarm tests and testing of electrical goods bought by residents is undertaken regularly to safeguard residents. Lindum Park House C53 CO4 S2377 Lindum Park House V237999 110705 Stage 4.doc Version 1.40 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. Where there is no score against a standard it has not been looked at during this inspection. 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 2 x x x Standard No 22 23 Score 2 3 Score ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score x 3 x 2 x 3 x x x 3 x 3 Standard No 24 25 26 27 28 29 30 STAFFING 3 x x 3 x x 3 Score 11 12 13 14 15 16 17 Standard No 31 32 33 34 35 36 x x x x x x x x x x 3 2 x Version 1.40 Page 22 CONDUCT & MANAGEMENT PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Lindum Park House Score x 3 3 x 37 38 39 40 41 42 43 C53 CO4 S2377 Lindum Park House V237999 110705 Stage 4.doc no Are there any outstanding requirements from the last inspection? 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 YA2 Regulation 14 Requirement Timescale for action 15/10/05 2. YA9 13(4) 3. YA42 13(4) The home must amend its policies/procedures to reflect that the home must carryout a pre-admission assessment with or with out other agencies (The timescale of 01/09/04 not met) The home must discuss with 15/10/05 residents their risk assessments and agree that they reflect the care required by the resident without curtailing their freedoms. The home must fit radiater 22/06/06 guards and thermostatic controls to ensure the safety of residents (Timescale of 15/12/04 not met) 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 YA22 Good Practice Recommendations The information in the homes homes service users guide needs to be changed to reflect the the inspectorate which is The Commision for Social Care Inspection. Lindum Park House C53 CO4 S2377 Lindum Park House V237999 110705 Stage 4.doc Version 1.40 Page 23 Commission for Social Care Inspection Unity House, The Point Weaver Road, off Whisby Road Lincoln LN6 3QN 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. 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