Inspection on 16/05/05 for Linelands

This inspection was carried out on 16th May 2005.

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

Linelands 27/06/07

Linelands 30/01/06

Linelands 20/12/04

Linelands 18/10/04

Linelands 12/02/04

Linelands 09/12/03

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Linelands All Saints Lane Nettleham Lincoln Lincs LN2 2NT Lead Inspector Ken Hague Unannounced Inspection 16 May 2005 - 08:30 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. 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. Linelands C53 C04 S41866 Linelands V227051 16-5-05 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Linelands Address All Saints Lane Nettleham Lincoln Lincs LN2 2NT 01522 750889 01522 753597 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) Lincolnshire County Council, Social Services Directorate Mrs Sheila Sibbons Care Home (CRH) 27 Category(ies) of Old Age not falling within any other category registration, with number (OP) - 24 of places Physical disability over 65 years of age (PD(E) 2 Dementia (DE) - 1 Linelands C53 C04 S41866 Linelands V227051 16-5-05 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 20 December 2004 Brief Description of the Service: Linelands is a care home owned by the Lincolnshire County Council. It is situated on the outskirts of the city of Lincoln, in the village of Nettleham. The home is a two-storey property purposely built unit surrounded by gardens with ample parking to the front and the side of the home. There are local shops, churches,cafe and public houses within walking distance of the home. The home is split into six wings, five of which are used to provide care and accommodation for older people. Each wing has its own lounge, quiet room, bathroom and two toilets. The first floor has three kitchen areas where drinks can be made. There are three dining areas in the home. Accommodation is provided in single rooms on the ground and first floors. There is a passenger lift which enables service user to access the second floor. The home provides intermediate/rehabilitation care and short-term care. There are some long-term service users staying the care home who were admitted to this home prior to the policy of the home being identified as to provide service users with short-term care with a view to them returning to their home within agree target dates. A separate day centre is situated in the care home this did not form part of this inspection. The home is registered to provide care for 27 service users Linelands C53 C04 S41866 Linelands V227051 16-5-05 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over an eight hour period. A tour of the building was conducted, care records and other documents were inspected. Two staff, five people using the service and the registered manager was interviewed. The Inspector shared a meal with the service users during this visit. 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. Linelands C53 C04 S41866 Linelands V227051 16-5-05 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Linelands C53 C04 S41866 Linelands V227051 16-5-05 Stage 4.doc Version 1.30 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 standard(s) 2,3&6 Service users are given information to allow them to make an informed choice to stay at the care home. The statement of the terms for their stay at the care home is given to service users. All service users are given a comprehensive assessment prior to them being admitted to the home. The home assists service users to retain and regain their independence and make a planned return to their home in the community. EVIDENCE: The registered manager stated that the home issues a service user guide to every person that comes to stay at the home. The people taking intermediate care confirmed that they had been given a copy of this document. A sample of files inspected did contain this document. A sample of care plans inspected identified all of the care and social needs of the individual service users and included their choices and wishes relating to the manner in which care should be provided. There was a comprehensive risk assessment on each file. If a risk was identified the management of that risk was transferred onto a care plan. The initial care plans were written immediately after the initial assessment. Linelands C53 C04 S41866 Linelands V227051 16-5-05 Stage 4.doc Version 1.30 Page 8 Three service users taking intermediate care stated that they would be returning to their own home in the community within an agreed timescale. They described how they were encouraged to develop their own personal skills. Service users taking intermediate care are encouraged to carry out small domestic tasks, for example they take away their own lunch plates, wash them and make drinks. The Inspector observed this training taking place. A service user going home on the day this inspection stated “when I came here I could not even stand without help. The help I have been given is wonderful and now Im going home”. Linelands C53 C04 S41866 Linelands V227051 16-5-05 Stage 4.doc Version 1.30 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 standard(s) 7,8,9&10 All service users have a detailed care plan which is written immediately after the initial assessment. This includes a full risk assessment and the management strategy for any identified risk. Service users are involved in the drawing up of their own individual care plan. The home provides the opportunity for service users to self-medicate after a risk assessment has been carried out. Alternatively trained staff administer medication in accordance with the homes medication policy. The privacy and dignity of service users is respected by all staff and influences the manner in which care is provided. EVIDENCE: A sampled number of individual care files were found to contain a detailed care plan, including a risk assessment written at the time of their admission. The care plans were signed and dated by both staff and the individual service users. One file contained the likes and dislikes of the service user in relation to diet. The file stated how the service user liked to bathe, which personal care task they were able to carry out for themselves and in what areas they required assistance. One service user said “I like to take a bath almost daily.” The care plan stated bathing should be provided as frequently as requested by the service user. Linelands C53 C04 S41866 Linelands V227051 16-5-05 Stage 4.doc Version 1.30 Page 10 The care records listed the health care needs of individual service user’s and set out how chiropody, dental care and eye care was to be provided. A service user stated that staff had taken him to Lincoln Hospital on the morning of this inspection to see his Consultant. A member of staff was observed giving out medication at lunchtime. She was observed to follow the policy and procedure of the care home for the administration of medication. She confirmed that training had been provided to her prior to her giving out medication. This member of staff explained all service users on intermediate care are offered the opportunity to selfmedicate. This is particularly important she said if they have been taking medication themselves without assistance while living at home. A service user confirmed that he was self-medicating. “I have been provided with a lockable facility within my bedroom in which I keep my own medication. The staff check my medication on a weekly basis.” Linelands C53 C04 S41866 Linelands V227051 16-5-05 Stage 4.doc Version 1.30 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 standard(s) 14&15 Staff speak with service users on a daily basis to ensure that their wishes, choices are always considered. Service users are actively involved in the decision making process particular relating to the provision of intermediate care. Catering arrangements reflect service users preferences and choices. EVIDENCE: Service users stated that they can make definite choices regarding their lifestyle while staying at the care home. One service user stated “I wish to get up between 8:30am and 9:30am. I have asked staff to bring me a drink when they wake me and this does happen. I choose to take my medication myself supported by staff”. One service user stated “I prefer to keep my own company, I spend a lot of my time in my own bedroom.” The choices and wishes indicated above were found to be written on the individual service users care file. The Inspector shared lunch with service users he saw a menu displayed offering choices in the dining rooms. He observed choices being offered to service users during the lunch period on the day of this inspection. The likes and dislikes of individual service users were recorded on their individual care plan. One file stated that the service user disliked peas, this was confirmed to be correct in an individual discussion with the service user. Linelands C53 C04 S41866 Linelands V227051 16-5-05 Stage 4.doc Version 1.30 Page 12 Service users stated their satisfaction with the food being provided. One person stating “the food is very lovely here and very well-prepared”. Linelands C53 C04 S41866 Linelands V227051 16-5-05 Stage 4.doc Version 1.30 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 standard(s) 16 The home has a complaints procedure which is displayed in the home and is known to staff and service users. Service users are able to raise any complaints or concerns through this procedure or service user meetings. EVIDENCE: The complaints procedure of the home meets the National Minimum Standards. Service users confirmed that they have been given a copy of the complaints procedure. All service users spoken to during this inspection stated they would feel confident to raise any concerns or complaints with any member of staff or the registered manager. Linelands C53 C04 S41866 Linelands V227051 16-5-05 Stage 4.doc Version 1.30 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 standard(s) 19,21,26 There is no evidence that the allocated budget for the replacement of equipment in this care home is sufficient to allow the replacement of equipment, or the establishment of an ongoing maintenance program. The failure to replace or repair essential hoists used within the home placed service users and staff at risk. The risk of the service user being injured by coming into contact with radiators with a high surface temperature has not been addressed fully since last inspection. EVIDENCE: The registered manager stated that her allocated maintenance budget does not allow her to carry out the repair and replacement of equipment that she would ideally like to do. A dishwasher identified as requiring to be replaced could not be replaced due to budgetary difficulties until April 2005. The following equipment was identified as needed purchasing for this care home at the time of this inspection. One dishwasher, one refrigerator, too actuators essential for the hoist being used in the home. A new vacuum cleaner was required and a security system to prevent day service users with dementia having unrestricted access to the care home. Linelands C53 C04 S41866 Linelands V227051 16-5-05 Stage 4.doc Version 1.30 Page 15 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, The home provides training for all care staff and encourages NVQ training. There are always sufficient staff on duty to provide essential care for service users although at times staff can feel under great pressure due to the physical layout of the care home. EVIDENCE: The home has 10 staff who have achieved NVQ 2 in care. There are 9 staff currently taking NVQ two in care, in addition to 2 staff taking a foundation course with a view to enrolling on the NVQ course. Staff stated that training is being provided and that all staff are encouraged to take advantage of the NVQ training system. The home does have a staffing problem. The registered manager stated that she is having to restrict admission to ensure all service user needs can be met with present staffing levels. There is no additional funding available to increase staffing levels to ensure all intermediate care beds can be used. The staff and registered manager express concerns that due to the layout of the building it is difficult even with restricted admissions to enable staff to easily move around the building. Service users stated staff are very kind. One service user stated “you could not wish for better staff they help me a great deal”. Three service users and confirmed when asked that staff came as quickly as possible when the call bell was pressed. Linelands C53 C04 S41866 Linelands V227051 16-5-05 Stage 4.doc Version 1.30 Page 16 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,36,38 The home has an experienced and supportive registered manager who has worked in the provision of residential care for many years. Staff are being provided with training supervisions and appraisals as required by the Care Home Regulations. The failure to provide the repair replacement of essential equipment demonstrates the health and safety policy of the care home has not been followed. EVIDENCE: The homes present registered manager has been in post for 13 years. She has worked within the provision of residential care for 22 years. Her qualifications include certificate in management studies, the Institute of occupational safety and health and she is currently working towards NVQ level 4 in management. Staff confirmed that appraisals have been carried out yearly. Supervision is being provided on a one-to-one basis eight times per year. Members of staff confirmed that training is being offered in specialised areas in addition to essential core training. Staff stated the manager is supportive to all staff. Staff meetings had been held frequently. Linelands C53 C04 S41866 Linelands V227051 16-5-05 Stage 4.doc Version 1.30 Page 17 The Inspector observed a staff meeting during this inspection. At the present time the care staff meet in small groups . There is a senior carers staff meeting and a second staff meeting for other care staff. Staff stated that they would prefer a full staff meeting to be held several times a year to which the registered manager would attend. This information was passed to the registered manager at the end of this inspection. A health and safety alert received by the care home stated that if actuators were not replaced on two hoists in daily use this equipment could fail without warning resulting in a serious injury. A financial quotation been obtained for new actuators, but none had been ordered. There has been work carried out on the hot water system to lag hot surfaces, the radiator covers still need to be fitted. There are full risk assessments in place to deal with this interim situation. Linelands C53 C04 S41866 Linelands V227051 16-5-05 Stage 4.doc Version 1.30 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x 3 3 x x 3 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 x 13 x 14 3 15 3 COMPLAINTS AND PROTECTION 3 x 3 x x x x 3 STAFFING Standard No Score 27 3 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x 3 x x x x 3 x 1 Linelands C53 C04 S41866 Linelands V227051 16-5-05 Stage 4.doc Version 1.30 Page 19 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 29 Regulation 13-4 Requirement The 2 hoists for which there is a Medic alert stating that they present a danger to the safety of service users and staff must be repaired or replaced immediately Timescale for action Immediate 2. 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 29 Good Practice Recommendations The maintenance budget for the care home should be reviewed to ensure that it is sufficient to allow ongoing maintenance to be carried out an essential equipment to be replaced without delay. 2. Linelands C53 C04 S41866 Linelands V227051 16-5-05 Stage 4.doc Version 1.30 Page 20 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 Linelands C53 C04 S41866 Linelands V227051 16-5-05 Stage 4.doc Version 1.30 Page 21 - 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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