Inspection on 05/04/06 for Linfield Care Home

This inspection was carried out on 5th April 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Linfield Care Home 25/07/08

Similar services:

Wingham Court

Old Hastings House

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

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

CARE HOMES FOR OLDER PEOPLE Linfield Care Home 18 - 22 Wykeham Road Worthing West Sussex BN11 4JD Lead Inspector Mrs Hilary Church Unannounced Inspection 5th April 2006 09:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Linfield Care Home DS0000065278.V288799.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Linfield Care Home DS0000065278.V288799.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Linfield Care Home Address 18 - 22 Wykeham Road Worthing West Sussex BN11 4JD 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) 01903 529629 Guild Care Mrs Patricia Hall Care Home 54 Category(ies) of Dementia (11), Dementia - over 65 years of age registration, with number (11), Old age, not falling within any other of places category (43), Physical disability (6), Physical disability over 65 years of age (6) Linfield Care Home DS0000065278.V288799.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. A maximum of fifty four (54) service users may be accommodated in the two units. Unit one for forty three (43) service users in need of physical care in the categories A) Older persons (not falling within any other category. B) Up to six of whom may have a physical disability aged 50 years to 65 years of age. (PD) C) Up to six of whom may have a physical disability and be aged over 65 years. PD (E) Unit two for eleven service users in the category dementia (DE) of whom up to eleven may be over the age of sixty five years. DE (E) N/A 3. Date of last inspection Brief Description of the Service: Linfield Care Home, registered for 54 people, is a large newly built, welldesigned Care Home operating under the Guild Care group of homes and provides specialist care for people with nursing needs; physical disabilities and dementia care needs. It is situated in the centre of Worthing approximately ½ a mile from the town centre and all its amenities and the sea front. A park gives an open aspect to the rear of the building and parking facilities are available in the grounds for visitors. The gardens are of an open aspect with a secure well-planned garden for those receiving care in the ground floor dementia unit. A roof garden provides as additional space for residents to enjoy. The building operates on three floors with a lift providing access between the floors. There are four cluster areas with each having an open-plan lounge and kitchen, giving the home a friendly homely aspect. There are two separate communal dining rooms on the ground and first floors and a large communal lounge that can be extended into the spacious hall when needed. All rooms are single rooms with en-suite facilities. The registered manager is Mrs Patricia Hall, a registered nurse and her deputies, one of whom manages the dementia care unit, support her. Linfield Care Home DS0000065278.V288799.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection, required under the Commission for Social Care Inspection was planned between the Lead Inspector Mrs H.Tomlinson and two other inspectors, who carried out the inspection, namely Mrs H L Church as Link Inspector and Mrs J Hough, a Registered Nurse. Mrs Church and Mrs Hough examined records and observed the morning and lunchtime activities for the different care needs of the residents. The manager was present throughout the inspection process and provided the inspectors with the information they required and a guided tour around the building. To plan for this inspection, registration records were reviewed together with registration agreements and examination of the two documents, the Statement of Purpose and Service Users Guide that form a contract of services. This informs enquirers and residents of how the home is run and how residents can change the way things are done to improve their lives there. During the inspection, 53 residents were being cared for. The inspectors examined records and spoke with residents in the nursing and dementia care unit. In total, the inspectors case tracked six residents by examining their records and observing or discussing their care needs with the residents, their relatives and the staff providing the care and other residents to provide additional views of eh way the home is run. Although some residents were confused, all were able to demonstrate or give a clear account of their life at Linfield. Without exception all comments were enthusiastic although it was clear that residents are encouraged to say what they like or don’t like about the home. The inspectors particularly observed the laughter and cheerful interaction between residents and staff in the specialist dementia care unit and it was clear that they were happy there. The visitors were full of praise for the insight of the staff into their relatives needs and from the discussions with staff, it was clear they were unanimous in their support of the manager, her deputies and their leadership skills. The care plans showed that all needs had been recorded, monitored and reviewed and that staff were providing the appropriate amount of support. There were no requirements or recommendations made at this inspection. What the service does well: Linfield Care Home provides good information about the home in a well presented Statement of Purpose and Service Users Guide. Care staff and ancillary staff work together as a team to enable residents to own it as their own home by listening to their comments and providing very individual care in a secure and homely environment. From resident’s comments and observing staff at work, it was clear that staff are committed to treat residents with respect and dignity and ensure that they are fully informed about their personal or collective activities planned for that day. Residents are encouraged Linfield Care Home DS0000065278.V288799.R01.S.doc Version 5.1 Page 6 to make suggestions or propose any changes they feel would improve their home or individual lives. The personal care and assistance provided to the residents is provided in a caring and sensitive manner. The home has policies and procedures in place to ensure safe practice in administering the medicines to the residents. 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. Linfield Care Home DS0000065278.V288799.R01.S.doc Version 5.1 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 Linfield Care Home DS0000065278.V288799.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4,5. Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. All residents had been assessed before moving into the home. The staff at the home are meeting the residents identified needs. Relatives were given enough information to help them decide the home would be suitable. EVIDENCE: The care home has provided a well planned easy to read format of the Statement of Purpose and Service Users Guide for all their residents and representatives. Six care plans, including those transferring from other Guild Care Homes were examined and it was clear residents had been assessed or re-assessed to ensure that Linfield would be able to meet their needs. Relevant risk assessments were in place and it was clear that all needs had been assessed with risk assessments updated to include risks in the new unit. Care plans to instruct staff how to meet identified needs had been written from the assessments and it was clear from the staff that they were well informed about the care needed and were generally updating records accordingly. Linfield Care Home DS0000065278.V288799.R01.S.doc Version 5.1 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10. Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. All residents had an individual care plan set out for staff to follow. No resident is managing any part of his or her medication without a full risk assessment being carried out and constantly monitored. Staff are meeting the health care needs of the residents in a respectful manner. Medication procedures in the home ensure safe practice. EVIDENCE: Six care plans gave good, clear information of care needed with risk assessments giving staff good information about the risks and how to minimise these. The home’s medication procedures ensure safe practice with the handling, administration, storage and disposal of medicines. The Controlled Drug cupboard and register was checked and the cupboard was seen to contain some Controlled Drugs that should have been disposed of as the resident was no longer accommodated in the home. The administration of Controlled Drugs was accurately recorded in the Controlled Drugs Register. Staff who administer the medicines to the residents are the registered nurses or senior staff who have been assessed as competent of carrying out this procedure. On Linfield Care Home DS0000065278.V288799.R01.S.doc Version 5.1 Page 10 examining MAR charts they were generally accurate and no gaps noted in recording of administration of medicines. However, it was noted on one MAR Chart that a reduced dose of medication was recorded on a separate sheet of paper but no indication of the reducing dose was recorded on the MAR chart. Another MAR chart contained a Post-it-note indicating that the resident was allergic to a specific antibiotic and this information was not documented on the allergy section of the Mar chart. These issues were discussed during feed back with the registered manager. Staff were observed speaking to and caring for the residents and treating them with respect. Staff knocked on doors before entering and then spoke to the residents in a caring manner. Residents’ and visitors’ comments included “staff are kind”. “Helpful”, “lovely” and “it is such a lovely home”. The visitor was fulsome in her praise of the care her mother received in the dementia care unit and felt her mother’s life had been enhanced by being encouraged to be more dependent and through providing such a sensitive service. Linfield Care Home DS0000065278.V288799.R01.S.doc Version 5.1 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15. Quality in this outcome area is excellent. This judgment has been made using available evidence including a visit to this service. Activities are suited to the conditions and dependency levels of each of the current residents. Visiting is positively encouraged. Residents are served meals that are nutritious and appetising and these were highly regarded. EVIDENCE: The book in the main entrance hall recording the visitor’s times showed the varied visits made to see their relative or friend. The visitors confirmed the open visiting times they had experienced. Activities are based on ability with dedicated members of staff providing these. These are listed on the day’s activities notice board in the hall where all the information required for residents to remind them of the day planned is given. In the dementia care unit daily activities are provided, some from care staff whilst specialist activity services are also regularly provided. The inspector observed a specialist organiser providing a ball, sing-a-long and action activity in the lounge with two volunteers assisting. From the residents’ demeanour and cooperation, it was clear that this had been well planned. All residents who wished to were being supported to achieve some success to the level of their abilities. An activities room with specially chosen washable flooring provides an area for painting, craft work and pottery. Linfield Care Home DS0000065278.V288799.R01.S.doc Version 5.1 Page 12 A particular favourite of the residents is their current pet dog, a westie who provides a sense of responsibility and a loving companion. Staff are well trained in issues arising from dementia care needs and the volunteers are also trained in this specialist care. Overall, there are four cluster areas, each with their own open planned lounge and kitchens with drink and snack facilities and large, easily seen flat screened television’s, video, DVD and CD players, large print books, videos and jigsaw puzzles. Broadband and computer access points are available. The residents told the inspector that they really enjoyed their food. It was clear from the menus that these are changed regularly from feed back at each meal and in the dementia care unit, residents are presented with the choice of meals at the time of the meal. A chef and his assistants had provided two main home cooked meals with fresh vegetables followed by a home cooked pudding. As well as this, other standard alternatives are always available at all times and it was clear that the standard of food exceeded expectations. A likes and dislikes list for each resident is updated regularly and any returns are noted for future meal planning. One resident told the inspector “it is very good.” Another said “If you don’t like it they will offer something else”. Linfield Care Home DS0000065278.V288799.R01.S.doc Version 5.1 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,17,18 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. Residents are confident that any complaints they may have are taken seriously and acted upon appropriately. Staff are well trained in Adult Protection Procedures. EVIDENCE: The home has a complaints procedure displayed in a prominent position and it is included in the Statement of Purpose and Service Users Guide. One resident and one relative said they knew who to complain to, but did not have any complaints. No complaints had been received since the home had been registered. The West Sussex Multi Agency guideline was available and from staff comments, staff are continuously updated in procedures. From the comments made by the manager, this is clearly an integral part of all their training and is included in the Induction and Foundation training packs. Linfield Care Home DS0000065278.V288799.R01.S.doc Version 5.1 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,22,23,24,25,26 Quality in this outcome area is excellent. This judgment has been made using available evidence including a visit to this service. The indoor areas used by residents are clean, safe and homely with good access to the rear garden. The resident’s rooms are suitable for their needs and are homely. EVIDENCE: During a tour of the home it was clear that residents are encouraged to move around the home as they wish and apart from those accommodated in the dementia care unit, have access to the main front hall, lounge where a parrot is accommodated and the two dining rooms. All of the rooms were comfortably furnished with dining tables accommodating four residents giving it a homely atmosphere. There is a passenger lift for those residents whose rooms are upstairs. The gardens have been designed to assist residents to walk independently around the home and take part in any gardening activity they wish. A roof garden has been included in the design of the home and although not Linfield Care Home DS0000065278.V288799.R01.S.doc Version 5.1 Page 15 accessible to those in the dementia care unit, overlooks the park and will be furnished with occasional garden furniture. There are 11 residents living in the specialist dementia care unit and from the care taken to provide safe and secure but homely surroundings, residents were clearly able to spend quality time either with others in the communal space or in their own spacious rooms, individually arranged to minimise anxiety and risk. Each resident’s room was clearly identified from chosen cherished items placed in a box on the door. Residents chose the corridor pictures and are consulted on every aspect of colour and how they use their space. The garden is particularly well laid out to provide a safe haven but through the railings, residents are able to see children playing in the park or dogs and their owners. There are four cluster areas, each with their own open planned lounge and kitchens with drink and snack facilities and large, easily seen flat screened television’s, video, DVD and CD players, large print books, videos and jigsaw puzzles. Broadband and computer access points are available. There are enough toilets and assisted baths to meet the needs of residents and thermostatic valves protect residents from scalding water temperatures. Radiators are guarded and the home was clean and hygienic. Resident’s rooms were visited and were homely and comfortably furnished with their own possessions around them. Training records were not examined but the manager told the inspectors that all staff are programmed to receive mandatory and periphery training as well as specialist training related to caring for people with dementia. Linfield Care Home DS0000065278.V288799.R01.S.doc Version 5.1 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,30. Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. The duty rotas did indicate that enough skilled and trained staff are on duty over the 24 hour periods to meet needs and that recruitment processes are robust to ensure residents are protected. EVIDENCE: The inspectors joined the care staff as they assisted residents after breakfast and provided the morning and lunchtime care. The rota confirmed the staff on duty. The numbers and skill mix of staff was appropriate to meet their needs. The members of staff spoken with said they were well supported by the manager. Staffing records were not inspected on this occasion but from the manager’s comments. recruitment is consistent with Guild Care’s other care homes and staff were receiving good induction, supervision and training. The seniors and other staff confirmed this was being provided. Currently, over 50 of staff have National Vocational Qualifications to level 2 or 3 with some senior staff holding National Vocational Qualifications Assessors Awards. Linfield Care Home DS0000065278.V288799.R01.S.doc Version 5.1 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,36,38. Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. The registered manager is well qualified and experienced to manage the home and is actively involved in the care of residents on a daily basis. The home is run in the best interests of the residents whose health, safety and welfare is promoted and protected. EVIDENCE: Mrs Hall is a Registered Nurse and she is well supported by senior care staff, some of whom hold National Vocational Qualification level 4 or are qualified National Vocational Qualifications Assessors. Mrs Hall has completed the Registered Managers Award. It was clear from staff comments that Mrs Hall supports them to carry out their roles and provides a good clear sense of direction to achieve high outcomes for residents. Linfield Care Home DS0000065278.V288799.R01.S.doc Version 5.1 Page 18 All communal rooms and rooms meet the National Minimum Standards giving resident’s sufficient space for them to have personal possessions or necessary equipment to support their care needs and move around their rooms safely. Some policies and procedures were examined and these were appropriate for both this care home and met the overall aspects of Guild Care’s other care homes. Linfield Care Home DS0000065278.V288799.R01.S.doc Version 5.1 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 4 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 4 4 3 3 4 3 4 X STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 3 X 3 3 3 3 3 Linfield Care Home DS0000065278.V288799.R01.S.doc Version 5.1 Page 20 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Linfield Care Home DS0000065278.V288799.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Worthing LO 2nd Floor, Ridgeworth House Liverpool Gardens Worthing West Sussex BN11 1RY 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. 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