CARE HOMES FOR OLDER PEOPLE
Lingdale Lodge Lingdale East Goscote Leicestershire LE7 3XW Lead Inspector
Helen Abel Unannounced Inspection 27th October 2005 11:30 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 Lingdale Lodge DS0000001730.V258332.R01.S.doc Version 5.0 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. Lingdale Lodge DS0000001730.V258332.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Lingdale Lodge Address Lingdale East Goscote Leicestershire LE7 3XW 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) 0116 2603738 0116 2603738 Mr John William Nunn Mrs Barbara Elsie Nunn Vacant Care Home 48 Category(ies) of Dementia (9), Mental Disorder, excluding registration, with number learning disability or dementia - over 65 years of of places age (10), Old age, not falling within any other category (37), Physical disability (8), Physical disability over 65 years of age (8) Lingdale Lodge DS0000001730.V258332.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. No one under the age of 55 years may be admitted to the home. Service user numbers - PD & PD(E) No one falling within the categories PD or PD(E) to be admitted to the home when there are already 8 persons falling within categories/combined categories PD or PD(E) already accommodated within the home. To be able to admit the person of category MD(E) identified in correspondence from the previous registration authority dated 5/4/2000. To be able to admit the named persons of category DE named in variation application number 55170 dated 10th September 2003. To be able to admit the named persons of category DE(E) named in variation application number V11211 dated 25th August 2004. 20th April 2005 3. 4. 5. Date of last inspection Brief Description of the Service: The home is owned by the Registered Providers Mr and Mrs Nunn and is part of fifteen homes owned by the Broadoak Group of Care Homes. Lingdale Lodge is a large 48 bedded home set in a modern building on one level. The home is set back off the main road in a quiet location of East Goscote but is accessible to shops, and other amenities. The home is situated next to Primrose Residential Home, also owned by the same Providers. Lingdale Lodge DS0000001730.V258332.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection during a weekday morning over a 4-hour period. A part tour of the building took place with care records, policies and procedures inspected. There was the opportunity to talk with four residents, and a visitor. The Acting Manager was present throughout the inspection and assisted with the inspection process. What the service does well: What has improved since the last inspection? What they could do better:
The Statement of Purpose and Statement of Terms and Conditions to be updated to include information around the costs of residents trips out and who pays for these. The Registered Providers process for arranging trips should be reviewed ensuring access and equal opportunities to all residents. First Aid training, Induction and Foundation training, and regular supervision is to be established, ensuring staff are adequately supervised and supported. Staff recruitment files should include a photograph of staff to ensure safe, robust policies and procedures. Lingdale Lodge DS0000001730.V258332.R01.S.doc Version 5.0 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. Lingdale Lodge DS0000001730.V258332.R01.S.doc Version 5.0 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 Lingdale Lodge DS0000001730.V258332.R01.S.doc Version 5.0 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): 1,2,4,5 The written information/contract available to residents does not provide sufficient information to make an informed choice. Residents are able to visit the home prior to living at the home. EVIDENCE: Written information about the home did not include services to be paid for over and above those included in the fees, such as trips out. This aspect was raised by a resident, “ We have to pay to go on trips. It’s too much I can’t afford it”. The Acting Manager confirmed not all trips incur a cost. A recent boat trip in April had incurred a significant expense to those residents who went. The policy around trips for residents should be discussed and reviewed with the Registered Providers. New residents and their friends and family are able to visit prior to living at the home. Lingdale Lodge DS0000001730.V258332.R01.S.doc Version 5.0 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): 9,10 Medication management is satisfactory. EVIDENCE: The medication area was well maintained with resident’s medicine records up to date and well organised. The Pharmacist had visited in early October and had confirmed medication management was compliant. Lingdale Lodge DS0000001730.V258332.R01.S.doc Version 5.0 Page 10 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): 14 Residents are helped to exercise choice and control in their lives. EVIDENCE: Residents are able to take part in monthly meetings with their relatives and key worker also invited. Any decisions made from the previous meeting are always talked through again. Residents recently requested a menu wipe board to be displayed, and suggested new dishes to go on the menu. The Acting Manager confirmed Halloween and bonfire celebrations are coming up, and has arranged sparklers and a tomato soup and hot dog meal one evening. One resident asked for his clock in his bedroom to be mended. The Acting Manager agreed to look into this. Lingdale Lodge DS0000001730.V258332.R01.S.doc Version 5.0 Page 11 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): These outcomes were inspected at the last inspection. EVIDENCE: Lingdale Lodge DS0000001730.V258332.R01.S.doc Version 5.0 Page 12 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): 21,23,24,26 The premises are generally well maintained clean and hygienic. EVIDENCE: The indoor area was well maintained, clean and comfortable. Staff were observed hovering, polishing and dusting and talking with residents. Resident’s rooms were personalised with items of resident’s furniture, pictures and photographs. The ambience in the home was relaxed and comfortable. The front outdoor area of the home was poorly presented with blue wooden garden furniture left scattered and broken, which may present a safety hazard to residents, staff and visitors. Lingdale Lodge DS0000001730.V258332.R01.S.doc Version 5.0 Page 13 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): 29,30 Staff are competent to do their jobs. EVIDENCE: Training towards National Vocational Qualifications (NVQ’s) in Care level 2 and 3 is ongoing. Over 50 of staff currently hold an NVQ. Some staff are receiving support from a local college with their literacy skills which gives staff confidence in their studies and care duties. See also Standard 38 Safe Working Practice staff Induction and foundation training. Staff recruitment files are set up but must include proof of a person’s identity, including a recent photograph. Lingdale Lodge DS0000001730.V258332.R01.S.doc Version 5.0 Page 14 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): 33,34,35,36,37,38 In general the health, safety and welfare of residents are met. EVIDENCE: The Acting Manager spoke of always making herself accessible and leaving the office door open and welcoming residents, family and friends to drop in and talk. The home received an inspection from Environmental Health in June. The process was explained to residents at their residents meeting and that they are safeguarded. Residents made the following general comments about Lingdale Lodge: “It’s alright here. Staff are okay.” “It’s not bad here.” “It just meets the standard.” “I do like xxxx (staff member) he is good.” Lingdale Lodge DS0000001730.V258332.R01.S.doc Version 5.0 Page 15 The Acting Manager is going to be working towards a quality assurance award in February 2006. This will confirm staff are appropriately supervised and supported. Due to a new staffing structure the Acting Manager is at the point of setting up formal supervisions and induction foundation training with the staff group. The Acting Manager confirmed First Aid training is to be arranged as a priority. The Acting Manager confirmed regular hot water checks would continue to be undertaken by the Deputy Manager alongside other health and safety checks. All the required health and safety checks are being implemented which protect residents. Lingdale Lodge DS0000001730.V258332.R01.S.doc Version 5.0 Page 16 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 2 2 x 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 x 8 x 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 3 15 x COMPLAINTS AND PROTECTION Standard No Score 16 x 17 x 18 x 2 X 3 X 3 3 X 3 STAFFING Standard No Score 27 x 28 x 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x x 3 3 3 3 3 2 Lingdale Lodge DS0000001730.V258332.R01.S.doc Version 5.0 Page 17 Are there any outstanding requirements from the last inspection? Yes 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 OP2OP1 Regulation 5 Requirement Information to be included in the Statement of Purpose: The arrangements for residents to engage in social activities, hobbies and leisure interests. The Statement of Purpose and Statement of Terms and Conditions should include who meets the costs for any organised trips as they are currently above those included in the fees. The Registered Person shall ensure the premises are of sound construction and kept in good repair externally: The front entrance area is poorly presented with blue wooden garden furniture left scattered and broken. This should be maintained and made safe. Ensure staff receive regular formal supervision. Outstanding since the last inspection of 20/04/05. The Registered Provider shall make suitable arrangements for the training of First Aid for the Deputy Manager and other staff.
DS0000001730.V258332.R01.S.doc Timescale for action 30/11/05 2. OP19 23 03/11/05 3. OP36 18 03/11/05 4 OP38 13 30/11/05 Lingdale Lodge Version 5.0 Page 18 5 OP29 7 Outstanding since the last inspection of 20/04/05. Staff recruitment files must include proof of a person’s identity, including a recent photograph. 30/11/05 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 OP38 Good Practice Recommendations It is recommended the Induction and Foundation training from the National Training Organisation for Social Care is started. The training is around principles of care, safe working practices, the organisation and worker role, the experiences and particular needs of the service user group, and the influences and particular requirements of the service setting. Outstanding since the last inspection of 20/04/05. Residents paying costs for some trips should be discussed further at a residents meeting in conjunction with the Registered Providers. To ensure equality and fairness a commitment to every resident having the opportunity to go on trips according to their needs. 2 OP2 Lingdale Lodge DS0000001730.V258332.R01.S.doc Version 5.0 Page 19 Commission for Social Care Inspection Leicester Office The Pavilions, 5 Smith Way Grove Park Enderby Leicester LE19 1SX National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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