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Inspection on 07/11/08 for Lingdale Lodge

Also see our care home review for Lingdale Lodge for more information

This inspection was carried out on 7th November 2008.

CSCI found this care home to be providing an Good service.

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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The staff are well trained to care for the residents. The staff are committed to the care of the residents and treat them with dignity and respect. `The staff are lovely` The home provides a welcoming, clean and well -maintained environment for the residents to live in. The bedrooms provide well decorated and personalised accommodation. The home provides a good range and choice of activities for the residents. Residents have a choice of healthy meals.

What has improved since the last inspection?

All the staff have two references in place before they start work. All the staff files contain completed Criminal Records Bureau and Protection of Vulnerable Adults checks. All the staff have now received training in handling dangerous chemicals.

What the care home could do better:

The contents of the daily record could be more comprehensive and the staff trained to understand what is needed to make sure that other staff are aware of how the residents have been in the day or night. Staff should not complete daily records before the care is given. Risk assessments should clearly show how a risk is to be managed. The complaints book should show an audit trail of dates and signatures to show when it was received and when it was resolved. Bins containing soiled materials should have a lid on them to avoid unpleasant odours and to protect the staff and the residents from infection. The staff application form should be reviewed to allow sufficient room for past employment and dates to be included. The annual questionnaires could be dated to allow the manager to look at any changes of view over the years.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Lingdale Lodge Lingdale East Goscote Leicestershire LE7 3XW     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Anthea Richards     Date: 0 7 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Lingdale Lodge Lingdale East Goscote Leicestershire LE7 3XW 01162603738 F/P01162603738 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Vacant Type of registration: Number of places registered: Mrs Barbara Elsie Nunn,Mr John William Nunn care home 48 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category physical disability Additional conditions: 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 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. To be able to admit the person of category MD(E) identified in correspondence from the Care Homes for Older People Page 4 of 28 9 0 0 8 Over 65 0 10 37 8 previous registration authority dated 5/4/2000. Date of last inspection Brief description of the care home Lingdale Lodge is a large 48- bedded purpose home built on one level. It is a care home providing personal care and accommodation for 48 older people with a physical frailty and/or mental health needs. 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. There is a central area that contains the main lounge, with corridors leading off it with the dining rooms, small lounges and the bedrooms. The residents with dementia live in a separate wing with their own staff. This gives them a family environment with people who they know well. There is a well- maintained garden where the residents may sit in the better weather. The home is set back off the main road in a quiet location of East Goscote and is close to shops, and other amenities in the village. It is easily accessible by car or public transport and there is parking available in the grounds. The home is situated next to Primrose Residential Home, which is also part of the Broadoak group of homes. The current registration certificate from the Commission for Social Care Inspection is displayed in the reception area. The latest report is available in the managers office. The home can be contacted by telephone or fax. The current level of fees range from £334.00 to £460.00pw. There are extra charges for hairdressing, chiropody, newspapers and personal items. Care Homes for Older People Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This was a key inspection of a care home for older people, which ended with an unannounced visit to the service. Before the visit we [throughout the report the use of we indicates the Commission for Social care Inspection], spent five hours reviewing information received by the Commission for Social Care Inspection [CSCI] since the last inspection on the 3rd December 2007. The visit took place on the 7th November 2008 and lasted seven hours. During the visit we checked all the key standards as identified in the National Minimum Standards. Care Homes for Older People Page 6 of 28 This was achieved through a method called case tracking. Case tracking means that we looked at the care provided to three of the residents. To achieve this, the residents were spoken with. We spoke with the staff supporting their care and with their permission their bedrooms were looked at. We also checked how the home was run and organised. This included looking at staff records, training and how the staff are organised. We looked at health and safety records, menus, minutes of meetings and the quality audit. The policy for handling complaints and how the home dealt with them were looked at. We looked at how prospective residents and their families are given information about the services the home can offer and whether they are suitable for them. During the visit we spoke with the acting manager, the staff, the residents and their families. We looked at the Annual Quality Assurance Assessment that the home had sent us. We looked at the comment cards that we had asked for and received from the residents, staff and relatives. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking Care Homes for Older People Page 8 of 28 following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 28 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The residents needs are assessed before moving into the home and they are given the right information for them to make an informed choice about the home. Evidence: All of the residents who were case tracked had been given a Statement of Purpose, service user guide and a copy of the terms and conditions. The registered provider can make these documents available in alternative formats such as large print and other languages, when needed to make sure that a wide group of people can understand the information. The provider has produced a new Statement of Purpose that contains all the required information. Providing a comprehensive Statement of Purpose and Service Users Guide results in good information for the residents, making sure that they they can get the most suitable care. Care Homes for Older People Page 11 of 28 Evidence: The acting manager visits all prospective residents before they are admitted to the home and completes a pre admission assessment form. This makes sure that that the staff in the home have the the right information, so that the resident gets the best care. The resident meets someone from the home who they can recognise, which makes the move into care easier to manage for them. The families spoken with confirmed that they were given the opportunity to visit the home before their relative came in and that they were visited at home or in hospital. New residents are given a months trial to see if they like the home. Members of the staff spoken with said that they knew what the residents needs were before they moved in. The current registration certificate from the Commission for Social Care Inspection [CSCI] was displayed in the reception area. An up to date insurance certificate was displayed in the entrance hall. Care Homes for Older People Page 12 of 28 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The staff meet the care needs of the residents as identified in the care plans and give them privacy and dignity with their care. Evidence: All of the case tracked records were found to contain good individual evidence of the care being given to the residents. There are records of the involvement of doctors, district nurses, chiropodist, optician and dentist in them, showing that thorough health care is being provided for the residents. The residents and their families spoken with said that they could see the doctor and other health professionals when they needed to. There are records of the residents weight and nutritional needs, which makes sure that they are not having an unexplained weight loss or gain. Care Homes for Older People Page 13 of 28 Evidence: The resident or their families had seen and had agreed with the care plans and those spoken with, said that they had been involved in the review process and were happy with the care being given. The daily record of care was found to be completed, but did not always contain the information that was needed. The staff should be made aware of the information that they should put in, which should be clear and accurate as to how the resident has spent their day or night. Entries in one of the care plans looked at had been filled in in advance, these should reflect what has happened to the resident during the day and not what might happen. We saw the residents being treated with dignity and respect when staff spoke with them and gave them their care. Staff seen giving care did so in the right way, giving the residents privacy where needed and talked with them whilst giving the care. The staff spoken with were aware of the care needs of the residents and the residents and the families spoken with were happy that all care needs were being met. Comments from residents included: They look after us well. The staff are lovely There are risk assessments in place, but these need to have better instruction about how to manage an identified risk. Medication records for the case tracked residents were in order. Medicines are given by the senior care staff who have had training to give medicines. We watched the medicine round and the medicines were given individually and the residents were seen to be taking them. The staff spoken with were knowledgeable about the medicines and where to obtain information. They were also aware of the requirements for the receipt, storage and disposal of medicines. The manager regularly looks at the record sheets and records that these have been checked. The controlled (dangerous) drugs were checked and were found to be correct, the book had been signed with two signatures. There is a policy for residents handling their own medicines, but there are currently no residents in the home doing so. Care Homes for Older People Page 14 of 28 Care Homes for Older People Page 15 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents have their social, spiritual and nutritional needs met. Their views are taken into consideration and acted on. Evidence: There was evidence of some activities being provided for the residents, they were listening to music and watching the television during the day and the staff were seen to be spending individual time with them. They have outside entertainers who regularly visit the home, which the residents all said that they enjoyed. The residents and the families spoken with were happy with the amount and variety of activities arranged. We enjoy the activities There were several visitors in the home on the day of the visit and those spoken with were positive about the communication with the manager and said that they were always made very welcome in the home. We saw the welcome given to visitors on the day of the visit. The residents have a choice of meals every day and the staff are able to offer the residents alternative, Care Homes for Older People Page 16 of 28 Evidence: individual choices if there is nothing the resident likes. We spent time the dining room during lunchtime and the meal looked appetising and plentiful. All the residents spoken with said that they were enjoying their meal and that they always had a choice. The staff have a good understanding of the dietary needs of the residents including diabetic diets. The staff were seen to be sitting and talking with the residents during the meal. One member of staff was seen to be standing over a resident whilst helping her to eat her meal. The resident could feel intimidated by this and staff should always sit down with the residents. The manager was spoken with and told us that she would address this with the member of staff. The manager sees each of the residents on a one to one basis every day. There are regular meetings with the residents and families are seen and spoken with regularly. This was confirmed by the residents and by the minutes seen. Religious needs are provided for, with a regular service held in the home. A hairdresser visits the home weekly, which the residents enjoy. Care Homes for Older People Page 17 of 28 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are systems in place to support and protect residents and staff are aware of the processes. Evidence: There is a complaints policy in place, which gives the details of how to complain and who to complain to if they needed to. This can be produced in other formats such as large print or other languages if needed. The complaints book was looked at and was found to have a record of any complaints received. The complaints book could contain confirmation of the progress of a complaint to make sure that the home is responding and resolving any complaints within the required time limits. There have been no recorded complaints since the last inspection. The Commission for Social Care Inspection [CSCI] has received one complaint since the last inspection, this was investigated by Social Services and has been resolved satisfactorily. The residents spoken with were happy that they would speak to the manager or a member of staff, if they had a problem and that it would be dealt with. Families spoken with on the day of the visit said that they were aware of the procedure to complain and would have no concerns about doing so. The staff spoken with knew how to deal with a complaint, which was given to them. Care Homes for Older People Page 18 of 28 Evidence: The staff said that they had had training in safeguarding adults, which was confirmed by the training records held in the home. The staff spoken with told us how they would handle such an incident and that they would have no concerns about whistle-blowing. This makes sure that the residents are safe from any abuse and that any concerns are handled correctly. The home had information displayed for the residents as to how they could find an advocate to act on their behalf if they had no one else and they wanted one. Care Homes for Older People Page 19 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The residents live in a safe, comfortable and pleasant home, which is run in their best interests. Evidence: Lingdale Lodge is a single storey, purpose built home close to the centre of the village of East Goscote in Leicestershire. There are several lounge and dining room areas, giving the residents a good choice of where they wish to sit. There are television and music centres in each lounge area. The home is well maintained, clean and well decorated, giving the residents a pleasant place to live in. There is a pleasant garden and patio area, which is easy for the residents to get to in the better weather. The bathrooms are clean, tidy and free of any hazards. One bathroom had a bin for used incontinence pads that did not have a lid on it, this could cause an unpleasant odour and a risk of infection. With their permission,we looked at the case tracked residents bedrooms. They Care Homes for Older People Page 20 of 28 Evidence: provided good accommodation, which had been personalised with the residents belongings. The bedrooms were clean and well maintained. They had recently been redcorated and been provided with new furniture. There was evidence of equipment such as hoists having been provided to help in the care and comfort of the residents. The cleaning materials were kept in locked cupboards and the staff have had training in handling dangerous chemicals. The fire records were being completed regularly and were found to be up to date. The hot water records were found to be up to date and within the recommended levels. There were no further outstanding safety or maintenance issues seen on the tour of the premises. The registration certificate from the Commission for Social Care Inspection was displayed with a current certificate of insurance. The inspection reports are available in the managers office. Care Homes for Older People Page 21 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The residents needs are met and their safety protected by the numbers of staff and the training that is in place. Evidence: There was evidence of a good skill mix of staff to make sure that the residents have the right care. The duty rota reflected the number of staff on duty. The residents, staff and relatives spoken with felt that there were always enough staff on duty to look after them properly. Two staff files were looked at by the inspector and the required information was complete in both of them. This included evidence of identification, adequately completed application forms, two written references and a Criminal Records Bureau [CRB] check. The application forms had been completed but consideration could be made to improve them to give more space for previous employment and the dates of employment. This would make sure that the manager could follow a sequence of employment and dates. These details are needed to make sure that the applicant is a suitable person to work in the home. Care Homes for Older People Page 22 of 28 Evidence: There were records of staff training including induction and the staff spoken with confirmed that they received regular training in moving and handling. They said that they had training in first aid, food hygiene and medicine training. All of the staff have a National Vocational Award at level 2 or above or are working towards it. The National Vocational Qualification is a qualification for care staff to make sure that they receive the right training in the needs of the resident group whom they are caring for. Regular staff meetings are held, this was confirmed by the staff and by the records held. Care Homes for Older People Page 23 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The residents live in a home, which safely provides for their needs with good staff training and supervision. Evidence: The acting manager was available throughout the visit to the home. The acting manager has been in post for two years and has made an application to the Commission for Social Care Inspection to be the registered manager. She is waiting to hear from them. There were records in place confirming that regular staff supervision was happening, the members of staff spoken with confirmed that they had received regular supervision. The process of formal supervision time gives the staff and their line manager the opportunity to have individual discussions about work and training needs. There are regular meetings with the residents and their families are invited to attend. There are minutes in place for these meetings. Where members of families are unable to attend the meetings the manager sends them a letter giving them information and asking for their views. Care Homes for Older People Page 24 of 28 Evidence: Annual questionnaires are sent out to residents and their families to gain peoples views about the service. The date could be on the questionnaires so that the manager can see how views may have changed over the years. There are accounts held to manage the residents personal allowances and are being managed correctly with receipts in place and two signatures are obtained for every transaction. The policies and procedures are in place for the home and are regularly reviewed. They are available for the staff to read to make sure that they know how the residents are to be cared for and protected. Records for the maintenance of fire equipment, fire drills and training were found to be in place and up to date. Care Homes for Older People Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 2 3 4 5 7 7 8 15 16 That the records of care are not completed in advance. That the daily records of care more accurately and fully reflect the residents day or night. That the risk assessments include comprehensive instruction on how to manage the identified risk. That staff are taught to sit with the residents when helping them with their meals and not to stand over them. That the complaints book is updated to include the dates and name of person recieving and resolving any complaints. That all bins used for the disposal of soiled waste have a closed lid. That the application form is redesigned to give sufficient space to include previous employment and the dates. 6 7 26 30 Care Homes for Older People Page 27 of 28 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 28 of 28 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!