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Inspection on 08/01/07 for Lingdale Lodge

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

This inspection was carried out on 8th January 2007.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

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 care well for the residents and they live, in a pleasant environment. All the residents, visitors and staff spoken with were happy and positive about the home, the food, activities and the care given. The staff appeared to be committed to the care of the residents and were observed spending individual time with them and delivering good care. `The staff are very kind` Staffing levels are good and some of the staff spoken with were aware of protecting the residents from abuse, the medication policy and the care needs of the residents. This ensures that the residents receive the appropriate care delivered safely.

What has improved since the last inspection?

The health needs of the residents are now met with records to show that they are receiving care from G.Ps, district nurses, chiropodist, physiotherapist and optician. The residents were being treated with dignity and respect.The odour in the home had improved. This gives a more pleasant environment to live in. All the necessary checks needed before employing staff were in place. This provides the residents with a safe staff to give them their care. The training programme for the staff had improved with moving and handling now up to date. There were plans in place for further training such as first aid. The health and safety systems have improved but need further improvement to provide a safe environment for the residents and staff. The complaints procedure has been updated to meet the national Minimum Standard. The staffing levels have been improved and the numbers on duty are adequate to meet the care needs of the residents. There is a quality assurance system in place to obtain the views of the residents and their families. All the recommendations made at the last inspection have been achieved.

What the care home could do better:

The residents` records could be reorganised to make them easier to work with to make sure that their care needs are not missed. The staff records could be reorganised to make sure that all the information can be found to make sure that safe staff are employed. All the staff, not just those doing a National Vocational Award should receive training in safeguarding adults. The induction programme for the staff should contain a wider range of training to meet the standard needed. The staff should have the opportunity of the required amount of supervision to allow them the time with their line manager to discuss work and training issues. The catering staff should be given training in the dietary needs of elderly people. Consideration should be given to changing the times of the last meal of the day to shorten the time between the teatime meal and breakfast. The bathrooms should not be used as storage areas as this practice could cause a hazard for the residents and the staff. The staff, particularly those doing maintenance tasks should have health and safety training to make sure that they and the residents are safe. The staff doing maintenance work should be provided with the right equipment to be able to do the job safely. The staff should have fire safety training and fire drills to make sure that they know what they should do if there was a fire to keep the residents and themselves safe.The health and safety records for fire alarm tests and hot water temperatures could have more detail as to which areas had been tested. This would show that all taps and fire points had been checked.

CARE HOMES FOR OLDER PEOPLE Lingdale Lodge Lingdale East Goscote Leicestershire LE7 3XW Lead Inspector Thea Richards Key Unannounced Inspection 8th January 2007 10:30 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.V325493.R01.S.doc Version 5.2 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.V325493.R01.S.doc Version 5.2 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.V325493.R01.S.doc Version 5.2 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. 11th October 2006 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 purpose home built on one level, corridors with the bedrooms, lead off the central area that contains the main lounge. 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. 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. The home is situated next to Primrose Residential Home, which is also part of the Broadoak group of homes. The home can provide care for older persons both with a physical frailty and those with dementia. The weekly fees range from £275 to £420 approximately - this information was provided prior to the inspection. There are additional costs for individual expenditure such as hairdressing, newspapers, outings and private chiropody. Lingdale Lodge DS0000001730.V325493.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a key inspection of the home that was concluded with an unannounced visit to the home. Prior to the visit the inspector spent four hours reviewing the previous inspection report and information relating to the home received since the last inspection on the 11th of October 2006. The visit took place on the 8 January 2007 from 09:30 and lasted six hours. During the course of the visit the inspector checked all the ‘key’ standards as identified in the National Minimum Standards. This was achieved through a method called ‘case tracking’. Case tracking means that the inspector looked at the care provided to four residents living at the home. This was done by talking to the residents themselves, talking with staff giving their care and by checking the records of their health and welfare. With their permission, looking at their rooms as well as looking at the communal living areas. The inspector also checked other issues to do with the running of the home. These included health and safety, management and staffing areas. During the visit the inspector spoke with other residents in the home, staff, visitors and the manager. The inspector also observed how the staff cared for the residents. What the service does well: What has improved since the last inspection? The health needs of the residents are now met with records to show that they are receiving care from G.Ps, district nurses, chiropodist, physiotherapist and optician. The residents were being treated with dignity and respect. Lingdale Lodge DS0000001730.V325493.R01.S.doc Version 5.2 Page 6 The odour in the home had improved. This gives a more pleasant environment to live in. All the necessary checks needed before employing staff were in place. This provides the residents with a safe staff to give them their care. The training programme for the staff had improved with moving and handling now up to date. There were plans in place for further training such as first aid. The health and safety systems have improved but need further improvement to provide a safe environment for the residents and staff. The complaints procedure has been updated to meet the national Minimum Standard. The staffing levels have been improved and the numbers on duty are adequate to meet the care needs of the residents. There is a quality assurance system in place to obtain the views of the residents and their families. All the recommendations made at the last inspection have been achieved. What they could do better: The residents’ records could be reorganised to make them easier to work with to make sure that their care needs are not missed. The staff records could be reorganised to make sure that all the information can be found to make sure that safe staff are employed. All the staff, not just those doing a National Vocational Award should receive training in safeguarding adults. The induction programme for the staff should contain a wider range of training to meet the standard needed. The staff should have the opportunity of the required amount of supervision to allow them the time with their line manager to discuss work and training issues. The catering staff should be given training in the dietary needs of elderly people. Consideration should be given to changing the times of the last meal of the day to shorten the time between the teatime meal and breakfast. The bathrooms should not be used as storage areas as this practice could cause a hazard for the residents and the staff. The staff, particularly those doing maintenance tasks should have health and safety training to make sure that they and the residents are safe. The staff doing maintenance work should be provided with the right equipment to be able to do the job safely. The staff should have fire safety training and fire drills to make sure that they know what they should do if there was a fire to keep the residents and themselves safe. Lingdale Lodge DS0000001730.V325493.R01.S.doc Version 5.2 Page 7 The health and safety records for fire alarm tests and hot water temperatures could have more detail as to which areas had been tested. This would show that all taps and fire points had been checked. 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. The summary of this inspection report can be made available in other formats on request. Lingdale Lodge DS0000001730.V325493.R01.S.doc Version 5.2 Page 8 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.V325493.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 3, 6 does not apply in this home. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Residents’ needs are well assessed prior to moving into the home by the completion of a pre-admission assessment by an experienced member of staff, by Social Services where appropriate and a visit to the service. This makes sure that the resident and their families know that they will receive the right care. EVIDENCE: The inspector checked the care records of four of the residents (with their permission) who were case tracked. All of the residents had received a Statement of Purpose and a Service Users guide. The Statement of Purpose and Service Users’ Guide provide all of the required information about the services offered and the Terms and Conditions that apply. Providing a comprehensive Statement of Purpose & Service Users’ Guide gives the residents good information, making sure that they get the most Lingdale Lodge DS0000001730.V325493.R01.S.doc Version 5.2 Page 10 suitable care. They also make sure that the home can give the resident the care that they need. Completed assessments were present in the files, showing the resident’s care needs, before they were admitted to the home. Care plans showed that they contained the needs of the resident which had been identified in the original assessment. The staff spoken with said that they usually knew what the resident’s needs were before they were admitted to the home. The care plans seen had been agreed by the residents or their families. Three of the clients and their families spoken with told the inspector that they had a visit from a member of staff from the home before they were admitted. They confirmed that they were given the opportunity to visit the home before they came in. They said that when they came in they had a month’s trial to see if they liked it in the home. The fourth resident was not able to confirm that they had a visit and the inspector was unable to contact a member of the family to discuss with them. The care plan did contain an assessment of need which showed that a visit had been made. Two further visitors in the home told the inspector that they had had the opportunity of visiting the home prior to their relative being admitted. They had also had a visit from a member of staff from the home. This makes sure that that the staff in the home have the the right information before the resident is admitted so that the resident gets the best care. It makes sure that the home can meet the residents needs. It also makes sure that the resident meets someone from the home who they can recognise. This makes the move into care easier to manage for them. The current registration certificate from the Commission for Social Care Inspection (CSCI) and up to date details of insurance cover were displayed in the entrance of the home. The registration certificate contained out of date conditions of registration. The manager was asked to write to the CSCI to confirm that they no longer applied so that a new certificate may be issued. Lingdale Lodge DS0000001730.V325493.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The staff fully meet the care needs of the residents as identified in the care plans. EVIDENCE: Care plans for four residents were ‘case tracked and were found to contain good individual evidence of care, which shows the care being given to the residents. This includes a regular assessment of the residents’ weight and what they have had to eat. There are records of the involvement of G.P.s, chiropodist, optician and dentist present, giving evidence of thorough health care being provided for the residents. The residents spoken with said that they could see a doctor whenever they needed to. They also said that they saw the other health professionals when they needed to. Lingdale Lodge DS0000001730.V325493.R01.S.doc Version 5.2 Page 12 There was an optician visiting on the day of the visit to test the residents sight and provide glasses. This makes sure that the residents get the best sight that they can and are more able to communicate with people. The daily record of care is up to date which makes sure that the residents receive the right care and the staff know what has happened to them during the day or night. The care plans contain the information needed but it is not easy to find with out of date information still in them. This could lead to staff looking at the wrong paperwork and the residents receiving the wrong care. If they were better organised they would be easier for the staff to use and find what they were looking for. Staff spoken with were aware of the care needs of the residents and the residents and the visitors spoken with were happy that all care needs were being met. Medication records for the case tracked residents were in order. Medicines are only administered by the manager or senior care staff in this home. Staff 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 completes monthly audits of the medication records to make sure that they are being completed corectly. The above makes sure that the residents are protected with the correct medicine administration. There is a policy and risk assessment in place for the residents who look after their own medicines. The resident spoken with who administers their own medication was happy with the policy. In the area where the residents with dementia live the keys to the medicine trolley were stored in an open box attached to the trolley. This practice is not safe as the keys were available for anybody to remove. The manager was advised about this practice and she made arrangements for the keys to be locked up before the end of the visit. The staff were told about the new procedure. The inspector observed residents being treated with dignity and respect when staff spoke with them. The staff were seen sitting with the residents helping them with their lunch and sitting talking with them in the lounge area. Staff seen giving care, which included moving and handling the residents, did so in the right way, giving the residents privacy and dignity. The residents spoken with were happy with the way staff treated them and said that they were very kind. ‘They look after us well’ Two visitors spoken with on the day of the visit were very happy with the level of care being given. Lingdale Lodge DS0000001730.V325493.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents have their basic social, spiritual and nutritional needs met. EVIDENCE: There was evidence of some activity being provided for the residents. On the day of the visit there was suitable music playing in the morning with staff joining in and singing along with the residents. In the afternoon there was a bingo session with most of the residents joining in. The residents spoken with said that they enjoyed the activities. The area where the residents with dementia live there was evidence of activity with skittles and drawing. Those residents who remain in bed or in their rooms have television, radio and talking books. Two of the residents told the inspector that the staff spent time talking to them when they could. The home does not employ a dedicated activities organiser, but has enough staff on duty to make sure that activities always happened. The manager told the inspector that there had been trips out arranged in the summer including to Skegness and Stratford. Two of the residents said that they had enjoyed the trips. Lingdale Lodge DS0000001730.V325493.R01.S.doc Version 5.2 Page 14 Taking part in activities is recorded on the daily record in the care plan but is not very clear. The manager could consider giving activities a separate sheet i when she reorganises the careplans. There is a choice of two main meals available every day and diabetic meals are provided. The cook had a limited knowledge of other diets but said that she would seek advice from the manager if it was needed. The inspector suggested that she could contact the community dietician for advice about diabetic diets and any other diets she may need. Residents spoken with all said that they enjoyed the food and were happy with the choices. The inspector observed lunchtime in the dining room and all the residents said that they were enjoying their meal. The meal was well presented although one resident told the inspector that the presentation was not always very good. The last meal of the day was at around four o’ clock which is very early, although the manager said that there were left over sandwiches and biscuits available at seven o’ clock, if the residents wanted them. This was confimed by the residents spoken with who said that they had enough to eat. What the residents had eaten at the main meals was recorded in the care plan but not if they had anything at suppertime. If the residents do not have anything to eat at suppertime there is sixteen hours before the breakfast. This is too long a gap to maintain adequate nutrition for elderly people. Consideration should be given to giving the residents their tea-time meal later in the day. One of the residents told the inspector ‘that I always have chocolate to eat if I’m hungry’ Visitors are made welcome in the home and some regularly take their relatives out. This was confirmed by visitors spoken with who told the inspector that they were made very welcome at any time. The inspector observed the welcome given to visitors when coming into the home which was warm and friendly. They told the inspector that the manager spoke with them regularly on a one to one basis. The manager sees each of the residents individually basis every day. There are annual quality audits to get the views of the residents and their families. These practices ensure that the residents maintain contact with the community and their families and that views for improvements can be considered. There is a monthly church service within the home and communion can be arranged. The local Roman Catholic church arranges visits for those residents of that faith. There are currently no residents in the home with different cultural or ethnicity needs. The inspector spoke with the ‘Lay Reader’ from the church who takes the services who said that he was always made very welcome. He said that the residents were very happy and that they appeared to be well looked after. Local members of the community also attend the services which gives the residents a good contact with local people. These practices make sure that the pastoral care needs of the residents are met and that all Faiths are provided for. Lingdale Lodge DS0000001730.V325493.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are systems in place to support and protect residents and staff are awrare 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. The complaints book was looked at and there are no records of any complaints having been received since the last inspection on the eleventh October 2006. 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. Visitors 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 Commission for Social Care Inspection has received no complaints or concerns since the last inspection on eleventh October 2006. The staff who have completed a National Vocational Awared have received training in ‘Safeguarding Adults’. Those who had and those spoken with were aware of the procedure to follow and would be prepared to ‘whistle blow’ if they thought there was a need to. The manager is arranging further training for those staff who have not received it. This will make sure that the residents are safe from any abuse and that any concerns are handled correctly. Lingdale Lodge DS0000001730.V325493.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 21, 24, 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The residents are not completely protected by the policies and procedures in the home to provide a safe environment. EVIDENCE: The registration certificate from the Commission for Social Care Inspection was displayed in the reception area. The current inspection report is available in the managers’ office. Lingdale Lodge is a purpose built home that is part of the Broadoak group of homes and is situated in the same grounds as Primrose Lodge. There is a small reception area that leads to a large lounge. The lounge is an area with balustrades around it with a corridor around three sides. The residents’ chairs are placed around the edge of the area. This arrangement was discussed with the acting manager who told the inspector that they had tried to put the chairs in a more homely arrangement in groups. Lingdale Lodge DS0000001730.V325493.R01.S.doc Version 5.2 Page 17 The residents preferred to have them as they are and had moved them back into the present arrangement. When the inspector spoke with the residents they told her that they liked the chairs like this. There are several lounges, including a smokers’ lounge, which gives the residents, a choice of sitting areas. The bathrooms are clean and mostly free from inappropriate items, which could present a hazard for the residents. One of the bathrooms in the area where those residents with dementia live contained toiletries that were unnamed and left in the room. This is unsafe practice in infection control, as using the same products for more than one resident could cause a spread of infection. The residents should have their own items to maintain individuality and safety. The residents with confusion might drink these items if they are left available to them, which could cause a reaction or damage to them. This was brought to the attention of the acting manager and she had the items removed before the end of the visit. This bathroom was also being used as a storage area for wheelchairs and incontinence aids, which could cause a hazard for the residents and the staff. This was also brought to the attention of the manager, however those items remained in the bathroom. With their permission the case tracked residents bedrooms were looked at by the inspector. They provided good accommodation with en-suite facilities of a W.C. and wash-hand basin. They had been personalised with the resident’s belongings and a resident spoken with was delighted that ‘she was able to bring her own things in’. The bedrooms were clean and well maintained. There are three shared bedrooms. Two of these are being used as single rooms and one is being shared by a married couple. There was evidence of a track on the ceiling between the beds, which shows that privacy could be provided with a curtain if the room was being shared. There was a slight odour noted in some communal areas particularly in the area where the residents with dementia lived. The acting manager told the inspector that the numbers of cleaning staff have been increased. There was evidence of cleaning activity in progress and a liberal use of air-freshener. She also said that they now have more access to the shared carpet shampoo machine. There was evidence of equipment such as hoists and special mattresses having been provided to help in the care and comfort of the residents. There were no further outstanding safety or maintenance issues noted on the tour of the premises. Lingdale Lodge DS0000001730.V325493.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The residents’ needs are met and their safety protected by the recruitment policy but could be put at risk with the limited training given to the staff. EVIDENCE: There is 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 visitors spoken with felt that there were always enough numbers of staff on duty to cater for their needs. Four staff files were looked at by the inspector and the required information was complete in all the files. This included evidence of identification, adequately completed application forms, two written references and Criminal Records Bureau checks. There was evidence of some staff training including induction and the staff spoken with confirmed that they received regular training in moving and handling. There was the availability of non mandatory courses which the staff could access such as dementia training. Thirty five per cent of the staff had completed a National Vocational Qualification(NVQ) in care at level two or above. Several more staff were about to commence the training. The acting manager holds an NVQ level 4 in care and in management. Lingdale Lodge DS0000001730.V325493.R01.S.doc Version 5.2 Page 19 The National Vocational Qualification is a qualification for care staff to make sure that they receive appropriate training in the needs of the resident group whom they are caring for. The acting manager told the inspector that there was a first aid course for the staff starting the week following the visit. The staff spoken with said that they were going to do the course. This will make sure that the staff can cope in an emergency situation. The staff files hold all the necessary records but are badly oganised and the information is difficult to find. This could lead to confusion and items being missed out. There is an induction process in the home but the content is very limited and does not contain all the necessary training. A more thorough induction programme should be produced to make sure that the staff are properly trained to give the best care to the client group. Lingdale Lodge DS0000001730.V325493.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 38 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The residents are partly protected by the policies and procedures in the home to provide a safe environment. The records, staff training and supervision are inadequate to protect the residents and the staff. EVIDENCE: The acting manager was available throughout the visit to the home. The acting manager has been a care home manager for 27 years, most recently at the sister home which is next door to Lingdale Lodge. She has completed National Vocational Awards at level four in both care and management. This ensures that managers have the required skills to manage a care home. She has no administrative support in the home but is Lingdale Lodge DS0000001730.V325493.R01.S.doc Version 5.2 Page 21 supported by the company’s head office where all the administrative tasks are done. Those staff who have done an NVQ receive training to equip them to care for the residents safely whilst protecting them from any abuse. This was confirmed by available records, the manager and by staff spoken with. The staff who have not completed this award have not received training, although most did have an idea of what to do in the event of abuse happening. This could put the residents at risk of not having an alleged incident reported properly. This was an outstanding requirement from the last inspection. There was evidence of some limited staff supervision taking place. This should happen at least four times a year and must be put in place. This process gives the staff and their ‘line manager’ the opportunity to have individual discussions about work and training needs. The acting manager told the inspector that the senior care staff were going to receive training in the supervision of staff. This training will allow them to supervise some of the staff which will give the manager more time to spend in other areas. The manager holds regular meetings with the residents and the staff as well as one to one discussions both to pass information on and to listen to their views and opinions. There are annual quality questionaires sent out to residents and their families to gain their views about the home. This allows the manager or the responsible person to respond to the residents and the staff’s needs. Residents finances are handled by their families with the home holding some monies on their behalf for incidental expenses. This is handled by the manager and there are always two signatures to confirm any transactions. The residents are well protected by the financial policies in the home. Records for the maintenance of fire equipment, and testing of water temperatures were found to be in place. These did not show which individual rooms or fire points had been tested. The maintenance person was seen to be changing light bulbs whilst standing on a stool. When asked about this practice he told the inspector that there was no stepladder to use. The acting manager confimed that this was the case. The maintenance person told the inspector that he had not received any health and safety training in this job but had done so in his previous employment. The home should provide proper equipment to make sure that the staff are safe when working above ground level. The person providing the day to day maintenance should be given health and safety training. There were no records to show that any fire drills or fire instuction had taken place. The acting manager told the inspector that there was not a regular day when the fire alarms were tested. She told the inspector that this meant that the staff had a fire drill every week. These are not formally monitored as a drill and could cause disruption in the home. Lingdale Lodge DS0000001730.V325493.R01.S.doc Version 5.2 Page 22 The home should have a regular weekly fire alarm test and a formal, recorded fire drill every three months. Fire instruction should take place twice ayear and be recorded. These practices will make sure that the staff are well trained to cope with a fire incident to protect the residents. The accident book was inspected and found to be complete and in order. There were copies of accident forms present in the residents careplans. Lingdale Lodge DS0000001730.V325493.R01.S.doc Version 5.2 Page 23 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 X 3 3 X X 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 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 X 2 X X 3 X 2 STAFFING Standard No Score 27 3 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 2 1 1 Lingdale Lodge DS0000001730.V325493.R01.S.doc Version 5.2 Page 24 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 OP37 Regulation 23(d) Requirement The registered provider makes sure that the staff receive training in fire prevention and that this is recorded. The registered provider makes sure that the staff receive fire drill and practices and are aware of the procedure to follow in the event of a fire and that this is recorded. This is outstanding from the last inspection. The registered provider makes sure that staff receive training in health and safety. The registered provider makes sure that the staff have adequate and appropriate equipment to undertake their tasks safely. Timescale for action 08/02/07 2. OP37 23(e) 08/02/07 3 4 OP38 OP38 18(c)(i) 23(2)(c) 08/02/07 08/02/07 Lingdale Lodge DS0000001730.V325493.R01.S.doc Version 5.2 Page 25 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. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. Refer to Standard OP7 OP15 OP15 OP18 OP19 OP19 OP21 OP26 OP29 OP30 OP31 OP36 Good Practice Recommendations Care Plans need to be reorganised to make sure that staff are able to access the correct information. That consideration is given to altering the time that the tea -time meal is served to give a shorter period between tea and breakfast. The cooks are given further training to increase their knowledge of the nutritional and specific dietary needs of elderly people. That all the staff receive training in safeguarding adults, not only those completing an NVQ. Individual rooms to be identified when checking water temperatures. Individual fire points to be identified when testing the system. To keep bathrooms clear of unnecessary items and toiletries to maintain a safe environment for residents and staff. That there is further improvement in the systems to keep the home free from odours. The staff records could be reorganised to enable easier access to the information The induction programme for the staff is updated to include training to acquire the required competencies. That the manager is made aware of her responsibilities for maintaining a safe home with suitably trained staff. The programme of staff supervision is improved and increased to meet the required standard. Lingdale Lodge DS0000001730.V325493.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT National Enquiry Line: 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 © 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 Lingdale Lodge DS0000001730.V325493.R01.S.doc Version 5.2 Page 27 - 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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