Inspection on 19/04/05 for Linwood

This inspection was carried out on 19th April 2005.

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

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

Other inspections for this house

Linwood 06/07/09

Linwood 10/02/09

Linwood 29/08/08

Linwood 31/08/07

Linwood 04/05/06

Linwood 01/12/04

Linwood 19/07/04

Similar services:

Springfield House

Sutton Lodge Nursing Home

The Shelley

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Linwood 9 Mercer Close Thames Ditton Surrey KT7 0BS Lead Inspector Miss Marianne Barham Announced 19 April 2005 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Linwood H58 H09 s59210 Linwood v214612 190405 Stage 4 ann.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service Linwood Address 9 Mercer Close, Thames Ditton, Surrey. KT7 0BS 0207 759 9100 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Anchor Trust Miss Annette Rance CRH (PC) 66 Category(ies) of Dementia - over 65 years of age (DE(E)) 27. registration, with number of places Physical Disability over 65 years of age (PD(E)) 9. Old age, not falling within any other category (OP) 30. Linwood H58 H09 s59210 Linwood v214612 190405 Stage 4 ann.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: Of the service users to be accommodated in the home up to twenty seven (27) may fall within the category Dementia DE(E) and up to nine (9) may fall within the category Physical Disability PD (E). Temporary respite care may be provided for one named service user under the age of sixty-five (65) years. Date of last inspection 25 January 2005 Brief Description of the Service: Linwood is a purpose built home, opened in April 2004 and provides accommodation and care for up to sixy six people who are elderly, some of whom may have dementia and/or physical disabilities. The home is owned and managed by Anchor Homes who are the registered providers. The home is located in a residential area within walking distance of Thames Ditton with its shops and other amenities. There is a GP surgery close by at which all residents are registered. There is car parking to the front of the building and more parking and an enclosed, well maintained garden to the rear. The accommodation is divided into six units over three floors. The home has wheelchair access across all floors, however wheelchair users are restricted to two per unit for health and safety reasons. There are eighteen single bedrooms on the ground floor, all have a fully functioning en-suite bathroom. There are forty eight single bedrooms over the first and second floors, these are all fitted with en-suite bathrooms, however a one off charge is made for these to be made functional. Communal facilities are arranged on each floor, these include small kitchens, dining rooms, lounges, toilets and assisted bathing facilities. There is also a hairdressing suite and a large reception area on the ground floor. All floors can be reached by staircase or passenger lift. Linwood H58 H09 s59210 Linwood v214612 190405 Stage 4 ann.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection carried out at 10.00am by Marianne Barham, lead inspector for the service. The inspection was undertaken over a period of four hours and was the first inspection in the Commission for Social Care Inspection year April 2005 to March 2006. The registered manager Ms Annette Rance was present, and a total of ten members of staff, nine service users and one relative were spoken to during the inspection. The home was functioning well during the inspection, despite having to manage an unexpected incident earlier in the day. There was a calm atmosphere in the home and the service users appeared to be relaxed and well cared for. All requirements made at previous inspections on 1st December 2004 and 25th January 2005 have been met. What the service does well: The home is furnished and decorated to a high standard, with coordinating curtains, carpets and seating. Service users rooms are comfortable and personalised with their own possessions. The home is very clean and tidy throughout. The home employs an activities coordinator and there is a wide range of activities, both in the home and in the local community for service users to access. Service users are encouraged to make choices in their daily lives and the home has a policy in place for staff to follow. Service users confirmed that they were able to make choices during the inspection. Service users needs are well met through thorough assessment and care planning. The staff team are well established at the home and are provided with the necessary training and supervision for them to be able to meet service users needs. Linwood H58 H09 s59210 Linwood v214612 190405 Stage 4 ann.doc Version 1.20 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Linwood H58 H09 s59210 Linwood v214612 190405 Stage 4 ann.doc Version 1.20 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 Standards Statutory Requirements Identified During the Inspection Linwood H58 H09 s59210 Linwood v214612 190405 Stage 4 ann.doc Version 1.20 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 standard(s) 1, 2, 3 and 5 Adequate information is provided to enable prospective service users and their families to make an informed choice about where they live. All service users are given a written contract of the terms and conditions of residence at the home. No service users are admitted to the home without their needs being assessed and agreed by the home as being able to meet them. Service users and their families are able to visit the home prior to admission. EVIDENCE: The homes service user guide has recently been reviewed and updated in January 2005. It is comprehensive and contains a copy of the complaints procedure. All service users have a copy and these were seen in their rooms. A discussion was held with the manager as to the possibility of producing the guide in a more accessible format for those service users who may not understand written information. A recommendation has been made concerning this. Linwood H58 H09 s59210 Linwood v214612 190405 Stage 4 ann.doc Version 1.20 Page 9 All service users are issued with a contract stating their terms and conditions of residence, room to be occupied and fees charged. These were observed to be in their rooms and a total of nine were examined and were found to have been signed by the service user or their representative in every case. Service users who are funded by the local authority have a comprehensive assessment carried out by their care manager, however the home still carries out their own assessment prior to admission. For those service users who fund themselves the home carries out their own assessment with input from their families and any involved professionals. The assessment covers areas such as medical conditions, medication, care needs, dietary needs, emotional and social needs. A total of nine pre admission assessments were examined and were found to have been completed prior to admission and with the involvement of other professionals and service users families. The manager reported that she would not admit a service user if she felt the home could not meet their needs. Prospective service users and their families are invited to visit the home before admission, usually for the day, though the manager reported that they can visit as often as needed. A copy of the homes statement of purpose, which includes the service users guide, is sent to them prior to visiting. A relative present during the inspection confirmed that this had happened when their relative was admitted. Linwood H58 H09 s59210 Linwood v214612 190405 Stage 4 ann.doc Version 1.20 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 9, 10 and 11 All service users have a plan that identifies their health, personal and care needs. The policies and procedures for dealing with medicines in the home protect the service users. Service users privacy is protected and they are treated with respect. Service users can be sure that in the event of their illness or death, they and their families will be treated with sensitivity and respect. EVIDENCE: A requirement was made at the last inspection that care plans and other confidential information was stored securely. This has now been met. Care plans are now held in the service user’s rooms, with all other information stored in a locked filing cabinet in the administration area. Care plans are generated from the pre admission assessment as detailed earlier in this report. A total of nine were examined and found to be clearly written and to cover all aspects of the individuals care. The plans were Linwood H58 H09 s59210 Linwood v214612 190405 Stage 4 ann.doc Version 1.20 Page 11 observed to be reviewed monthly and to have been signed by the service user or their representative. It was pleasing to see that individual risk assessments had been reviewed and updated to include greater detail on how to reduce the risk, thus meeting a requirement made at the last inspection. The home has a comprehensive policy and procedure in place for the receiving, administration, recording and disposal of medications. Medication is supplied by Boots the Chemist, mainly in blister packs. Boots carry out carry out advisory visits twice a year. The deputy manager trains the staff to administer medication and has devised a training pack for staff to follow. The most recent training was on 11th February 2005. The deputy is also responsible for carrying out regular medication audits on all units throughout the home. The medical room was found to clean and tidy with evidence of regular temperature checks on the medication fridge. Records of the receipt and return of medications were observed to be kept. It was pleasing to see that there are now two full signatures entered into the controlled drugs register when administering, this meets the requirement made at the last inspection. The medication recording charts were examined and found to be completed accurately, with no gaps in the records. It was noted that one, handwritten entry had not been signed by the staff entering the information, however on examination of all the recording charts it was clear that this was a ‘one off’ omission by that staff rather than a regular practice. A recommendation has been made concerning this. Staff were observed to interact with service users in a positive and respectful way during this inspection. They were seen to address service users politely and explain their actions when giving care. Staff were observed to knock on bedroom and bathroom doors prior to entry. The home has a policy in place for staff to follow with regard to protecting service users privacy and dignity. The home has a comprehensive policy and procedure for service users dying and death. This covers the physical, emotional and social aspects of terminal illness and death for both the service user and their family. All staff have signed to show they are aware of the procedure. Linwood H58 H09 s59210 Linwood v214612 190405 Stage 4 ann.doc Version 1.20 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, and 14 Service users lifestyle in the home reflects their social, cultural, religious and recreational interest and needs. Service users are able to maintain contact with their family, friends and the local community. Service users are supported to make choices about their lives. EVIDENCE: The home employs an activities coordinator who has devised a programme of activities such as sing a-longs, arts and crafts, card games etc, however the programme is flexible according to the preferences of those taking part. The home maintains links with the local community and service users attend the local day centre as well as accessing facilities in the town. Some service users attend a bridge club and others attend local church services. The activities coordinator also arranges for professional entertainers to perform at the home and organises outings to places of interest. Service users spoken to were complimentary about the range of activities and confirmed that they are given a choice about what they do. Linwood H58 H09 s59210 Linwood v214612 190405 Stage 4 ann.doc Version 1.20 Page 13 Services users family and friends are able to visit them at any time, without making an appointment. They are able to see visitors in any of the lounges, in their bedrooms or in the dedicated visitors room. Visitors can stay for lunch if they ask in advance. The home has a room with en-suite facilities that family and friends can use to spend the night if they wish, a modest charge is made for this facility. The home has a policy in place for promoting choice for service users in areas of daily living, such as menus, care plans, activities and when they go to bed and get up. Service users spoken to confirmed that they were able to make choices about their lives. The home employs a chef and meals are at set times owing to the size of the home, however drinks and snacks can be made at any time in the kitchens on each unit. Linwood H58 H09 s59210 Linwood v214612 190405 Stage 4 ann.doc Version 1.20 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and17 Service users and their relatives can be sure that their complaints will be listened to and acted upon. Service users legal rights are protected by the home. EVIDENCE: The home has a comprehensive policy and procedure on complaints. All staff are made aware and sign that they have read it. All complaints are recorded along with any action taken to resolve issues. As stated earlier the complaints procedure is included in the service users guide, a copy of which is given to all service users and their families. At the time of the inspection there were no unresolved complaints. A visiting relative stated that they were aware of the complaints procedure, but had never had to make use of it. The home has a detailed policy in place on the protection of service users rights, of which all staff are aware. All service users are registered to vote and are supported to take part in the civic process if they wish. Linwood H58 H09 s59210 Linwood v214612 190405 Stage 4 ann.doc Version 1.20 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 24 and 26 The home is safe and well maintained. Service users bedrooms are comfortable, safe and they are able to have their possessions around them. The home is clean, pleasant and hygienic. EVIDENCE: As stated earlier in this report, the home is purpose built and this is reflected in the layout of the building and the facilities provided. The home is in a very good state of decoration and repair throughout and detailed maintenance records are kept. All communal areas meet the National Minimum Standards (NMS) and are decorated and furnished in to a good standard. Service users bedrooms are attractively furnished with matching curtains, bed covers and chairs. The rooms are light and airy and all have locks with a key available to service users should they require one. Service users are able to Linwood H58 H09 s59210 Linwood v214612 190405 Stage 4 ann.doc Version 1.20 Page 16 bring in personal possessions with them and this was evident during the inspection. Service users spoken to said that they were pleased with their rooms and found them comfortable and easy to move around in. The home was clean and tidy with no offensive odours on the day of the inspection. The home employs domestic staff for all cleaning duties. There are laundry facilities on each floor, with washing machines and dryers. Gloves and aprons were seen in the appropriate areas and a specialist contractor collects clinical waste on a weekly basis. Linwood H58 H09 s59210 Linwood v214612 190405 Stage 4 ann.doc Version 1.20 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 28 and 30 Service users safety is protected by a well trained and competent staff team. EVIDENCE: The home employs thirty staff, twenty- three of which are care staff. Of these care staff, seven have completed the NVQ level two qualification, and the remainder are working towards it. The home manager holds the registered managers award and the deputy is working towards it. One of the senior care staff is working towards NVQ level three. The home has a large room at the top of the building, which is used for staff training. Records are maintained of all staff training and a training programme is in place. Alongside mandatory training such as fire safety, moving and handling and health and safety, staff have also received training on specialist areas such as dementia. It is pleasing to see that all senior staff have been booked to attend the four days first aid at work course, meeting a requirement made at the last inspection. All service users spoken to were complimentary about the staff and the care they receive. Linwood H58 H09 s59210 Linwood v214612 190405 Stage 4 ann.doc Version 1.20 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 35 and 37 The management approach of the home benefits the service users. Service users financial interests are protected by the home. The homes record keeping and policies and procedures safeguard the service users rights and best interests. EVIDENCE: The manager has an open and inclusive approach to the management of the home. Staff spoken to reported that they enjoyed working at the home, they received regular supervision, that the manager was approachable and was flexible regarding the staff roster. Service users were complimentary about the manager, again stating that she is approachable and kind. A visiting relative stated that they think the home is brilliant and that it is well managed and a high level of care is given to their relative. Linwood H58 H09 s59210 Linwood v214612 190405 Stage 4 ann.doc Version 1.20 Page 19 Each service user has their own bank account and has an individual personal allowance record kept by the home. Amounts are entered of all monies put into or taken out of their accounts, with two people signing for every transaction. The home maintains a small amount of cash in the home for service users and a running total is maintained of this, along with receipts and signatures for every transaction. The home has a robust procedure in place managing service users finance and records examined show that this is being followed. It was pleasing to see that service users records are now locked securely, meeting the requirement made at the previous inspection. The home has a comprehensive list of policies and procedures designed to protect service users and promote their rights. Linwood H58 H09 s59210 Linwood v214612 190405 Stage 4 ann.doc Version 1.20 Page 20 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. Where there is no score against a standard it has not been looked at during this inspection. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 x 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 3 15 x COMPLAINTS AND PROTECTION 4 x x x x 3 x 3 STAFFING Standard No Score 27 x 28 3 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 x x 3 x x 3 x 3 x Linwood H58 H09 s59210 Linwood v214612 190405 Stage 4 ann.doc Version 1.20 Page 21 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard 1 9 Good Practice Recommendations It is recommended that the homes produces its service users guide in formats that are accessible to those service users who are unable to understand the written format. It is recommended as good practice that when it is necessary to handwrite a medication on to a medication administration record chart, that the member of staff writing the charts signs the entry, and that a second carer checks the entry for accuracy and then initials the chart. Linwood H58 H09 s59210 Linwood v214612 190405 Stage 4 ann.doc Version 1.20 Page 22 Commission for Social Care Inspection The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Linwood H58 H09 s59210 Linwood v214612 190405 Stage 4 ann.doc Version 1.20 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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