Inspection on 24/07/06 for Lobswood House

This inspection was carried out on 24th July 2006.

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

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

Other inspections for this house

Lobswood House 29/09/05

Lobswood House 20/05/05

Lobswood House 15/12/04

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

CARE HOMES FOR OLDER PEOPLE Lobswood House 16 Fitzalan Road Littlehampton West Sussex BN17 5JR Lead Inspector Mrs D Peel Unannounced Inspection 24th July 2006 09:15 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 Lobswood House DS0000014615.V296406.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. Lobswood House DS0000014615.V296406.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Lobswood House Address 16 Fitzalan Road Littlehampton West Sussex BN17 5JR Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01903 715055 lobswood_house@hotmail.com Dr G S Kalkat Mr G S Nijjar Mr James Muldoon Care Home 26 Category(ies) of Dementia - over 65 years of age (26), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (26) Lobswood House DS0000014615.V296406.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. One person under the age of 65 years n the category of Dementia can be accommodated until they no longer reside in the home. 29th September 2005 Date of last inspection Brief Description of the Service: Lobswood House is a care home that is registered to accommodate up to 26 residents in the category of dementia and mental disorder in older people. The property is located in an easily accessible area of Littlehampton, opposite a wooded green and near to the sea. It is a large, detached, older style property covering three floors with a passenger lift accessing all floors. The home has a secure secluded garden to the rear of the property, which includes a patio and a raised water feature. Apex Healthcare privately owns the service, and the registered Manager is Mr. J. Muldoon. The responsible person operating on behalf of the company is Dr. G S Kalkat. The proprietor and Manager have both received satisfactory Criminal Record Bureau checks. Lobswood House DS0000014615.V296406.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out by Mrs Diane Peel on the 24th July 2006. The intended outcomes for 33 standards were assessed; these included the key standards for care homes providing a service to older people. Prior to the visit to the home the inspector reviewed information provided by the manager in a pre inspection questionnaire completed at the request of the inspector some weeks prior to the visit and other information received from the provider since the last visit to the home on the 29th September 2005. Previous inspection reports were referred to in order that the inspector could judge to what extent the service was meeting its stated aims, objectives and statement of purpose of the home. A case tracking exercise for four residents was undertaken to look at how the assessed needs of this group of residents with diverse needs were being met. Where possible residents were spoken with to gain some information about what it is like to live at the home, those residents able to express an opinion made positive comments. A full tour of the home was undertaken, with all communal and private accommodation being viewed. Staff were observed assisting and interacting with residents in the lounge and the dining room. The atmosphere was friendly and relaxed, residents were spoken with meaningfully and staff demonstrated respect and recognition of individual residents needs. The records of three staff were inspected and staff were spoken with informally during the visit to find out what it is like to work at the home and what training had been provided. Samples of other records required to be kept by the home were viewed during the visit to ensure that the provider is meeting their obligations with regard to the administration of the home. Four service user/relative surveys were returned to the inspector prior to the visit all reporting satisfaction with the service at the home and commenting on how friendly and helpful staff are. The current scale of fees being charged at the home is from £389 to £580 per week. What the service does well: Lobswood House DS0000014615.V296406.R01.S.doc Version 5.2 Page 6 Lobswood House provides a good standard of care. The home is clean and well maintained, providing a comfortable homely atmosphere for residents to enjoy. The care staff take the time to ensure that residents are treated as individuals, respecting their right to make choices and maintaining individual levels of independence. Staff speak to residents in a respectful manner, taking time to explain things when they are confused. Visitors are welcomed into the home and are encouraged to continue to be involved in the care of their relative or friend living at the home. Meals are varied, nicely presented, offer choice and are served in pleasant surroundings. Residents who were able to speak with the inspector and staff spoken with; all had confidence in the managers approach to running the home. There are good training opportunities to ensure that staff have the combined skills to meet the needs of the residents. Relatives report that staff are good at: “looking at every client as an individual and seeing to their needs and care and communicating with us “ “ giving a warm friendly welcome to guests and relatives and always offering a drink to them. All staff seem to be friendly”. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Lobswood House DS0000014615.V296406.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Lobswood House DS0000014615.V296406.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3,4,5,6 Prospective residents and their families are provided with the information they need to make an informed choice about the home and are encouraged to visit the home before making a choice. Residents are assessed prior to moving into the home to make sure that the home can meet their needs. The service is able to demonstrate its capacity to meet the assessed needs of individuals admitted to the home. The outcomes for residents are good EVIDENCE: Lobswood House has a Statement of Purpose and Service Users Guide, which is regularly updated. The most recent version was provided to the inspector some weeks prior to the visit to the home and was observed to provide informative information, which would assist prospective residents and relatives to make a choice about the suitability of the home. Residents who were able to speak to the inspector about their experience of moving into the home were satisfied with the process and had relied on relatives and representatives to help them make a choice about moving into the home. Lobswood House DS0000014615.V296406.R01.S.doc Version 5.2 Page 9 Care records observed for the two residents case tracked who had moved to the home since the last visit in September 2005 included an assessment of need which had been carried out prior to the residents moving into the home. A member of staff told the inspector that if a resident has to be admitted to hospital, the manager would visit them and assess that the home could continue to meet that persons needs before they were able to return to Lobswood House. Training records show that the staff group collectively have the skills and experience to deliver the service and care which the home offers to provide. Rotas and staff records show that there is a good mix of male and female staff of varied age groups which residents have an opportunity to spend their time with. Intermediate care is not provided at Lobswood House. Lobswood House DS0000014615.V296406.R01.S.doc Version 5.2 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 the following standard(s): 7,8,9,10 Care planning systems give clear information to assist with all aspects of health, personal and social care needs. Records are in place to monitor the health care needs of residents to make sure that any signs of residents being unwell are recognised. The home can demonstrate good medication handling. Staff respect the privacy and dignity of residents so that residents are treated as individuals Outcomes for residents are good. EVIDENCE: All residents have a robust care plan, which has been developed from an assessment of need. At this visit to the home four care plans were examined and a case tracking exercise was undertaken to find out if the assessed needs of residents had been developed into a care plan which staff were following to meet individual residents needs. Staff have copies of the care plans and use them as a working tool. Each resident has a daily record sheet on which any occurrences and changes to the residents health is monitored. Lobswood House DS0000014615.V296406.R01.S.doc Version 5.2 Page 11 Records showed that care plans have been reviewed monthly. A sample of Quality Assurance Questionnaires viewed prior to the visit to the home and comment cards returned to the Inspector, reported that relatives feel that they are kept up to date with the changes of the care of their relative living at the home and feel that they are involved in the care provided. Residents have the right of access to health services and discussion with the manager and staff confirmed that the homes policies and procedures strongly support these rights. On the day of the visit a district nurse visited a resident who has a heath care need. Records in this person’s room showed that care staff are providing care tasks as directed by the district nurse and monitoring this persons fluid intake. Accidents records seen at this visit were detailed and showed what action had been taken. The home has a medication policy, which was provided prior to the visit to the home. The inspector observed the secure storage of medication during the visit to the home and observed the administering of medication at lunch time to see if the procedures were being followed. Medication records viewed at this visit were up to date with no gaps observed. The induction training at the home covers privacy and dignity. During the visit the inspector observed staff interacting with residents in the lounge and the dining room. They were observed to treat residents as individuals and speak to residents in a meaningful, caring manner. All Quality Assurance Questionnaires viewed by the inspector reported that relatives feel that staff treat their relative living at the home with dignity and respect. Lobswood House DS0000014615.V296406.R01.S.doc Version 5.2 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 the following standard(s): 12,13,14,15 The home provides a lifestyle that respects privacy, dignity and choice, matching resident’s expectations and individual preferences. Residents are encouraged to maintain contact with their family and friends so that they so that they can satisfy their social and emotional needs. Meals are of an good standard, providing choice and variation. Outcomes for residents are good. EVIDENCE: There is a clear move to finding out more about residents by involving residents families, friends and advocates to develop a care plan which will ensure that the lifestyle experienced in the home as far as reasonably practical satisfies all social, cultural religious and recreational interests and needs. Activities provided by the home include: weekly music entertainment, theatre shows, outings in the summer months, exercise to music and reminiscence therapy. A hairdresser visits the home every week and a chiropodist visits every 6-8 weeks. The home has a visitor’s book, which shows that there are regular visitors to the home. Lobswood House DS0000014615.V296406.R01.S.doc Version 5.2 Page 13 Relatives and visitors report in the comment cards returned to the inspector that staff make them welcome during their visits to the home and that they are able to visit their relative living at the home in private if they wish. One relative commented, “ Everyone is very helpful and willing to help me when I visit. I always get a cup of tea. The Christmas party is very goodsomething to suit everybody.” An experienced cook is responsible for providing home cooked food, which residents say, is of a good standard. The inspector spoke with the cook who was able to confirm that there is always an alternative to the main meal of the day and there are various choices at tea time. She commented that fresh vegetables are always provided and that the majority of food provided including cakes is home made. The cook was able to demonstrate that she is familiar with the dietary requirements of individual residents and provides a diet that meets their individual needs. The inspector joined residents for the main meal of the day, which was Chicken casserole, marrow, cabbage and mashed potatoes followed by rice pudding or fruit. The meal was of a good standard, nicely presented with very little waste. The mealtime was relaxed and staff were available to supervise those residents who needed assistance. Staff confirmed that not all residents want to eat in the dining room so they have the meal in the lounge or they can have a meal in their own rooms. A resident spoken with at lunchtime commented that “there is always plenty to eat” and “I usually like the food”. Lobswood House DS0000014615.V296406.R01.S.doc Version 5.2 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 the following standard(s): 16,18 The complaints procedure is clear and enables those using the service to have the confidence that their complaint will be responded to within a maximum of 28 days. The registered person has arrangements in place to protect residents from being placed at risk of harm or abuse. Outcomes for residents are good. EVIDENCE: Lobswood House has a clear complaints procedure that highlights the importance of complaining and making suggestions for improvement. Relatives returning the comment cards to the inspector prior to the visit to the home report that they are aware of the complaints procedure but have never had to use it. There have been no complaints made to the home since the last visit in September 2005. The home has an adult protection procedure. The majority of staff have attended Adult protection training by an independent training provider and staff are aware of procedures to follow. Lobswood House DS0000014615.V296406.R01.S.doc Version 5.2 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 the following standard(s): The home is clean and residents have a comfortable, homely environment to live in. Bedrooms are comfortable and meet the needs of the residents. Residents are encouraged to contribute to making their bedrooms their own by having their own personal possessions around them. To avoid an unnecessary outbreak of infection, action needs to be taken to repair or replace the bath identified to the manager. Outcomes for residents are good EVIDENCE: The inspector visited all areas of the home at this visit. The home was observed to clean and has many homely touches to encourage residents to feel comfortable. There is an enclosed garden to the rear of the home which residents are able to access with supervision. Lobswood House DS0000014615.V296406.R01.S.doc Version 5.2 Page 16 The front of the home is currently without a boundary wall. Staff confirmed that residents do not use this area and the manager told the inspector that the wall is being replaced by fencing. Bathrooms and toilets have rails and adaptations to assist residents to use the facilities safely and promote independence. Hot water temperatures were sampled during the tour of the home and were found to be in good order. Bedroom windows sampled had restricted openings to protect residents from falling out and most radiators were covered or had low surface temperature to avoid residents from being burnt. Locks have now been fitted to bedroom doors so that if residents want to lock their room when they are away from the premises they are able to. Some bedrooms do not meet the National Minimum Standards for Older people with regard to bedroom sizes but this is brought to the attention of prospective residents and their relatives in the homes Statement of Purpose. Residents who were able to speak with the inspector were satisfied with their rooms and one resident commented “its ok here”. It was observed that the enamel had worn off two areas of the bath in a downstairs bathroom. This matter could be an infection control hazard and so the inspector has made a Statutory Requirement that the bath is repaired or replaced. Lobswood House DS0000014615.V296406.R01.S.doc Version 5.2 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 consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 The staffing numbers are set at level, which allows residents assessed needs to be met. Recruitment procedures safeguard and protect residents at the home. Lobswood House provides well-qualified staff so that residents are able to feel safe and well looked after. Outcomes for residents are good EVIDENCE: Rotas provided to the inspector before the visit show that there is sufficient staff on duty with additional staff working at busy times of the day. During the visit the visit it was observed that staff were readily available to attend to residents needs when needed. The recruitment records of four staff were seen at this visit. Those records seen were as required with references and CRB and POVA checks being undertaken for new staff. The training programme at the home provides staff with the skills needed to carry out their role efficiently. Records of training are kept. A schedule of training was provided to the inspector prior to the visit to the home. NVQ percentage targets have not yet been met by the home. Information provided prior to the visit reported that four care staff have an N.V.Q. The manager confirmed that more care staff are to commence an NVQ in September 2006. Lobswood House DS0000014615.V296406.R01.S.doc Version 5.2 Page 18 Relatives report through Comment Cards and Quality Assurance Questionnaires that in their opinion there are enough staff on duty and that the staff are very helpful and friendly. Lobswood House DS0000014615.V296406.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,37,38 The home is well managed providing leadership and guidance for staff. The views of residents, their families and friends are sought to measure how successful the home is at meeting its aims and objectives and the Statement of Purpose of the home. Records required are constructed and maintained so that up to date information is available about residents to safeguard their best interests. Procedures are in place to ensure that the home is a reasonably safe environment to live in. Outcomes for residents are good. EVIDENCE: The manager has over two years experience as a manager and is qualified in working with people with mental health issues. Relatives and advocates report that the manager and staff are approachable and offer support. Lobswood House DS0000014615.V296406.R01.S.doc Version 5.2 Page 20 Customer consultation questionnaires show that relatives and advocates have been consulted about their views of the home. Regulation 26 reports supplied to the Commission for Social Care Inspection are of a good standard and show that meaningful visits to the home take place to monitor the standard of care and the environment of the home. Records viewed at this visit to the home were clear and showed that staff understand the importance of keeping records up to date. The manager confirmed that no monies are held at the home for distribution to residents. Relatives are invoiced directly for any additional services not covered by the fees. One health and safety issue came to the attention of the inspector with regard to infection control outlined in standard 26. The inspector noted that the rooms on the 2nd and 3rd floors do not have a call bell system fitted. The service user guide does bring this matter to the attention of prospective residents and their families and states that any prospective residents would have their needs assessed before placing in one of these rooms to “ensure both their safety and that of out staff”. A recommendation has been made that any future refurbishment of the home should include extending the call bell system to all rooms. Lobswood House DS0000014615.V296406.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 2 3 3 3 1 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 3 3 1 Lobswood House DS0000014615.V296406.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP26 OP38 Regulation 13.3 Requirement The bath identified to staff and the manager must be repaired or replaced as a matter of infection control. Timescale for action 01/09/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP38 OP22 Good Practice Recommendations Any future refurbishment of the home should include extending the call bell system to all rooms. Lobswood House DS0000014615.V296406.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Worthing LO 2nd Floor, Ridgeworth House Liverpool Gardens Worthing West Sussex BN11 1RY National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Lobswood House DS0000014615.V296406.R01.S.doc Version 5.2 Page 24 - 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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