Inspection on 16/07/08 for Loran

This inspection was carried out on 16th July 2008.

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

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

Other inspections for this house

Loran 26/07/07

Loran 31/07/06

Loran 25/01/06

Loran 13/06/05

Loran 25/11/04

Loran 29/06/04

Similar services:

Abbey The

Snydale Care Home

Hawkhills

Larchfield Manor

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 08/11/2008.

CARE HOMES FOR OLDER PEOPLE Loran 106a Albert Avenue Anlaby Road Hull East Yorkshire HU3 6QU Lead Inspector George Skinn Key Unannounced Inspection 16th July 2008 09:30 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 Loran DS0000000861.V367229.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. Loran DS0000000861.V367229.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Loran Address 106a Albert Avenue Anlaby Road Hull East Yorkshire HU3 6QU 01482 355996 01482 571230 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) Sandco 1(T/A Hill Care Services) Ms Brenda Johnson Care Home 35 Category(ies) of Dementia - over 65 years of age (35), Old age, registration, with number not falling within any other category (35) of places Loran DS0000000861.V367229.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 26th July 2007 Brief Description of the Service: The large old house and extension is behind the properties on Albert Avenue, Hull. It accommodates 35 older people, some of whom may have dementia, in single and double rooms (22 new singles have en-suite shower and toilet). The facilities within the home and grounds include a chair lift and a passenger lift, a large conservatory, a secure garden and car park. Local shops, health services and pubs can be found near by, and the home is on a bus route to the city centre. Information about the home and its service can be found in the statement of purpose and service user guide, both these documents are available from the manager of the home. A copy of the latest inspection report for the home is on display in the entrance hall. The home charges a fee of £348.50 per week and that there are no additional charges other that those for hairdressing, private chiropody treatment, toiletries and newspapers/magazines. A full list of prices for these additional services is available from the manager. Loran DS0000000861.V367229.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means that the people who use this service experience good quality outcomes. The key inspection has used information from different sources to provide evidence. These sources include: • • • • Reviewing information that has been received about the home since the last inspection. Information provided by the registered person on an Annual Quality Assurance Assessment (AQAA) Comment cards returned from people who live at the home, relatives and staff A visit to the home carried out by one inspector. A site visit was carried out which lasted 5 hours. We spoke with the people who live at the home, their relatives and staff. Records relating to the people who live at the home, staff and the management activities of the home were inspected. During the visit care practices were observed, where appropriate, and time was also spent watching the general activity within the home The Manager was available to assist throughout the day. What the service does well: Information provided by the home on their AQAA told us that they thought they provided a good service because of: “We ensure that all clients are well cared for and that their needs and requirements are always met. We always put the well being of our clients first. We listen to Clients, Families, Professional bodies and all views are considered. We feel we are good employers as staff turnover in the past 12 months is exceptionally low. We have over the past 12 months worked very hard to improve our service. We have managed over this period with the aftermath of the flood with no help from any other professional body. We kept our clients safe and together there was no lasting affect on them. We helped Social Services by taking in flood Loran DS0000000861.V367229.R01.S.doc Version 5.2 Page 6 victims and assisting one to keep her independence so enabling her to go home. We kept clients and family’s informed of all the way. Staff worked exceptional well alongside management to keep the residents and their possessions safe and together in the worst possible conditions. They really worked as a team”. The people who live at the home told us they liked living there; one person said, “It’s like home from home”. They told us that the food was good one person told us that “there is always plenty of it and there is always a choice at all meal times”. They told us that they could come and go as they pleased one person told us that he regularly goes out and about on his own when he pleases. One person told us that she goes out with the help of staff or her relative takes her out. They told us that there were plenty of activities to choose from but they did not have to join in these if they didn’t want to. We saw that the home encourages people to be as independent as possible but there were always the right amount of staff on duty to help people and make sure they are cared for properly. We saw that the staff receive a lot of training about the need of older people and that they are trained in those areas which protect people from harm. We saw that the home do all the proper checks before someone is allowed to work at the home, so this keeps the people who live there safe from harm. We saw that the home makes sure that they have all the information they need before some one comes to live at the home so they can meet their needs properly. What has improved since the last inspection? What they could do better: Loran DS0000000861.V367229.R01.S.doc Version 5.2 Page 7 The home should make sure that the staff receive more specialist training to work with those people with dementia, this will enable them to feel more confident and to meet the needs of the people who live at the home better. The should be making sure that they ask relatives, friends, doctors and nurses who visit home how well the home is run and if they could make any changes to way it is run. 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. Loran DS0000000861.V367229.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 Loran DS0000000861.V367229.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): 3 People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. EVIDENCE: We looked at the files which belong to the people who live at the home and these contained evidence of a full needs assessment being made prior to them moving in by both the home and the placing authority. We saw that the assessments involved all relevant parties including the person or their relatives. The home then develops a care plan from their own assessment and the local authority’s assessment. The home does not admit people for intermediate care. Loran DS0000000861.V367229.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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine the care home supports them with it in a safe way. EVIDENCE: We looked at a number of care plans, which belonged to the people who live at the home. We saw that personal support is provided in accordance with the care plan; these contained risk assessments around the area of falls, tissue viability, nutrition and diet. We saw that the care plans looked at had been updated regularly and changed along with the changing needs of the person. The daily notes were comprehensive and reflected how the home met the needs of the people who live there. Risk assessments were in place for those people who had bedrails fitted to their beds to ensure their safety; we saw that these were in line with current guidelines and recommendations issued by the Department of Health. At the last inspection it was noted that the care staff Loran DS0000000861.V367229.R01.S.doc Version 5.2 Page 11 should encourage people to have more involvement with their care plans. This had been done and we saw evidence of people agreeing care plans and being involved with their formulation. One person who lives at the home told me she was involved in her care plan, she felt the staff consult her and she is involved in her reviews. We saw that the people who live at the home can access healthcare professionals like doctors and nurses when needed, some people also have input from specialist nurses like community psychiatric nurses (CPN). Some people have involvement with psychiatrists, specialist social workers, physiotherapist and dieticians. Occupational therapist, optical, dental and chiropody services are arranged when needed. When we spoke with the staff they were clear about how to maintain someone’s dignity and uphold their rights. We saw that the staff were sensitive to peoples needs when undertaking any personal tasks and were sensitive and patient when dealing with those people who have dementia. At no time did we hear any of the staff using any derogatory language or belittling any one in any way. We saw that staff treat the people with respect and their dignity was upheld. Shared rooms are fitted with privacy curtains and staff were observed to take people to their rooms if they needed any personal tasks undertaking. We looked at the way the home handles and stores medication. We saw that the way this was done ensures the safety of the people who live at the home. The medication was stored in the proper cabinets and secured in a locked room. The staff make sure that correct medication has been supplied by the pharmacist when it is delivered and any mistakes are quickly rectified. The staff make sure that the recording of the medication is up to date and gives a clear indication that the medication has been administered. The recording also indicates when the medication has not been given and why. All of the staff who give out medication have had the proper accredited training and we saw certificates which confirmed this. At the last inspection it was noted that the home should obtain 2 signatures if they had to transcribe any change of medication on the Medication Administration Record (MAR) sheet where this is recorded. This had been done and we saw that two people always sign to make sure the information has been recorded accurately. Loran DS0000000861.V367229.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 People who live at the home experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. People are helped to be as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, wellpresented meals and snacks, at a time and place to suit them. EVIDENCE: The home continues to provide activities for the people who live there. During the site visit we saw that the staff have relaxed friendly relationships with the people who live at the home and there was a lot of friendly banter. Loran DS0000000861.V367229.R01.S.doc Version 5.2 Page 13 The home provide a monthly activities session through an occupational therapist which is called “days gone by”. This takes the form of quizzes slides and talks about past lives. The home provides a monthly outside entertainer. The people who live at the home can also attend a religious service every month as the Reverend Bagshaw visit the home, the people can see him in private or attend communion. The home have recently employed an activities coordinator and they proved group activities and 1:1 time with the people who live at the home. The staff also get involved with activities with the people who live at the home by playing music and sing along with them. The home receive large print books from the library and these are changed on a regular basis. Key workers spend time with the people who live at the home and one person told us that she regularly goes out to the pub and shopping with her key worker. We saw that families are able to visit at any time and they told they were made to feel welcome and involved with the relatives. The home continue to provide the people who there with nutritious and wholesome food. Those people who we spoke with were complementary about the food and told us that they enjoyed and it and it was varied. We saw that staff were sensitive when helping those who needed help with eating. Loran DS0000000861.V367229.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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 People who live at the home experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. If people have concerns with their care they, or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. EVIDENCE: The home continue to have a complaints procedure and this is made available to the people who live there and their relatives. Information on how to make a complaint is posted a round the home The AQAA sent back by the home indicated that 2 complaints have been received by the home since the last inspection. The CSCI have received no complaints about the home since the last inspection. In discussion with the people who live at the home they were aware that they had the right to make complaints and told us that they would talk to their key worker or the manager. The home has a policy and procedure for safeguarding adults and the staff interviewed were aware of this, all had received training about Protection Of Vulnerable Adults (POVA). They told us that they were confident that if they Loran DS0000000861.V367229.R01.S.doc Version 5.2 Page 15 had concerns the management would take these seriously and deal with it properly. The manager has attended a “training for trainers” course on Safe Guarding Adult facilitated by the Local Authority and she cascades this training to the staff at the home. When we asked the staff about the quality of this training they were positive and spoke highly of the continent and how it was delivered. Loran DS0000000861.V367229.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 & 26 People who live at the home experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People live in home which is generally safe and clean, and well maintained. EVIDENCE: Loran Care Home was originally a Vicarage and has had extensions built on to the old house to create more modern facilities for the people who live there. The new rooms have shower and toilet en-suites, whilst the older rooms have space and high ceilings. There are numerous staircases to the first floor and accessibility to this area is aided by use of the stair lift or passenger lift. The corridors are wide enough for a wheelchair or person using a Zimmer frame to pass along comfortably and thought has gone into providing flat walkways for those with difficulty mobilising. Discussion with the staff indicates that there is a wide range of equipment provided to help with the moving and handling of people and to encourage their independence within the Loran DS0000000861.V367229.R01.S.doc Version 5.2 Page 17 home, this includes mobile hoists, slide sheets, turntables, moving belts and handrails. At the last inspection it was noted that the new bedrooms have been provided with lockable drawers, but this facility has not been extended to the older rooms. This has now been done. Since the last inspection the home have recarpeted the ground floor, and some of the bedrooms; increased laundry equipment, fitted heat reflecting blinds in the conservatory area, created a new office and quite lounge and created a new bathroom with an assisted bath fitted. Overall the environment is clean, warm and comfortable with no malodours present. Loran DS0000000861.V367229.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 People who live at the home experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, and support they need from their managers. EVIDENCE: There is a satisfactory staff rota in place that records the role of each member of staff. The staffing levels are based on the needs of the people who live at the home. There is a cook on duty each day as well as a kitchen assistant, and other ancillary staff. This enables care staff to concentrate on assisting people with personal and social care activities. Training records indicated that that more than 50 of the staff are now trained to NVQ level 2 which includes training on equality and diversity and an awareness of abuse. The recruitment and selection procedures remain robust and all checks are undertaken prior to staff commencing work at the home. The staff files looked at contained references from previous employer; an application form, which Loran DS0000000861.V367229.R01.S.doc Version 5.2 Page 19 identified gaps in employment and a completed Criminal Record Bureau (CRB) check. There is a training and development plan in place that shows all staff have undertaken core training and that some staff are to undertake more specialised training concerning the needs of older people. We saw that staff records include information about individual training achievements and a copy of training certificates is kept on their file. Staff have refresher training as appropriate to ensure that their skills and knowledge are kept up to date. All staff have received mandatory training in Health and safety, Manual handling, Basic Food Hygiene, First Aid and Fire. The home has not kept up to date with staff supervision and developmental. When we spoke with staff they said they found the training excellent and where pleased that the manager encouraged them to attend lots of training. They felt this gave them the skills needed to care for the people who live at the home. Loran DS0000000861.V367229.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 People who live at the home experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People have confidence in the care home because it is run and managed appropriately. The environment is safe for people and staff because health and safety practices are carried out. EVIDENCE: The manager of the home is registered with the Commission for Social Care Inspection (CSCI) and is continuing to work towards the Registered Managers Award. When we spoke with the people who live at the home they said she was approachable and they felt confident that they could go to her if they had any concerns. The staff also said she was approachable and they could go to her for advice or guidance. Loran DS0000000861.V367229.R01.S.doc Version 5.2 Page 21 At the last inspection it was noted that the home’s Quality Assurance (QA) system does not take into account the views of other stakeholders in the home like doctors nurses and family. This has now been addressed and the manager is in the processes of sending surveys to families and giving surveys to any visiting doctors or nurses. The home continues to hold meeting with people who live at the home. The home has a certificate for the local authority quality development scheme. The AQAA completed by the home indicates all policies and procedures are reviewed annually and the manager confirmed changes are also made as necessary. The home promotes the health, safety and welfare of people there and the staff. Mandatory training and updates are all taking place and a health and safety poster is displayed in the home for all staff to see. All the relevant maintenance certificates were available for us to look at. We saw that all the appliances had been serviced since the last inspection. The AQAA returned by the home was comprehensively completed and showed that the home had plans for future improvement. It showed that the home had identified areas of improvement and were addressing these. Loran DS0000000861.V367229.R01.S.doc Version 5.2 Page 22 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 X 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 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Loran DS0000000861.V367229.R01.S.doc Version 5.2 Page 23 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. 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. 3 4 Refer to Standard OP30 OP31 OP33 OP36 Good Practice Recommendations The staff should receive more specialist training to enable them to care for those people with dementia The manager should complete the Registered Manager’s Award by the end of 2008. The QA system should include others who have an interest in the care of the people who live at the home. The staff should receive more regular supervision. Loran DS0000000861.V367229.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB 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 Loran DS0000000861.V367229.R01.S.doc Version 5.2 Page 25 - 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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