CARE HOMES FOR OLDER PEOPLE
Lordington Park Lordington Chichester West Sussex PO18 9DX Lead Inspector
Mrs H Church Unannounced Inspection 31st January 2006 10:15 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 Lordington Park DS0000014616.V274547.R01.S.doc Version 5.1 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. Lordington Park DS0000014616.V274547.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Lordington Park Address Lordington Chichester West Sussex PO18 9DX 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) 01243 371536 Mr David Harold Rutland Mrs Fiona L Gordon-Smith, Mrs E Rutland, Mrs J Smith Mrs E Rutland Care Home 17 Category(ies) of Old age, not falling within any other category registration, with number (17) of places Lordington Park DS0000014616.V274547.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 28th July 2005 Brief Description of the Service: Lordington Park is a privately owned care home registered to accommodate up to seventeen service users in the category older persons not falling within any other category (OP). Lordington Park is situated approximately eight miles from Chichester. The property is a large detached house set in its own grounds and providing seventeen single rooms with ensuite facilities on the ground and first floors. A vertical lift provides access between the floors. Communal accommodation includes a dining room and a large drawing room situated on the ground floor. The registered providers of this care home are Mr D Rutland, Mrs E Rutland, Mrs F Gordon-Smith, and Mrs J Smith. The registered manager, who is responsible for the day-to-day running of the establishment, is Mrs E Rutland. Lordington Park DS0000014616.V274547.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection, one of two under the Commission for Social Care Inspection was undertaken over the morning and lunchtime areas when the manager was on duty and able to assist the inspector with her enquiries. The manager daughter, Mrs Smith, one of the registered providers, also assisted the inspector with some of the computerised paperwork. Overall, the inspector was provided with a good overview of the care being provided to the residents. The inspector examined the home’s records before spending time with some of the residents, a visitor and two members of staff to hear their views of their life at Lordington Park. To prepare for this inspection, previous reports and letters were reviewed. Two documents, namely the Statement of Purpose and Service Users Guide form a contract of service and care and have recently been updated to inform resident’s about how the home is run and how changes can be made to improve their individual lives at Lordington Park. During the inspection, spoke to four residents in depth and met a number of other residents as they continued with their morning and lunchtime activities. The home is registered for seventeen older persons and has recently completed a major extension, changes to existing rooms and a continuous refurbishment. During the inspection, a prospective new resident was being shown the accommodation for respite care. Following this introduction to the home, the manager would make an assessment of their needs ensure the home was able to meet the prospective residents needs. All of the comments received from the residents, visitor and staff were very positive and enthusiastic about the care and services provided. It was clear that residents are encouraged to say what they like or able to say if changes could improve their lives there. The visitor said the “it is a second home” and that the staff were very caring towards her relative. The manager and staff were always available if there were any concerns. Four records were examined to see if this matched the way that the residents said they lived their lives there and the care provided by staff. The care plans showed that staff provide the appropriate amount of support and the records clearly showed that every assistance is given to staff to enable them to provide good quality care. Two care staff said they felt Mrs Rutland provided good leadership and was very supportive in her management of the staff. There were no requirements and only one recommendation made at this inspection. What the service does well:
Lordington Park DS0000014616.V274547.R01.S.doc Version 5.1 Page 6 Lordington Park provides a care home with a warm homely atmosphere, good personal care service and encourages residents to personalise it as their own home by furnishing it with their own furniture and personal items. From information gained and through observation, detailed care is recorded and provided in a respectful manner. It was clear that the commitment to privacy and dignity is high. Residents are supported to lead fuller and happier lives as individuals and follow those activities that are personal to them, making suggestions or proposing any changes they feel would improve their lives. The food is prepared and cooked to a very high standard and the home has recently been updated and refurbished to a very high standard. The outcomes for residents are high and the manager and her staff provide a good service in a care home where the emphasis is on a professional but caring service provided in a homely atmosphere. What has improved since the last inspection? What they could do better:
It is difficult to find any major aspect of improvements that could be made as the proprietors are clearly committed to providing a high quality environment and are fully involved in every aspect of the management of the home. However, staff training has not been reviewed since the building work commenced and although in-house training continues, some training needs a professional trainer involved or staff trained to be instructors to provide this inhouse. The manager agreed that staff need to be updated, particularly in manual handling, to ensure residents and staff are not put at unnecessary risk. Arrangements are being made to provide this. There were other very minor changes to be made around staff records but the inspector recognised that the overall care is of a high standard and centred entirely on the residents needs. Lordington Park DS0000014616.V274547.R01.S.doc Version 5.1 Page 7 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. Lordington Park DS0000014616.V274547.R01.S.doc Version 5.1 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 Lordington Park DS0000014616.V274547.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1-5 All residents had been assessed before moving into the home. The staff at the home are meeting identified needs. Relatives were given good information to help them decide the home would be suitable. EVIDENCE: The visitor told the inspector they had turned up unannounced and received good information about the way the home operates. The inspector noted that the Statement of Purpose and Service Users Guide had been recently reviewed and four care plans showed a Pre-Assessment had been carried out with information from these, transferred onto the care plans. The risk assessments covered every aspect of care and it was clear from the resident’s comments about the care provided by staff, that staff were well informed about the care needed and were updating records accordingly. The inspector observed that a key-worker system is in place to benefit residents. Lordington Park DS0000014616.V274547.R01.S.doc Version 5.1 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): 7,8,10,11. All residents had an individual care plan set out for staff to follow. Care staff are meeting the health care needs of the residents in a respectful manner. EVIDENCE: Lordington Park provides residents with full information regarding the home’s responsibility in managing their medication and although formal paperwork is being introduced, it was clear that resident’s abilities to continue with this process are being monitored. The medication disposal sheets were completed accurately and complies with the Medicines Act 1968, guidelines from the Royal Pharmaceutical Society and the requirements of the Misuse of Drugs Act 1971. Four care plans included up-to-date information with good information about how to support residents to take identified risks. Care staff were observed speaking to and caring for the residents in a respectful manner. Residents said staff are “kind”, “excellent”, “caring” and from the visitor “they make us very welcome at any time”. Lordington Park DS0000014616.V274547.R01.S.doc Version 5.1 Page 11 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. A number of regular activities are provided with individual activities arranged according to the requests and dependency of the residents. Visiting is positively encouraged. Residents are served meals that are nutritious and appetising. EVIDENCE: Few residents have high dependency needs and in the main prefer to arrange their own routines according to their wishes. However, the home still provides regular activities by recognised outside entertainers. The visitor’s book showed visitors are welcomed at all times and the visitor confirmed that drinks are readily offered. The inspector noted that the food is cooked to a very high standard and noted that the lunch provided during the inspection demonstrated this. Lunch consisted of home-made vegetable soup, steak and kidney pie with creamed potatoes, broccoli, cauliflower, sprouts and parsnips followed by lemon mousse. The vegetables are grown in the gardens and freshly gathered for the lunch. The residents were fulsome in their praise of the food provided and the inspector noted that the manager recorded their likes and dislikes, updating
Lordington Park DS0000014616.V274547.R01.S.doc Version 5.1 Page 12 these regularly and providing alternatives where needed. The inspector also noted one resident had a fortified drink where eating was a problem. The dining room is able to accommodate all the residents with dining room tables beautifully presented and accommodating four residents at each table. Although most residents gathered in the dining room and this was clearly a very sociable occasion, some residents choose to have lunch in their rooms. All of the residents’ comments were very enthusiastic with the most usual comments being “excellent”, “always good” and “lovely food”. Lordington Park DS0000014616.V274547.R01.S.doc Version 5.1 Page 13 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): 16,17,18 The complaints process is on display. Staff have regular updates of training in Adult Protection Procedures. EVIDENCE: The home has a complaints procedure displayed in the new hallway and included in the Statement of Purpose and Service Users Guide. Residents were clearly aware of their rights but had no formal complaints, although they knew who to complain to. There were no complaints recorded since the previous inspection. The West Sussex Multi Agency guidelines were available in the office and care staff have regular in-house training sessions in Protection of Vulnerable Adults and abuse recognition. Lordington Park DS0000014616.V274547.R01.S.doc Version 5.1 Page 14 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): 19 - 26 The indoor areas used by residents are clean, safe and homely with good access to the front, side and rear gardens. The resident’s rooms are suitable for their needs and are homely. EVIDENCE: During a tour of the home the inspector noted that the home was providing a well decorated and furnished environment that is clean and safe and encourages residents to access all areas. There is one large ground floor lounge, separate dining room and a covered veranda for residents to use as appropriate. The dining room is furnished with tables accommodating four residents giving it a homely atmosphere. The lounge was large and well provided with seating areas overlooking the countryside, horses grazing in the fields’ dressage areas. All rooms had en-suite facilities, most with wet rooms suitable for wheelchair access. In addition to these there are assisted bathrooms and assisted shower
Lordington Park DS0000014616.V274547.R01.S.doc Version 5.1 Page 15 rooms all suitable for wheelchair users. There is a new toilet close to the lounge and arrangements were being made to provide liquid soap and paper towels to prevent cross infection. The new laundry room provides all the necessary equipment and again was just awaiting the finishing touches of liquid soap and paper towels. Thermostatically controlled hot water outlets and covered radiators ensure the safety of residents. All the residents rooms visited were clean, fresh, homely and comfortably furnished with resident’s personal possessions around them. The manager confirmed staff have received training in fire safety procedures and fire risk assessments. It was clear that during the summer months, residents are encouraged to use the outside areas from the provision of safe access to the front, side and rear gardens. Suitable garden furniture and an awning to give shade is provided. The garden is both wheelchair friendly and arranged so residents can walk around it independently. All the accommodation exceeds the National Minimum Standards. Lordington Park DS0000014616.V274547.R01.S.doc Version 5.1 Page 16 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): 27-30 Sufficient staff are on duty over the 24 hours period to meet needs and staff are recruited and trained to meet the Care Homes Regulations. EVIDENCE: The inspector noted that sufficient staff are on duty at all times over the twenty-four hours period. The numbers and skill mix of staff was appropriate to meet resident’s individual and collective needs with most staff considering undertaking National Vocational Qualification at level 2. Both of the members of staff spoken with said they felt well supported by the manager. Lordington Park DS0000014616.V274547.R01.S.doc Version 5.1 Page 17 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): 31,32,33,36,38. The registered manager is Mrs E Rutland. Mrs Rutland has the experience to manage the home. EVIDENCE: Mrs Rutland is a registered nurse and has a number of years of experience in managing the care home. Mrs Rutland is also one of the registered providers along with other members of her family who assist her in managing the records and paperwork involved in keeping the care home running smoothly. Staff clearly feel confident and well supported in their work and feel part of a team. One member of staff said, “We have a good team spirit” and the other who appeared to enjoy the different aspects of the work said, “we can be creative if we like”. There was a clear commitment to their work and felt very supported by the manager and other family members. Lordington Park DS0000014616.V274547.R01.S.doc Version 5.1 Page 18 The inspector could confirm that the residents do take priority in the home and their best interests are safe guarded. Accidents and incidents are being appropriately reported to the Commission for Social Care Inspection and outcomes for residents are very high. Lordington Park DS0000014616.V274547.R01.S.doc Version 5.1 Page 19 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 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 4 4 4 X 4 4 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 X X 3 3 3 X Lordington Park DS0000014616.V274547.R01.S.doc Version 5.1 Page 20 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. Refer to Standard OP30 Good Practice Recommendations The Registered persons must ensure staff receive accredited training in lifting and handling to minimise risks to residents and the staff working in the home. Lordington Park DS0000014616.V274547.R01.S.doc Version 5.1 Page 21 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 Lordington Park DS0000014616.V274547.R01.S.doc Version 5.1 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
