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Inspection on 15/06/07 for Lothian House Care Home

Also see our care home review for Lothian House Care Home for more information

This inspection was carried out on 15th June 2007.

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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

During this inspection the people spoken to were complimentary about the care provided and the staff working in the home. The staff were motivated and enthusiastic, they receive regular appropriate training and support. There were written care plans in place for each resident. This helps staff make sure that each resident gets the support and assistance that is needed for them to live safely and comfortably. There was a range of activities offered and the people said they really enjoyed this. Everyone spoken with said they enjoyed the food and that it was cooked nicely and the choice of meals was also good. The home is maintained to a high standard, all the areas of the home are lovely and clean. All the furniture and fittings were of a good quality. Regular meetings are held with people that live at the home so they can have a view on how the home is managed and how they are cared for.

What has improved since the last inspection?

There were no requirements or recommendations made at the last inspection. The home has continued to offer a good standard of care for the people who live there. The manager and staff are continually working hard and looking to improve the care and support they give to the residents who live at the home. Staff training has improved. The number of staff who are trained to NVQ (National Vocational Qualification) in care at level two or above has increased to 80%.

What the care home could do better:

Medication that has a limited shelf life once opened must have the date of opening identified on the bottle.

CARE HOMES FOR OLDER PEOPLE Lothian House Care Home Clyde Terrace Spennymoor Durham DL16 7SG Lead Inspector Mrs Sue Lowther Key Unannounced Inspection 09:30 15 & 29th June 2007 th 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 Lothian House Care Home DS0000000728.V337110.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. Lothian House Care Home DS0000000728.V337110.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Lothian House Care Home Address Clyde Terrace Spennymoor Durham DL16 7SG 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) 01388 811488 01388 811693 Southern Cross Home Properties Limited Jill Carr Care Home 48 Category(ies) of Old age, not falling within any other category registration, with number (48) of places Lothian House Care Home DS0000000728.V337110.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 16th May 2006 Brief Description of the Service: Lothian House is a registered care home providing personal care and accommodation for up to 48 older persons in the category of (OP). It is owned by Southern Cross Healthcare Properties Ltd and operates within the private sector. The home is located on the outskirts of Spennymoor, County Durham, close to local amenities. It is a two-storey building located in its own well-maintained private grounds that are easily accessible. Personal accommodation and communal areas are provided on both floors. All bedrooms are used as single accommodation giving the home an occupancy level of forty seven older persons. Thirty three of the bedrooms have ensuite facilities. The fees charged are between £364:50p and £445:00. This does not include hairdressing, chiropody and personal newspapers. Lothian House Care Home DS0000000728.V337110.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection of Lothian House took place on the 15th and 29th June 2007. The first day of inspection was on an unannounced basis. Records were examined and a tour of the building took place. The registered manager was present on the second day of the inspection. Time was spent talking to service users, staff and relatives. Some information was supplied on a pre inspection questionnaire. The inspection focussed on key standard outcomes for the people who live in the home. What the service does well: What has improved since the last inspection? There were no requirements or recommendations made at the last inspection. The home has continued to offer a good standard of care for the people who live there. The manager and staff are continually working hard and looking to improve the care and support they give to the residents who live at the home. Staff training has improved. The number of staff who are trained to NVQ (National Vocational Qualification) in care at level two or above has increased to 80 . Lothian House Care Home DS0000000728.V337110.R01.S.doc Version 5.2 Page 6 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. The summary of this inspection report can be made available in other formats on request. Lothian House Care Home DS0000000728.V337110.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 Lothian House Care Home DS0000000728.V337110.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. JUDGEMENT – we looked at outcomes for the following standard(s): 3. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Assessment procedures are in place to ensure that the home can meet all of the needs of the people who go to live there. The home does not provide intermediate care. Therefore assessment of Standard 6 is not required. EVIDENCE: The manager visits people in their current place of residence to carry out a comprehensive assessment before they go to live in the home. This makes sure their needs can be met within the home. A care plan is agreed and this is reviewed regularly. The files of three people were looked at and confirmed this. One person who lives in the home said, “I chose this home after I was given loads of information”. Lothian House Care Home DS0000000728.V337110.R01.S.doc Version 5.2 Page 9 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 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Good systems are in place to ensure that health care needs of service users are met. People who live in the home can be confident that their privacy and dignity is protected and that they are treated with respect. EVIDENCE: There were individual care plans available that identified health and personal care needs and how they would be met. Three were looked at during the inspection. Daily records showed this care was provided. People who live in the home and their relatives said that they were aware of these plans. They also contained evidence that people have access to health care professionals. One district nurse visiting on the day of inspection confirmed that the staff contact her promptly when needed. Lothian House Care Home DS0000000728.V337110.R01.S.doc Version 5.2 Page 10 The medication of three people was audited and found to be in order. The drug fridge was checked. This contained medication that had a limited shelf life once opened. The date of opening was not identified on the label. This medication was still in date as it had only been dispensed eight days previously, however there was potential that out of date medication may be given in the future. A similar situation was identified when checking medication in the controlled cupboard. The date of opening must be written on any bottle of medication which has a limited shelf once it is opened. The inspector saw that staff treat the people with dignity and respect. Staff were seen to knock on doors before entering rooms and spoke to the people in a respectful manner. One relative said that the staff were “very caring” and “couldn’t be better”. One person who lives in the home said, “ I have been here for seven years. The staff are great. They treat me like I am one of their family”. Lothian House Care Home DS0000000728.V337110.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The activities are varied and provide recreation for the people living in the home. Family and friends can visit the home at any time and are made to feel welcome. The meals are of a good standard. Menus are varied and service users are given a choice. EVIDENCE: Comments about activities within the home were good. Care staff currently organise the activity programme as the activity organiser is not available. One visitor said “My relative likes to get involved in the activities when she can. She really enjoys the singers”. One person who lives in the home said, “I like the activities here. They are really good”. The home produces a monthly newsletter, which includes details of forthcoming activities. Family members can access community transport and facilities and sometimes take their relatives out. Lothian House Care Home DS0000000728.V337110.R01.S.doc Version 5.2 Page 12 Lothian House has a policy of open visiting. Visitors said they always felt welcome. One relative said, “Staff are nice. They always make me welcome and offer me a cup of tea”. People said they are given choice and have control over their lives. One person said, “I go out with my friends nearly every afternoon and come back in the evening”. Another said “I can get up and go to bed when I want. The staff help me to have a bath every three days. This is my choice”. The menus are displayed each day. Staff ask people if they are happy with this or if they want an alternative. The people who live in the home were very complimentary about the food. One person said,” The food is good and you get a choice. The only problem is there is too much”. The evening meal was observed. Staff were assisting people who required help in a dignified and discreet manner. Lothian House Care Home DS0000000728.V337110.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who live in the home can be confident that their concerns and complaints are dealt with appropriately and that safeguards are in place to protect them from abuse. EVIDENCE: The home has a complaints procedure for service users and relatives. The people who live in the home and family members said that if they had any concerns they would talk to the manager and staff. They felt confident that they would be listened to and action would be taken. One person who lives in the home said, “I tell the staff if I have a problem and I know things will be done.” There were three complaints recorded within the home since the last inspection, these had been appropriately investigated following the procedure laid down by Southern Cross. Staff spoken to had been trained in adult protection. They were all aware of policies and procedures to ensure the protection of vulnerable adults. They said that they felt confident they would know how to respond if an incident occurred. Lothian House Care Home DS0000000728.V337110.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is clean and well maintained. It is decorated and furnished to a good standard and provides a homely environment for the people who live there. EVIDENCE: Some areas of the home have recently been redecorated to a good standard. The décor throughout the home is bright and cheerful. The bedrooms viewed were found to be clean and comfortable. People had their own belongings, photos, ornaments and televisions in their rooms giving them a homely feel. The home has a variety of communal areas including a small quiet lounge and a large lounge and very attractive dining area. All of these were found to be Lothian House Care Home DS0000000728.V337110.R01.S.doc Version 5.2 Page 15 clean and comfortable and are available for people to see friends and families if they do not want to use their bedrooms. A relative said, “This home is well decorated. One of the better ones I think”. There were no unpleasant odours apparent on the day of inspection. Lothian House Care Home DS0000000728.V337110.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a good recruitment and selection system, which ensures that people are cared for by competent staff. EVIDENCE: The duty rota supplied with the pre inspection questionnaire evidenced that sufficient staff are on duty and deployed appropriately in order to meet the needs of the people who live in the home. All of the people spoken to said that staff were around when they needed them, and if they rang the buzzer it was answered promptly. There is a commitment at the home to having a trained workforce and a variety of training courses are available to all staff. Staff said they found the training helpful in improving their day-to-day practice. Recent training has taken place in moving and handling, care planning, protection of vulnerable adults, dementia training and falls awareness. Over 80 of care staff are trained to NVQ (National Vocational Qualification) in care at level two or above. The home had staff files in place that provided evidence that the appointment of a new staff member is made through proper recruitment processes. This Lothian House Care Home DS0000000728.V337110.R01.S.doc Version 5.2 Page 17 includes the vetting of staff through the use of references, POVA first checks and Criminal Record Bureau (CRB) checks. Lothian House Care Home DS0000000728.V337110.R01.S.doc Version 5.2 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 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people who live in the home can be confident that the home is well managed. There are systems and safeguards in place to ensure the health, safety and welfare of the people who live in the home. EVIDENCE: The manager is well qualified with several years experience in working with older people. The area manager carries out a quality assurance and monitoring visit on a monthly basis. This covers all aspects of care delivery and environmental issues. Copies of the report produced following this visit were available within Lothian House Care Home DS0000000728.V337110.R01.S.doc Version 5.2 Page 19 the home. Surveys are carried out by the company on a regular basis. The home holds a monthly meeting for the people who live in the home and their relatives. This gives people an opportunity to say how they would like the home to be run and discuss any changes that they feel will improve any aspect of the home. A monthly newsletter is produced. This includes details of any changes in the home with regard to staffing, including a personal profile of any new staff. It also includes details of any proposed environmental changes. The administrator is responsible for the record keeping with regard to the monies held by the home on behalf of the people who live there. The records for three people were checked during this inspection. They were found to balance. The company also audits these on a monthly basis to ensure that people are protected. The manager confirmed that regular health and safety checks are carried out within the home. Some of the records were checked and were found to be up to date. Lothian House Care Home DS0000000728.V337110.R01.S.doc Version 5.2 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. 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 2 10 3 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 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 Lothian House Care Home DS0000000728.V337110.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? N/A 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 OP9 Regulation 13(2) Requirement Timescale for action 31/07/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Lothian House Care Home DS0000000728.V337110.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Darlington Area Office No. 1 Hopetown Studios Brinkburn Road Darlington DL3 6DS 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 Lothian House Care Home DS0000000728.V337110.R01.S.doc Version 5.2 Page 23 - 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. 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