CARE HOMES FOR OLDER PEOPLE
Lothian House Clyde Terrace Spennymoor Durham DL16 7SG Lead Inspector
Belinda Parker Unannounced 24 May 2005 09:30 am
th The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Lothian House B54 S0728 Lothian House V227746 240505_Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Lothian House Address Clyde Terrace, Spennymoor, Durham. DL16 7SG Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01388 811 488 01388 811 693 Highfield Home Properties Ltd Jill Carr Care Home 48 Category(ies) of OP - Old Age 48 Places registration, with number of places Lothian House B54 S0728 Lothian House V227746 240505_Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: The registered manager must attain (by 2006) a qualification at Level 4 NVQ in management and care or equivalent. Date of last inspection 15th February 2005 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 Highfield Homes 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 47 older persons. Thirty three of the 47 bedrooms ensuite facilities. Service areas located on the ground floor. Lothian House B54 S0728 Lothian House V227746 240505_Stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection took place on 24/5/05 over a period of 6 hours. During the inspection we spoke to service users, staff, examined a number of records and toured the building. Since the last inspection one of two requirements made and two of three recommendations made remain outstanding. What the service does well: What has improved since the last inspection?
Since the last inspection new carpets have been laid in the corridors and foyer, creating a more comfortableand pleasent environment for service users. Lothian House B54 S0728 Lothian House V227746 240505_Stage 4.doc Version 1.30 Page 6 Training on Adult Protection has been made available to staff, to equip them with the knowledge and skills to ensure service users living in the home are protected from abuse. 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. Lothian House B54 S0728 Lothian House V227746 240505_Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Lothian House B54 S0728 Lothian House V227746 240505_Stage 4.doc Version 1.30 Page 8 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2 and 5 The system for informing service users and obtaining their signed agreement for the Terms and Conditions for living in the home is slow. Flexible visiting arrangements are available to prospective service users and their family to enable them to make an informed decision as to whether the prospective service user wishes to move in. EVIDENCE: Since the last inspection the process for issuing service users with a copy of Terms and Conditions of residency is still ongoing. Where service users lack capacity the manager said relatives are asked to sign as to their agreement with this document. The manager said all prospective service users and their relatives are invited to visit the home at a time that suits them and spend time with staff and other service users. A service user who recently moved into the home said her son looked around the home on her behalf. Lothian House B54 S0728 Lothian House V227746 240505_Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 9 The home has made progress since the last inspection with regard to the arrangements for receiving medication into the home, which ensures the protection of service users. EVIDENCE: Since the last inspection, the system for recording handwritten entries on the medication recording sheet has improved. Staff improved awareness of the procedure for recording medication received into the home was evident during discussion. This standard is met ensuring the protection of service users. Lothian House B54 S0728 Lothian House V227746 240505_Stage 4.doc Version 1.30 Page 10 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12 Following discussion with service users and staff, the lifestyle experienced in the home provides service users with the opportunity to satisfy their social and recreational interests. EVIDENCE: During discussion with the manager and activities co-ordinator who confirmed that, consideration is given to providing a varied range of activities appropriate to the collective needs of the service users. Activities are displayed daily on the notice board for service user information. Monthly service user meeting’s are held to discuss activity programme. A service user spoken to talked about the flexible routine within the home, she said she set the tables for meals and assisted staff with other small tasks. This lady said her independence was encouraged. A service user spoken to said she reguarly joins in activities of her choice. The hairdresser visiting on the day of the inspection said she, “ likes to create in the salon a social atmosphere, where service users can have a chat, listen to music and be pampered” . Lothian House B54 S0728 Lothian House V227746 240505_Stage 4.doc Version 1.30 Page 11 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and 18 The home has a satisfactory Complaints and Adult Protection system in place with some evidence that their views would be listened to and acted upon. EVIDENCE: Since the last inspection there had been three complaints made to the home. 1 x care fees (Not upheld), 1 x POVA (Partially upheld) and 1 x Termination of accommodation (Not upheld). Records examined showed time scales and outcome. Staff spoken to during inspection were able to demonstrate awareness of the complaints procedure and process. Service users spoken to said they would speak to the manager if unsatisfied with any aspects of the care service delivery. Since the last inspection there has been an improvement in training provided for staff on Adult Protection issues. Staff spoken to were able to demonstrate an awareness of the POVA process. All staff spoken to said they would immediately report any alledged incidents of abuse. Lothian House B54 S0728 Lothian House V227746 240505_Stage 4.doc Version 1.30 Page 12 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 21, 22, 23, 24, 25 and 26 The standard of the environment in this home is good providing service users with an attractive and homely place to live. EVIDENCE: We toured the home and found it be commendably clean, well maintained and furnished appropriately for the comfort of the service users. Communal and private accommodation space standards were appropriate. A service user spoken to who had recently moved into the home commented, “ My son decorated my room with family photo’s before I moved in, it felt like home”. Bathing, washing and toilet facilities were adequate to meet the collective needs of the service users. A range of disability equipment was available to meet the assessed needs of individual service users. Laundry facilties are sited away from food preparation areas.
Lothian House B54 S0728 Lothian House V227746 240505_Stage 4.doc Version 1.30 Page 13 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28 and 30 There is a good match of staff with the appropriate skills and abilities to offer consistancy of care within the home. EVIDENCE: Evidence was available to show that care and ancillary staff are employed in adequate numbers to meet the collective needs of the service users. Training records examined and discussion with staff showed that the home is positive towards developing the skills and abilities of staff to ensure a good standard of service is delivered to service users and other visitors to the home. A staff member spoken to talked about the opportunity to attend training and the benefits of gaining knowledge to enable her to carry out her role effectively in providing a good standard of care to the people who live in the home. Lothian House B54 S0728 Lothian House V227746 240505_Stage 4.doc Version 1.30 Page 14 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 34, 36, 37 and 38 The manager has a good understanding that the home must continue to develop to ensure the standard of care delivered to the people who live in the home is of a good with appropriate planning put in place to achieve this. EVIDENCE: The manager said the training co-ordinator for the company is arranging a start date for her to commence the Registered Managers Award, which will enhance the managers skills and knowledge for the effective management of the home. Evidence of financial viability was not available in the home on the day of the inspection to show that the home is being ran in the best interests of the service users. Lothian House B54 S0728 Lothian House V227746 240505_Stage 4.doc Version 1.30 Page 15 Since the last inspection the manager had developed a programme of formal supervision for all staff. Evidence was available to show that staff are given the opportunity to discuss all aspects of care practice, philosopy of care and career development. A staff member spoken to said this system offered the opportunity to discuss their role and identify training needs to enable the staff member to deliver a good service to the people who live in the home. Records examined for the protection of service users including care, staff and health and safety were accurate and up to date. Lothian House B54 S0728 Lothian House V227746 240505_Stage 4.doc Version 1.30 Page 16 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x 2 x x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 x 8 x 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 x 15 x
COMPLAINTS AND PROTECTION 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 2 x x 2 x 3 3 3 Lothian House B54 S0728 Lothian House V227746 240505_Stage 4.doc Version 1.30 Page 17 yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 34 Regulation 25 Requirement The registered person must provide CSCI with evidence of financial viability. (outstanding since the last inspection) Timescale for action 1/8/05 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 2 Good Practice Recommendations The registered manager should continue to issue a copy of the Terms and Conditions of resdency to all service users living in the home. Service users or their representative should sign as to their agreement. (outstanding since the last inspection). The registered manager should achieve the Registered Managers Award 2006. 2. 31 Lothian House B54 S0728 Lothian House V227746 240505_Stage 4.doc Version 1.30 Page 18 Commission for Social Care Inspection No 1 Hopetown Studios Brinkburn Road Darlington DL3 6DS 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 Lothian House B54 S0728 Lothian House V227746 240505_Stage 4.doc Version 1.30 Page 19 - 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!
