Inspection on 06/03/06 for Lound Hall Nursing Home

This inspection was carried out on 6th March 2006.

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

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

Other inspections for this house

Lound Hall Nursing Home 21/08/07

Lound Hall Nursing Home 15/11/06

Lound Hall Nursing Home 01/04/05

Lound Hall Nursing Home 20/09/04

Lound Hall Nursing Home 18/06/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Lound Hall Nursing Home Jay Lane Lound Lowestoft Suffolk NR32 5LH Lead Inspector Iain Smith Unannounced Inspection 6th March 2006 08:50 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 DS0000024439.V285874.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. DS0000024439.V285874.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Lound Hall Nursing Home Address Jay Lane Lound Lowestoft Suffolk NR32 5LH 01502 732331 01502 732331 loundhall@yahoo.co.uk 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) Lound Hall Ltd Mrs Elizabeth May Care Home 43 Category(ies) of Old age, not falling within any other category registration, with number (43) of places DS0000024439.V285874.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 1st April 2005 Brief Description of the Service: Lound Hall is a care home with nursing, accommodating a maximum of 43 service users, aged 65 years and over. The home provides accommodation for the 43 service users in twenty nine single and seven double rooms with thirty rooms containing en suite facilities. All rooms are fitted with a lock, are domestic in character with furniture and a carpet. Most of the rooms overlook the gardens and all ground floor rooms have direct access to the gardens. The home is situated beside Lothingland Middle School in the village of Lound, a large house that has extended in recent years to provide additional rooms and facilities. The house is accessed from the main road with a long driveway with car parking facilities at the front of the home. DS0000024439.V285874.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This visit was arranged as an unannounced inspection, the second inspection for the year 2005/2006. The visit commenced at 8.50 and lasted 5.40 hours during which time the inspector spoke to 10 service users, administration, catering and housekeeping staff. The registered manager Elizabeth May and the owner Mark Binns and Christopher Christou, Commercial Director were present throughout the visit and contributed fully to the inspection process. A tour of the premises was made, two rooms were visited and the remaining standards assessed that were not covered at the first inspection. The home had received a complaint since the first inspection, therefore an assessment of the elements of the complaint were made to ensure that any requirements and recommendations made from this complaint had been put into place. What the service does well: What has improved since the last inspection? The home has reviewed their policies and procedures as a result of the recent complaint. Examples of the reviewed policies include the pre-admission assessment, staff handovers and key worker role. The key worker role has the responsibility of being allocated new admissions, this ensures there is better communication between the staff and service user throughout their stay at the home. The manager stated the job description for this role has improved consistency in care. DS0000024439.V285874.R01.S.doc Version 5.1 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. DS0000024439.V285874.R01.S.doc Version 5.1 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 DS0000024439.V285874.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1 Prospective service users and their representatives are provided with relevant information about the home that enables them to make a decision about living in the home. EVIDENCE: The statement of purpose was assessed and included relevant information for prospective and current service users. This information included the aims and objectives of the home and the provision of care. This stated that Lound Hall provides both long term and short term residential and nursing care in addition to respite care. The document states that the fees cover the provision of all accommodation charges including meals. Whilst each bedroom is equipped with both telephone and TV outlets, the service users are required to bring their own equipment in, including those on respite care. The manager stated that service users could have access to the office phone for private conversations. The owner stated that there were plans to install a public phone in the future. DS0000024439.V285874.R01.S.doc Version 5.1 Page 9 A new organisation chart has been produced by the owner and includes a business manager, Mr Christopher Christou. There are clear lines of responsibility with the manager responsible for the care staff, catering and maintenance man. A new service user, who was staying at the home for respite care stated that he was welcomed into the home and was being looked after very well. The manager stated that ‘we consider each service users needs and requests when they stay here. They can get up and go to bed when they wish to but at the same time we are sensitive to everybody’s needs’. DS0000024439.V285874.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): 11. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. EVIDENCE: The home has a policy for all staff to read and follow. This indicates that all staff ‘ensures that care and comfort is given to residents who are dying, that their death is handled with dignity, their spiritual needs, rites and functions are observed.’ The home has committed to a Department of Health initiative led by the Macmillan Nurses and introduced to the home, of a Gold Standard framework end of life care. This is led by one of the trained staff, who attends meetings externally and introduced for all staff in the subject of Palliative care. This initiative will train staff and promote a more consistent approach to service users end of life care. The manager stated that the General Practitioners for each of the service users had been involved. DS0000024439.V285874.R01.S.doc Version 5.1 Page 11 Staff who are involved with this element of care are trained and this is included in the training records. DS0000024439.V285874.R01.S.doc Version 5.1 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 15 Service users are given the choice of meals and the home provides a wholesome appealing diet. EVIDENCE: The home continues to provide a variety of meals and each service user can choose from a menu. The home has three dining areas, one of which was available for those twelve service users who require additional assistance with their meals. Care staff were seen to be sitting with the service users and assisting them with their food. All three dining areas had tables covered with cloths and with knives, folks and spoons available for all service users to use. Salt and pepper pots were available to all service users. One of the other dining areas was situated in a small room that had five gentlemen dining together. The meals were seen to be served individually with a member of care staff taking the meal from the kitchen to the service user on a tray. The responsibility for the ensuring that service users receive their choice is that of the team leader for each of the three areas of the home. The meal on the day of inspection included lamb and herb stew with dumplings and vegetables. There was lemon meringue pie or pears and ice cream. There were other meals prepared for the special diets. DS0000024439.V285874.R01.S.doc Version 5.1 Page 13 Each of the dining tables had a cold drink available for the service users, with tea and coffee served on the request of individuals. One of the respite service users stated that ‘the food is marvellous and they bring the menu round the previous day to chose what you want’. The manager stated that service users, who were nursed in bed, would have drinks available in their room. Service users who self medicated would also have drinks available in their rooms. There were no service users currently in the home who were self medicating. The home has employed a head of catering that was appointed in September 2005. This member of staff states that she is responsible for ensuring the menus are planned, food is ordered and prepared appropriately and there is sufficient equipment for the kitchen and service users for example crockery and cutlery. ‘I assess the quality of the table presentation’. Another positive commitment relating to the kitchen and provision of food is the employment of a person who works a shift covering 14.00 – 19.00 hours, five days a week. This ensures that individual service user choices are met and that meals can be prepared for tea - time. DS0000024439.V285874.R01.S.doc Version 5.1 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 Service users and their relative’s complaints are listened to and acted upon. EVIDENCE: The home has received one complaint since the last inspection. The provider and then the Commission for Social Care Inspection investigated the complaint. All elements of the complaint have been assessed and addressed by the home. The complaint is recorded in the log. The procedure states that the complainant can contact the Ombudsman if they are not satisfied with the outcome of the complaint, this would be relevant for those service users who are NHS funded. The complaints procedure is included as part of the statement of purpose and states that a written response will be made to any complainant within 28 days. DS0000024439.V285874.R01.S.doc Version 5.1 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 21 and 22. Service users live in a safe and well-maintained environment with sufficient and suitable toilet and washing facilities. EVIDENCE: The home maintenance man was decorating the front hallway and the manager stated that a new carpet was on order for that area. The home was warm and comfortable with a number of lounge and sitting areas throughout the home. Two service users were sitting in the lounge near the kitchen. They were occupying themselves with reading a book and the other doing word searches. The corridors were carpeted and clean with sufficient space for wheelchair users. The bathrooms were assessed and found to include appropriate equipment to enable service users to bathe in a safe and comfortable way. This included a Parker bath in coach house extension. The sides of the bath lifted to enable the service user to sit on the seat and swivel into the bath before the side is closed and the water is raised. Another bath had a high/low seat to enable the service DS0000024439.V285874.R01.S.doc Version 5.1 Page 16 users to change the position in the bath. There are two showers rooms therefore ensuring that the service users have the choice with their bathing arrangements. Two bedrooms were visited. They were found to include a bed; wardrobe and the windows had curtains to maintain privacy for the service users. Carpets were in the rooms and they were clean and tidy. Each of the rooms had a lock on the door and the manager stated that each service user is given the opportunity to have keys to secure their rooms. The pre admission assessment form has a section where the assessor will ask if the prospective service user wishes for a key or not. DS0000024439.V285874.R01.S.doc Version 5.1 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 and 30. The numbers and skill mix of staff meets the service users needs and they are trained and competent to do their jobs. EVIDENCE: The staff rota was examined and found to be sufficient in numbers to meet the needs of the service users. There was a trained nurse, registered with the Nursing and Midwifery Council (NMC), in charge of the home on each of the three shifts covering 24 hours. The rota evidenced that there were nine staff including the person in charge on the morning shift, six staff in the afternoon and four at night. The manager stated that either one or two staff were brought in at 07.00 hrs to assist the night staff. All the staff that were on duty during the inspection were seen to be identified on the rota, this included the housekeeping and catering staff. Training and development are essential for staff to gain the required skills and experience to meet the needs of the service users. There was evidence that the staff received appropriate training for example digestive course, aging, palliative care and pressure sore prevention. DS0000024439.V285874.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31 and 36. Service users live in the home that is run and managed by a person who is fit to do so. Staff are appropriately supervised. EVIDENCE: The registered manager is currently undertaking her RMA training. There are clear lines of accountability in the home for example the manager has an overall responsibility for all care, housekeeping and catering staff. There is a registered nurse responsible for a team of care staff on a day to day basis. The home operates four teams of care staff, green, red, yellow and a night team. The head of catering is responsible for all catering staff that includes undertaking their supervision. The carers, following their probation period are allocated the responsibility for a key worker role. The care workers have three service users allocated to them and there is a job description for the role. This role includes being allocated to DS0000024439.V285874.R01.S.doc Version 5.1 Page 19 a new admission to the home and ensuring that each person is introduced to the layout of the home and the routines for example the times of meals. The manager stated that this role has been reviewed and more time will be spent with the new admission to ensure a clear understanding of the facilities and staff. DS0000024439.V285874.R01.S.doc Version 5.1 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 3 X X X X x HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 X 10 X 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 x X X 3 3 X X X x STAFFING Standard No Score 27 3 28 X 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X X 3 X x DS0000024439.V285874.R01.S.doc Version 5.1 Page 21 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. Refer to Standard Good Practice Recommendations DS0000024439.V285874.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Suffolk Area Office St Vincent House Cutler Street Ipswich Suffolk IP1 1UQ 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. 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