Inspection on 04/10/05 for Lovat House

This inspection was carried out on 4th October 2005.

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

Lovat House 11/04/07

Lovat House 03/05/05

Lovat House 13/09/04

Lovat House 22/04/04

Lovat House 27/10/03

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE Lovat House 6 Crescent Road Wokingham Berkshire RG40 2DB Lead Inspector Stephen Webb Unannounced Inspection 4th October 2005 10:00 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 Lovat House DS0000011399.V249902.R01.S.doc Version 5.0 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. Lovat House DS0000011399.V249902.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Lovat House Address 6 Crescent Road Wokingham Berkshire RG40 2DB 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) 0118 978 6750 Mr Ian Tappin Mrs G Tappin Ms Fiona Honeyman Care Home 26 Category(ies) of Old age, not falling within any other category registration, with number (26) of places Lovat House DS0000011399.V249902.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 3rd May 2005 Brief Description of the Service: Lovat House is a twenty-six bedded home providing residential care to older people. This is a long-standing home, operating in a converted Edwardian detached house, with later extensions, in a residential street in Wokingham. Ownership transferred to the current proprietors, Mr and Mrs Tappin, in 1988. The home is close to local amenities. Residents are accommodated on three floors served by a passenger lift. The building has been subject to extensive improvement, over the past three years and work is now complete in most areas. Additional en-suite bedrooms have been provided, together with the provision of en-suite toilets to some existing bedrooms; and improvements made to kitchen, laundry, bathrooms, toilets, dining and lounge space, as well as to the general internal layout and environment. The rear garden has been attractively landscaped to provide full accessibility with level paths, raised beds, sunny and shady areas and plenty of seating. The side and front gardens were in the process of being landscaped. Entertainment, physiotherapy and activities are provided to residents, and various faiths can be supported via access to local clergy. Lovat House DS0000011399.V249902.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection carried out between 10.00am and 3.00pm, which included discussion with residents, staff and the manager, a tour of the building, examination of records, policies and procedures, and observation of care practice. The inspector also had lunch with residents in the dining room. This was a positive inspection. The work to the interior of the building had been completed and the remaining exterior works were in process. Despite the inevitable disturbance during the extensive building works, the feedback from residents indicated that it had had minimal impact on them. The staff have had to be extra vigilant and have worked hard to manage the inevitable disruptions to the routine, but on the whole they remained positive throughout this. The facilities have been significantly enhanced as the result of the works undertaken, to the benefit of residents and staff. The direct feedback from residents was very positive, as was that obtained via the home’s quality assurance system. What the service does well: What has improved since the last inspection? Lovat House DS0000011399.V249902.R01.S.doc Version 5.0 Page 6 Additional areas of the interior building works have been completed since the last inspection, including the provision of en suite toilet extensions to some of the existing ground floor bedrooms, the redecoration of the entrance hall and some new carpets. The landscaping of the side and front gardens was in progress during the inspection and once completed will further enhance the appearance of the home. Additional staff have been recruited to reflect the increase in occupancy as various building works were completed. (See below however). It was positive that a further cycle of quality assurance survey had been carried out recently, and the results indicated a lot of positive satisfaction with the service, as well as one or two issues for improvement. The manager was planning to follow up any criticisms made to try to resolve the issues raised. 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. Lovat House DS0000011399.V249902.R01.S.doc Version 5.0 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 Lovat House DS0000011399.V249902.R01.S.doc Version 5.0 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): Standard 3 was addressed at the previous inspection. Standard 6 does not apply in this home. EVIDENCE: N/A Lovat House DS0000011399.V249902.R01.S.doc Version 5.0 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 the following standard(s): 8, 10 The health needs of residents are effectively met by the home. The residents spoken to, felt that they were treated with dignity and respect and that their privacy was maintained. EVIDENCE: During the inspection, the manager liaised effectively with health colleagues to ensure that the health needs of a very frail resident were effectively and promptly met to ensure her comfort, and freedom from pain. Staff were checking the resident’s welfare frequently and monitoring fluid intake carefully. Another resident had received surgery for cataracts the week prior to the inspection and another was due to receive this the following week. Residents had been seen the week before the inspection, by the visiting optician, and the home has regular visits from chiropodists, (every 8-9 weeks), and retains a physiotherapist who visits weekly to monitor the welfare of all of the residents, and advise on the support of those with particular needs. Lovat House DS0000011399.V249902.R01.S.doc Version 5.0 Page 10 Residents’ privacy is provided for by individual, lockable bedrooms, though two bedrooms can be shared if this is specifically requested. Bathrooms and toilets also have appropriate locks. Residents can and do spend time privately in their bedrooms if this is their preference, though they are encouraged to join the group for some of the time to avoid isolation. The majority of residents are checked on during the night-time, but this too can be declined if preferred. Residents can see visitors in private in their bedroom, and would also be seen here by visiting district nurses or doctors. Residents’ records are stored appropriately to maximise their privacy and are accessible to relevant staff only, on a need-to-know basis. Feedback from residents confirmed that they felt their health needs were well met and that their privacy was respected by staff. They confirmed that they were treated with respect and dignity by the staff. The opinion of service users were recently sought as part of the home’s ongoing quality assurance programme, and the results were due to be posted on the notice board so they could be seen by residents and visitors. Lovat House DS0000011399.V249902.R01.S.doc Version 5.0 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): 14, 15 Residents are enabled to exercise choice within their daily lives wherever possible. Residents receive a varied and wholesome diet, which is well presented and tasty. The dining room is a pleasant environment in which to eat meals. EVIDENCE: Residents are supported to make daily choices whenever they are able. This would include choices around food, clothing activities etc. One resident said that she could elect to go for a walk into Wokingham, and another confirmed that he could choose whether to join in with activities or stay in his bedroom. One of the complaints within the complaints log indicated that the home had supported residents to have the choice of whether they wished to listen to one resident’s choice of music or watch the TV, in the lounge. Although some activity is provided daily and there are also periodical visits from outside entertainers, residents confirmed they could elect not to take part if this was their wish. Lovat House DS0000011399.V249902.R01.S.doc Version 5.0 Page 12 Residents can also choose to bring in personal items for their bedrooms, and this was confirmed by the residents, and was evident from the diversity of personal items within individual rooms. The inspector ate lunch with residents, and as on previous occasions, the food was tasty, and well presented. Residents were offered second helpings and several commented on how nice the meal had been. The level of satisfaction with the food is also confirmed from the quality assurance feedback obtained from individual residents, the vast majority of whom, were very satisfied with the meals. Detailed menus are available, and although there is one main choice listed, individual likes and dislikes are provided for as well as dietary needs. This was evident from the alternative options provided to some individuals at lunch. The cook is a long-standing member of the staff team and knows the individual likes and dislikes of the residents. The dining room is attractively decorated and furnished, and is a very pleasant dining environment. Staff engage well with the residents and there is a good deal of conversation and banter during meals. Lovat House DS0000011399.V249902.R01.S.doc Version 5.0 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, 18 Residents and their relatives who have raised concerns have been satisfied that these have been listened to and addressed. Service users are protected from abuse by the home’s procedures and staff receive training on the protection of vulnerable adults. EVIDENCE: The home has an appropriate complaints procedure, which is posted on the notice board in the home. There were a number of complaints recorded, indicating that the procedure is accessible. All of the matters raised had been appropriately addressed by the manager. Feedback from a resident also indicated that an issue had been appropriately addressed when it was raised with the proprietor. The home has a vulnerable adults protection procedure and a copy of the local multi-agency protection procedure. Some staff received training on the protection of vulnerable adults last week, from an external trainer, and remaining staff will attend the training later in October. Staff are also trained on moving and handling and use of the hoists to ensure they are able to transfer residents safely. Training on working with dementia is also scheduled during October. Lovat House DS0000011399.V249902.R01.S.doc Version 5.0 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 Residents live in a safe attractive and well-maintained environment which meets their needs. EVIDENCE: The redevelopment of the interior is now completed and the building presents an attractive and homely environment, well furnished and equipped with the necessary adaptations to meet the needs of residents. Since the previous inspection, the front hall had been refurbished following completion of the ensuites for the bedrooms in this area, and the new lounge carpet had been fitted. The additional en-suite extensions to these existing bedrooms have proved very successful, with the new skylights providing considerably more light in the rooms. Facilities include a lift to all floors, adapted bathing facilities, hoists and handrails, and changes of height are provided with ramps. The communal areas of the home are fully accessible to those with mobility problems, and the garden has also been designed to be fully accessible. Lovat House DS0000011399.V249902.R01.S.doc Version 5.0 Page 15 The remaining landscaping of the side and front gardens was in process during the inspection. The end result will be a secure garden with level access for residents throughout, provided with seating and areas of both sun and shade. The home was clean and odour free, and staff were seen shampooing one of the bedroom carpets during the course of the inspection to maintain hygiene. Lovat House DS0000011399.V249902.R01.S.doc Version 5.0 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): 29 The ability of the home to fully support and protect the residents might be compromised if the required recruitment processes are not being fully complied with. EVIDENCE: It was positive that additional staff had been recruited to reflect the increase in resident numbers, as building works were completed. However, examination of the available recruitment records for the four newest recruits indicated a number of shortfalls in the records required to be available. It was not clear from the available records, whether all of the required recruitment checks had been carried out. The proprietor must confirm that all of the required recruitment checks have been carried out, and ensure that copies of the relevant records are retained securely on site for inspection. (I.D. copies, references etc). It is understood that the company previously used to carry out CRB checks on behalf of the home ceased trading without notifying the home, which had caused the home some difficulty; and that a new registered body has now been located. Any outstanding CRB’s must be forwarded for processing and interim POVA First clearance obtained and confirmed to the inspector. Lovat House DS0000011399.V249902.R01.S.doc Version 5.0 Page 17 It was noted that some ‘testimonial’ type references were on file. These are not acceptable as references, as they do not address the specific points required of a reference and their origins may be difficult to verify. Written references must be obtained which address the applicant’s suitability for the specific post, and these must be telephone verified to check the identity of the referee. Feedback from residents indicated that they found the majority of the staff to be excellent, friendly and caring. This was also borne out by the quality assurance feedback from residents. Lovat House DS0000011399.V249902.R01.S.doc Version 5.0 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): 33, 35 The home is run in the interests of residents, and their views are sought and listened to. The financial interests of service users are not directly managed by the home. EVIDENCE: There is good evidence that the home is run in the interests of residents. The feedback from the quality assurance survey recently undertaken, confirms that for the most part, residents feel the home meets their needs very well. The existence of the ongoing quality assurance programme attests to the home’s willingness to consult the residents, (some with the help of their families), and the staff on their perceptions of the home. There are also plans to broaden the scope of the QA system to include seeking specific feedback from relatives, funding authorities, GP’s etc. This would be a very positive step. Lovat House DS0000011399.V249902.R01.S.doc Version 5.0 Page 19 The feedback obtained by the inspector, from staff and residents indicated clearly that the needs of residents were a high priority. Observations of the care provided, during the inspection bear this out. The complaints record also indicated that the view of residents and others are listened to. The quality assurance responses from staff appeared to indicate a dip in staff morale and this should be addressed to maximise the effectiveness of the expanded staff team. The home does not manage the finances on behalf of residents and does not hold personal allowance on their behalf. Each bedroom is lockable and is provided with a lockable space in which to secure items. Relatives usually retain the responsibility for management of residents’ finances, wherever possible and are billed for items required. Some residents hold small amounts of personal allowance for their own use. Lovat House DS0000011399.V249902.R01.S.doc Version 5.0 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 X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 X 8 3 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X X STAFFING Standard No Score 27 X 28 X 29 2 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X 3 X X X Lovat House DS0000011399.V249902.R01.S.doc Version 5.0 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. 1 Standard OP29 Regulation 19 Requirement The proprietor must confirm in writing that the required recruitment checks have been carried out, and ensure that copies of required evidence are available for inspection within the unit. Timescale for action 06/11/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Lovat House DS0000011399.V249902.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Berkshire Office 2nd Floor 1015 Arlington Business Park Theale, Berks RG7 4SA 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 Lovat House DS0000011399.V249902.R01.S.doc Version 5.0 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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