Inspection on 09/08/05 for Lowmoor Care Home

This inspection was carried out on 9th August 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Lowmoor Care Home 30/09/09

Lowmoor Care Home 25/08/09

Lowmoor Care Home 22/07/08

Lowmoor Care Home 18/04/07

Lowmoor Care Home 25/04/06

Lowmoor Care Home 20/12/05

Lowmoor Care Home 03/02/05

Lowmoor Care Home 17/08/04

Lowmoor Care Home 09/02/04

Lowmoor Care Home 02/10/03

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

CARE HOMES FOR OLDER PEOPLE Lowmoor Care Home Lowmoor Road Kirkby In Ashfield Nottinghamshire, NG17 7JE Lead Inspector Judith Avill and Steve Keeling Unannounced 09 August 2005 @ 09:30 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. Lowmoor Care Home C53 C03 S24647 Lowmoor V243527 090805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Lowmoor Care Home Address Lowmoor Road, Kirkby In Ashfield, Nottinghamshire, NG17 7JE 01623 75228 01623 75228 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) Dr J S Lidder Thiyagraja Govindaraju Care Home (CRH) 50 Category(ies) of Mental Disorder, excluding learning disability or registration, with number dementia - over 65 50 of places Years of age (MD(E)) 50 Lowmoor Care Home C53 C03 S24647 Lowmoor V243527 090805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Mental Disorder, excluding learning disability or dementia - over 65 Both years of age (MD(E)) 50 Both 50 Date of last inspection 2nd February 2005 Brief Description of the Service: Lowmoor is a privately run, purpose built two storey 50 bedded care home for people with dementia and mental heath needs. Qualified nursing care is provided throughout the 24 hour period. The home is situated in a semi residential area within half a mile of local amenities and the town centre of Kirkby -in - Ashfield. It can accommodate up to 50 people, in 40 single bedrooms, 10 of which are en-suite and there are 5 double bedrooms. The home has an enclosed garden and a car park for visitors and staff. There is a passenger lift to the first floor. There are lounges on the ground and first floor. Toilets are situated near communal rooms and convenient for service users with no en-suite facilities. Bathrooms are fitted with adapted facilities. Lowmoor Care Home C53 C03 S24647 Lowmoor V243527 090805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This Inspection was the first of two unannounced Inspections to be carried out between April 2005 and March 2006. The inspection lasted for 5 hours and the main focus of Inspection was called ‘case tracking’ which involved selecting residents and tracking the care they receive checking through their records and discussing this with them or staff as appropriate. Additional records were seen. Discussion was held with the registered manager, qualified nurses, care staff and the activity co-ordinator and Inspectors observed care practices. The premises were not inspected in detail but various parts of the building were visited as part of the inspection. What the service does well: What has improved since the last inspection? Overall record keeping has improved and staff induction is comprehensive and training records are well maintained. Previous requirements issued are being addressed. Lowmoor Care Home C53 C03 S24647 Lowmoor V243527 090805 Stage 4.doc Version 1.40 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. Lowmoor Care Home C53 C03 S24647 Lowmoor V243527 090805 Stage 4.doc Version 1.40 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 Lowmoor Care Home C53 C03 S24647 Lowmoor V243527 090805 Stage 4.doc Version 1.40 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) 3 Assessment documentation is completed to ensure the home can meet the individual service user needs. EVIDENCE: The service user guide states that emergency clothing is available for service users. Initial assessment’s are completed by qualified staff. Records seen were comprehensive and include daily living and Risk Assessments. Lowmoor Care Home C53 C03 S24647 Lowmoor V243527 090805 Stage 4.doc Version 1.40 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) 7&8 Healthcare needs are attended to but has limited information in identifying individual preferences, personal health care needs and the procedures for staff to follow. Record keeping was not consistent and up to date. EVIDENCE: Residents records viewed included care plans, daily records medication records and risk assessments. From care plans viewed details of action to be taken by staff were not recorded to meet individual service users needs. Monitoring systems to meet needs of individual service users were not in place and changes from reviews were not maintained up to date. Follow- ups and monitoring following resident’s falls and accidents were not consistently recorded. Risk assessments did not include details of action to be taken by staff. No care plan was evidenced for weight loss and action to be taken. Staff’s spoken with were aware of the needs of service users. Service user / relative involvement in care plans and reviews is being developed. Some service users observed by the Inspectors were not wearing footwear. Staff reported that this was service users individual preferences. However no record of this choice was evidenced on care plans. Service users spoken with Lowmoor Care Home C53 C03 S24647 Lowmoor V243527 090805 Stage 4.doc Version 1.40 Page 10 and observed by the inspectors were clean, appeared settled at the home and well cared for. Lowmoor Care Home C53 C03 S24647 Lowmoor V243527 090805 Stage 4.doc Version 1.40 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 standard(s) 12 &15 The home has a programme of activities. choices are available. The menu is well balanced and EVIDENCE: The home employs an activities co-ordinator. Records of preferences, recreational interests and participation in activities were not available. The menu viewed included choices. Details of assistance with eating and drinking required and individual style was well maintained. Lowmoor Care Home C53 C03 S24647 Lowmoor V243527 090805 Stage 4.doc Version 1.40 Page 12 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 &18 Complaints records are maintained. Staff report concerns to the qualified staff or the manager. EVIDENCE: Since the last Inspection the home has developed a new complaints form. No records of complaints since the last inspection were recorded. A complaint to the Commission was discussed with the manager and action to be taken agreed. Dates for Adult Protection training are planned for all staff. Staff spoken with stated they would report concerns to qualified staff or the manager. Recruitment records seen contained records of checks on staff. Lowmoor Care Home C53 C03 S24647 Lowmoor V243527 090805 Stage 4.doc Version 1.40 Page 13 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) 19,23 & 26 The home was clean and had no malodour. Individual service user bedrooms and corridors would benefit from personalisation. EVIDENCE: The home has record of maintenance and redecoration. The garden is attractive but requires some attention. At the time of inspection bedrooms were being redecorated. Some service users bedrooms did not contain any personal effects. Corridors walls were plain and had no pictures. Laundry services are well organised Inspectors advised re disposable laundry bags. Lowmoor Care Home C53 C03 S24647 Lowmoor V243527 090805 Stage 4.doc Version 1.40 Page 14 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, 29,30 Staffing levels meet the assessed needs of the residents accommodated at the home EVIDENCE: The rota provided included details of the hours worked by the manager and staff. Record of the roles and responsibilities of individual staff and details of who was in charge of the shift was evidenced on the rota. Staff files viewed evidenced that recruitment policies and procedures are followed and all checks and references are obtained prior to employment. Training records are well maintained. Details of planned and refresher training were seen. Lowmoor Care Home C53 C03 S24647 Lowmoor V243527 090805 Stage 4.doc Version 1.40 Page 15 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) 37&38 Maintenance and safety records are well maintained. Accident record keeping is not consistent. EVIDENCE: Maintenance records are well documented and maintained up to date. Some daily records viewed seen stated service users had been found on the floor but no record of the accident had been recorded nor followed up following the event. Lowmoor Care Home C53 C03 S24647 Lowmoor V243527 090805 Stage 4.doc Version 1.40 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 x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 x 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 x 14 x 15 3 COMPLAINTS AND PROTECTION 3 x x x 2 x x 3 STAFFING Standard No Score 27 3 28 x 29 3 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 x x x x x x 2 3 Lowmoor Care Home C53 C03 S24647 Lowmoor V243527 090805 Stage 4.doc Version 1.40 Page 17 no 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. 2. Standard 7,8,37 7 Regulation 17 15 Requirement The registered person must ensure that all records are maintained up to date The Registered person must ensure that care plans are developed and identify all the needs of the service users in sufficient detail to enable staff to provide comprehensive care. The registered person must ensure that risk assessments include action to be taken by staff The registered person must ensure that service uses choices are recorded and that they wear personal clothing at all times Ensure records of service users activities are available for Inspection Timescale for action 12th September 2005 12th September 2005 3. 8,24 13 12th September 2005 12th September 2005 12th September 2005 4. 10 12 5. 12,37 17 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 12 Good Practice Recommendations Review the hours of the activities co-ordinator to meet the C53 C03 S24647 Lowmoor V243527 090805 Stage 4.doc Version 1.40 Page 18 Lowmoor Care Home 2. 3. 23 26 needs of the service users Consider personalisation of service user bedrooms and corridors Consider purchase of disposalable laundry bags Lowmoor Care Home C53 C03 S24647 Lowmoor V243527 090805 Stage 4.doc Version 1.40 Page 19 Commission for Social Care Inspection Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT 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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