CARE HOMES FOR OLDER PEOPLE
Lunesdale House Lunesdale House Hale Milnethorpe Cumbria LA7 7BN Lead Inspector
Jane Strawbridge Unannounced Inspection 23rd March 2006 1:05 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 Lunesdale House DS0000062846.V281874.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. Lunesdale House DS0000062846.V281874.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Lunesdale House Address Lunesdale House Hale Milnethorpe Cumbria LA7 7BN 015395 63293 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) Mr Christopher David Green Mr Christopher David Green Care Home 14 Category(ies) of Old age, not falling within any other category registration, with number (14) of places Lunesdale House DS0000062846.V281874.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. The home is registered for a maximum of 14 service users to include: Up to 14 service users in the category of OP ( Old age, not falling into any other category) The service should at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. 22nd August 2005 Date of last inspection Brief Description of the Service: Lunesdale House is a residential care home providing personal care and accommodation for older people. The home is a large detached, older property with two modern extensions that have been purpose-built to provide an additional four bedrooms with en-suite facilities and a large communal lounge. It is situated on the A6 approximately two miles south of the town of Milnthorpe, a market town in the southern Lake District. The premises are set back from the main road and are surrounded by large, attractive gardens that are easily accessible, with a car park at the front for visitors. There are views over the surrounding hills and countryside from most rooms in the home. There is a stair lift for easy access to the first floor. All bedrooms have ensuite facilities and were being used for singe occupancy only. In addition to the new extensions the home has recently been refurbished throughout to improve the quality of the accommodation. Lunesdale House DS0000062846.V281874.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection of the home that took place during one afternoon. The deputy manager, Mrs Helen Smith was present throughout the inspection and Mr Christopher Green the owner and registered manager returned to the home part way through the inspection. The inspector spent time talking with the residents either in small groups or individually and with the managers and staff on duty. Records to do with the care of the residents and the day to day running of the home were looked at and the inspector visited all parts of the home. What the service does well: What has improved since the last inspection? 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
Lunesdale House DS0000062846.V281874.R01.S.doc Version 5.1 Page 6 contacting your local CSCI office. Lunesdale House DS0000062846.V281874.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 Lunesdale House DS0000062846.V281874.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 The residents and their families were satisfied that they had been given adequate information to help them to make informed decisions about moving there. EVIDENCE: The home has an attractive new brochure that has been recently been updated and is well presented to give a realistic impression of what the home has to offer. There are photographs and concise descriptions of the accommodation and the range of services provided by the staff. Lunesdale House DS0000062846.V281874.R01.S.doc Version 5.1 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): 11 Residents and their representatives are confident that their wishes will be respected. EVIDENCE: This home has detailed personal files recording a wide range of information about the residents’ health and personal care needs, daily routines and preferences, including residents’ expectations and wishes after their death. Discussions with the residents and their families mean that staff in the home can help to maintain preferred lifestyles for as long as possible. The deputy manager said that the staff would accept professional advice from the local GPs and district nurses to ensure that wherever possible residents who requested it would be nursed at the home during a critical illness. In these situations the staff worked with the support of the local doctors and community based nurses who visited frequently and whenever necessary. The home offered extra support to the families of seriously ill residents in their care and welcomed them to visit as often as they wished. Lunesdale House DS0000062846.V281874.R01.S.doc Version 5.1 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 the following standard(s): 14 People living in this home are encouraged to be involved in making the decisions that affect their daily lifestyle. EVIDENCE: The manager and staff value the views and opinions of the residents. They appreciate the comments and suggestions that come naturally during conversations between residents and staff, and wherever possible, changes are made within the home to further establish good practice and improve the quality of the services. All residents are actively involved in putting forward their preferences for menu choices, activities and locations for outings. Some outings are spontaneous to take advantage of the weather, or may become extensions to shopping trips or visits to the doctor and others are planned in advance. All outings are undertaken by individuals or in small groups, usually in the company of a member of staff, so that people can exercise their choice and preferences using the home’s car for transport. The residents said they enjoyed and looked forward to the twice- weekly activity and exercise sessions organised by a visiting specialist. Residents are able to choose whether or not to join in, and one of these sessions was taking place during the inspection to the obvious delight and enjoyment of the participants. Lunesdale House DS0000062846.V281874.R01.S.doc Version 5.1 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 the following standard(s): 17 The home has satisfactory procedures in place to ensure that the legal rights of residents are protected. EVIDENCE: Some residents have families who look after their personal finances and currently there was nobody who had their affairs supervised by the Court of Protection. An advocate can be arranged, if necessary, for someone who is unable to speak for themselves and does not have a family member or close friend who is willing to act on their behalf. Senior staff in the home make sure the electoral register is kept up to date and usually the residents request postal votes in preparation for political elections. Staff will assist any residents to vote in person if they prefer to vote at the local polling station. Lunesdale House DS0000062846.V281874.R01.S.doc Version 5.1 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 the following standard(s): 23, 25 This home continues to provide a safe and comfortable environment that meets the needs of the people who live there. EVIDENCE: All of the communal rooms and private bedrooms were warm, homely and comfortably furnished, smelt fresh and were clean and tidy. The residents said they enjoyed the extensive views from the windows in the dining room and the new lounge that overlooked the garden and local countryside. All rooms are attractively decorated and furnished to a high standard and the residents had been encouraged to bring treasured small pieces of furniture and other possessions to make their rooms special. Lunesdale House DS0000062846.V281874.R01.S.doc Version 5.1 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 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): 28, 30 Procedures in this home ensure that residents’ safety and wellbeing are protected. EVIDENCE: The manager follows a strict recruitment procedure to ensure that only people who are suitable for the job are appointed. After appointment staff are expected to undertake training courses to maintain or improve their knowledge and expertise. Progress has been made with staff working toward their National Vocational Qualifications (NVQ) in Care. Approximately 70 of care staff have either achieved or are working towards the NVQ level 2 in Care and the deputy manager should achieve NVQ level 3 in Care during the near future. Lunesdale House DS0000062846.V281874.R01.S.doc Version 5.1 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 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, 34, 35, 36, 37, 38 There are procedures and practices in place to protect the rights of the residents and to ensure the health and safety and wellbeing of the residents, staff and visitors. EVIDENCE: This home does not hold any money on behalf of the residents and the registered manager uses a monthly invoice system for payment of fees and extras such as hairdressing and daily newspapers. Work had started on the formal staff supervision programme in response to the requirement made at the previous inspection. There has been sufficient progress to suggest that this should be fully implemented during the next few months. Records relating to the health and safety of people who live and work in the home, including the fire log had been completed correctly. Lunesdale House DS0000062846.V281874.R01.S.doc Version 5.1 Page 15 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 N/A 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 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 3 18 X X X X X 3 X 3 X STAFFING Standard No Score 27 X 28 3 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 3 3 3 3 3 Lunesdale House DS0000062846.V281874.R01.S.doc Version 5.1 Page 16 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 Lunesdale House DS0000062846.V281874.R01.S.doc Version 5.1 Page 17 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith Cumbria CA11 9BP National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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