Inspection on 16/11/05 for Lydfords Care Home

This inspection was carried out on 16th November 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Lydfords Care Home 22/08/09

Lydfords Care Home 11/06/08

Lydfords Care Home 23/07/07

Lydfords Care Home 02/05/06

Lydfords Care Home 13/05/05

Lydfords Care Home 18/10/04

Lydfords Care Home 26/04/04

Similar services:

Springfield House

Sutton Lodge Nursing Home

The Shelley

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Lydfords Care Centre 23 High Street East Hoathly Lewes East Sussex BN8 6DR Lead Inspector Debbie Calveley Unannounced Inspection 16th November 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 Lydfords Care Centre DS0000014016.V249469.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. Lydfords Care Centre DS0000014016.V249469.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Lydfords Care Centre Address 23 High Street East Hoathly Lewes East Sussex BN8 6DR 01825-840259 01825-840997 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) Tamaris Healthcare (England) Ltd (wholly owned subsidiary of Four Seasons Health Care) Ms Karen Waddington Care Home 50 Category(ies) of Old age, not falling within any other category registration, with number (50) of places Lydfords Care Centre DS0000014016.V249469.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. That only service users over the age of sixty-five (65) are to be admitted. That the service can provide up to fifty (50) nursing places and of those, thirteen (13) can be social care places. That no more than fifty (50) service users are to be accommodated at any one time. 13 May 2005 Date of last inspection Brief Description of the Service: Lyford’s Care Centre was originally a Victorian private family home that has been extended and adapted with two purpose built extensions. It is a home registered to provide both nursing and social care for fifty residents, and is situated in a village location in a semi rural position. The accomodation is divided in to two units, Firs and Orchard and is on two floors with level access provided by a lift and a chair stair lift. There are four double rooms without an ensuite facility and forty-two single rooms, twentyfour of which have an ensuite bathroom. There is ample communal space consisting of a large dining room, two lounge areas and an activity room which are on the ground floor and central in the home. On the first floor and on Orchard unit, there is a comfortable quiet lounge, also on Orchard unit there are two areas with comfortable chairs which are used by families and residents. The gardens are natural, large and are to the side and rear of the proprerty. There are car parking facilities to the front of the home for approximately fifteen cars. The village shops are 200 yards away and there is also a public house and church in close proximity to the home. A local bus service runs through the village and Uckfield town centre is approximately five miles away. Lydfords Care Centre DS0000014016.V249469.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on the 16 November 2005 at 10 am, by two inspectors and was conducted over 6.5 hours. The inspection methodology consisted of viewing the homes documentation, a tour of the premises, talking to seven staff members, twelve residents in depth and three visitors and observing the mid-day meal and a medication round. After completing the inspection a phone call was received from the senior management of the home informing the commission that a complete refurbishment of the premises was to commence in January 2006. What the service does well: What has improved since the last inspection? There is now a written contract/statement of terms and conditions that all residents receive on admission to the home. This contract is confirmation of the room booked, the type of admission, either respite or permanent and the fees to be paid. The home has continued to review and audit the system of care planning, which when fully completed should identify residents needs and the individual care to meet them. The documentation regarding medication continues to improve as a result of on-going audits and training. The kitchen has been redecorated and a new floor is in place, some equipment has been repaired. Lydfords Care Centre DS0000014016.V249469.R01.S.doc Version 5.0 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. Lydfords Care Centre DS0000014016.V249469.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 Lydfords Care Centre DS0000014016.V249469.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): 1, 2, 3, 4 and 5. The Statement of Purpose and Service Users Guide give prospective residents the information required enabling them to make an informed choice about where they live. A contract/statement of terms and conditions is now available which confirms the service agreed. A pre-admission assessment is undertaken on all prospective residents before admission to ensure the home can offer them the care they require. Residents and representatives have the opportunity to visit the home prior to admission to view the accommodation and meet other residents and the staff. This enables them to make the decision of choosing the home themselves. EVIDENCE: The Statement of Purpose and Service Users Guide were on display in the home and were viewed, it was found to be up to date and contained Lydfords Care Centre DS0000014016.V249469.R01.S.doc Version 5.0 Page 9 information that prospective residents need to make an informed choice of where to live. There is now a written contract/statement of terms and conditions that all residents receive on admission to the home. This contract is confirmation of the room booked, the type of admission, either respite or permanent and the fees to be paid. Four Seasons Health Care have an assessment tool, which covers all the needs as defined in standard 3.3. Ten pre-admission assessments were viewed, eight of which were found completed and informative, however two preadmission assessments viewed were found inaccurately completed in respect of their mental health. The assessment takes place at the prospective residents’ place of residence, and involves the relatives whenever possible and input from other relevant professionals is sought when required. Three residents spoken with confirmed that they had been seen by a member of the staff before admission to the home. One relative said she had been present when her sister was assessed prior to admission. Self-funding residents are invited for a trial period to ensure suitability of the home; this is clearly stated in the Statement of Purpose and in the statement of terms and conditions. Two residents confirmed that they had first come to the home for a short stay before making it permanent. This practice is not adopted by Social Services when placing clients, but if a resident placed by Social Services is not settling in to the home it is reviewed and an alternative placement found. On viewing two residents care files, it was found that they had specialised mental health needs that had not been fully explored and did not meet the category of the home. There is a need to ensure that these needs are recognised and documented to ensure that the home can meet these needs. Lydfords Care Centre DS0000014016.V249469.R01.S.doc Version 5.0 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): 7, 8, 9, and 10. Care plans still do not contain sufficient information to evidence that the health, personal and social care needs of individual residents are being met. The risk assessments are inadequate for some residents. The systems for the administration of medication are good with clear and comprehensive arrangements being in place to ensure residents medication needs are met. EVIDENCE: Ten care plans were tracked from the pre-admission assessment to the delivery of care. There was evidence of regular review and the physical needs of the residents were identified. However as discussed with the deputy manager the outcomes for some needs were not the best for the individual resident. E.g. mobility- the outcome was ‘to use a hoist’, instead of to encourage to retain her independence by various exercises or physiotherapy input. One resident who was very determined to retain her independence said that she was “moved by the hoist as there was not enough time to let her try to move by other aids and gain back her independence”. Feedback from a Lydfords Care Centre DS0000014016.V249469.R01.S.doc Version 5.0 Page 11 visiting physiotherapist was that exercises could improve outcomes for residents if there was time allocated and encouragement from staff. There was also little documented about the social and mental health needs of some residents. The risk assessments do not score the level of the risk identified, and so do not have a scale to adjust for risk lessening or for risk increasing, also when reviewed, it is recorded as “no change” month after month. There are no guidelines supplied as to how risks are to be managed by staff. Fluid charts were in place, but it was noted that many of them had last been completed at 0700 am, they were then seen filled out towards the end of the morning shift, which means that there is a possibility that they are not a correct reflection of the fluids taken. The clinical rooms were clean and tidy, the equipment well maintained. There are policies and procedures in place for the storing, administrating, disposal and receipt of medication. The temperature of the fridge and room are recorded daily and of an acceptable temperature to maintain dressings and medications. However the fridge and the clinical room were both found unlocked. All medications that have a short life from the day of opening need to be dated to ensure that they are not used when out of date. The Medication Administration Charts were found correctly completed in the main. A self-administering policy is in place, but there were no residents at this time self-administering their medication. Throughout the inspection there was positive interaction seen between staff and residents. The residents spoken with said that there was more stability of the staff now, which gave them time to get to know the staff and the staff to know them. One resident said that staff were “always polite and caring”. Another said that the “staff were really very nice, but some what stretched during the day” A relative said the “staff were great, but they were always busy”. Two residents said that a “couple of staff are a bit snappy”. Lydfords Care Centre DS0000014016.V249469.R01.S.doc Version 5.0 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): 12, 13, 14 and 15. The activities in the home meet the individual preferences of the more able residents, however the more dependent residents were found less stimulated. The more able residents are enabled to exercise the choice and control of their every day life. Less abled residents are not helped to exercise choice and control over their daily routine. The dietary needs of residents are well catered for and offer a balanced and varied selection of food that has been updated in line with the personal likes and choices of residents. EVIDENCE: Activities are an important part of life in Lydfords for those that are able to attend, fifty-five hours are provided weekly. The activities change according to the seasons and trips out are arranged depending on the funds available. There are fund raising events held throughout the year whose profits are used for the activities. A recent addition is a shopping trolley from which residents can buy cards, toiletries, chocolates and stationary. Some of the residents were making individual Christmas cakes on the day of the inspection and it was confirmed that another session would be for decorating and icing the cakes. Lydfords Care Centre DS0000014016.V249469.R01.S.doc Version 5.0 Page 13 The residents spoke warmly of the fireworks they had seen when they went into the village to watch the display, one resident said that she had thoroughly enjoyed her first hotdog for years. The residents enjoy the activities, but from observing the morning session the room used at present is too small, not everyone was able to attend that wanted to as the majority are in wheelchairs. Again it is identified as a risk if a fire broke out. It was also noted that the residents that do not have the capacity to attend or make the decision not to attend are quite isolated. Many were found in the lounge and their bedrooms with little stimulation available. It was found from talking to the residents that they are able to choose the way they spend their time and are offered choice and flexibility on a daily basis. Lydfords promotes an “open door” policy during the day. Residents spoke of visitors they had received and the home maintains a record of the contact each resident has with relatives and friends. Three relatives visiting said that “whatever time they visited they felt welcomed, and were offered refreshments”, however the security of the building at weekends was mentioned as two relatives said that “the door is open and they could wander around the building without seeing anyone”. The feedback regarding the food at Lydfords was in the main complimentary from both residents and relatives. One resident said the “food is tasty and plenty of it”. Another said “there is always a choice, so if you change your mind you can always have something else”. The lunchtime meal was observed and it was evident that choice and flexibility are offered. The dining area is large and attractively set out with tables. Residents are encouraged to use the dining area to encourage interaction with other residents. The meal served was casserole with vegetables and chips, liver and bacon with mash and vegetables and a vegetarian option. Also served was the pureed meal of their choice, the food was attractively served and enjoyed by the residents. Staff were seen assisting residents unable to feed themselves discreetly and with dignity. The menu demonstrated choice, variety and nutritionally valuable food. One resident and her relative said that the “ food is good, but they always serve vegetables I hate, even though I keep telling them I do not like them”, it was also mentioned by several residents that they are offered a choice of food the day before and can not remember what they choose when it arrives. One resident said, “that my food is always cut up for me and it infuriates me because I can do it myself. It was confirmed by relatives that they could eat with their parent for a moderate charge. Lydfords Care Centre DS0000014016.V249469.R01.S.doc Version 5.0 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 and 18. The home has a satisfactory complaints system with some evidence that residents feel that their views are listened to and acted upon. Staff have knowledge, understanding and training to protect residents from abuse. EVIDENCE: There are appropriate policies and procedures in place for residents, relatives and staff to follow if a complaint or concern is raised. The complaint book was available and this demonstrated that all complaints are recorded, along with the outcome and action taken by the home to resolve the complaint. There has been a marked decrease in the amount of complaints received in the home and none have been received by CSCI in the last ten months and this is seen as a continued positive move forward in the management of the home and an improvement in the standard of care. The staff interviewed were knowledgeable of the complaint procedure and of how to start the process if the manager is not available. Three of the residents referred to the service users guide when asked if they knew how to make a complaint, whilst one resident said she had given the brochure to her son and he would know how to if required. One resident said she would talk to the nurse in charge if she had a problem. There have been no complaints received by the CSCI. There is a compliments folder with letters of thanks from relatives on display. Lydfords Care Centre DS0000014016.V249469.R01.S.doc Version 5.0 Page 15 The Adult Protection policy in the home was found to be up to date and staff interviewed were knowledgeable about the systems in place to protect vulnerable residents, there was also an awareness of how to whistle blow if the situation should arise. There is on-going training for all staff in adult Protection. Lydfords Care Centre DS0000014016.V249469.R01.S.doc Version 5.0 Page 16 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, 20, 21, 22, 23, 24, 25 and 26. The resident’s benefit from having an environment which provides a choice of communal space, but not all of the home provides a homely and comfortable environment. Residents are enabled and encouraged to personalise their room, and these reflect the resident’s personalities and interests. However not all bedrooms are homely and comfortable. There is specialist equipment in the home for residents’ use to maximise their independence. EVIDENCE: Lydfords is a large property, which has four double rooms and thirty-six single rooms, twenty-one of which have an ensuite facility. The communal areas are spacious and well decorated offering a comfortable and homely environment. The older wing in general is lacking in warmth and homeliness. Some of the older furniture on Firs unit is still tatty, bedside tables have locks missing or Lydfords Care Centre DS0000014016.V249469.R01.S.doc Version 5.0 Page 17 broken, many rooms did not have all the necessary furniture in place as required by the Standard. New washbasins have been fitted on Firs unit, but the carpets at present do not fit properly, this may be a trip hazard. Windows on Firs unit were very difficult to open and when opened did not stay open which need to be appropriately risk assessed. On Orchard unit the residents rooms were homely and many of the residents have personalised their rooms with items from home. The gardens are large and unspoiled, and there is a patio area to the rear. Bathrooms and toilet facilities are adequate for the needs of the residents, with the equipment necessary for the physically frail. A bath on Firs unit had a broken side and this needs to be attended to. An ensuite bathroom on Orchard unit had a broken toilet seat and patches of damp were noted on ceiling tiles There was specialist equipment available, which includes hoists, air mattresses and cushions. There are still a high number of residents with nursing needs on divan beds. The cleanliness of the motors of air mattresses was a concern as they were found heavily covered in dust and dirt, this questions whether they are being checked regularly for maintenance and hygiene. Once again some residents were found in bed or in their room without access to a call bell, and this was also identified in a lounge area, two residents were seen calling for assistance, as they could not reach the call bell. This is not acceptable and all residents must have access to a call bell at all times. An immediate requirement was left. It was also noted that between the hours of 10am and 11am that the response to call bells was poor. A call bell audit needs to be performed which will identify if the staffing levels are sufficient to meet the needs of the residents. Random hot water temperatures were tested and many were found to be inaccurate, some were in excess of 50°c and some were cold. It was an immediate requirement that this be attended to for the safety of the residents. The temperature of the home was comfortable and all radiators were found with appropriate guards. One heater in the lounge on Orchard unit was found unsecured; this needs to be attended to. The general cleanliness of Orchard unit and the communal areas of the home was found adequate, but Firs unit was below an acceptable standard. The bathrooms were found unclean and the carpets were stained. The equipment in some bedrooms were found stained and sticky, these included the folders, tables, and bedsides. The bed linen on some beds were found freshly stained. There was a heavy smell of cigarettes noted in this part of the home. The sluice areas were found clean with appropriate equipment. The laundry remains small to cope with fifty residents, and it was seen that only one washing machine was working, it is awaiting repair. Lydfords Care Centre DS0000014016.V249469.R01.S.doc Version 5.0 Page 18 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 28. The staffing levels were not seen to be sufficient at key times to meet the needs of the residents. Residents are supported by a team of staff that have received training in order to perform their job competently. EVIDENCE: On viewing the staffing rota, the ratio of night staff for up to fifty residents was 2 trained staff and three carers, from meeting residents and seeing the level of care required it was not seen to be sufficient. The residents would benefit from the carers working in pairs to ensure their health and safety. The staffing levels for the morning shift was three trained nurses and eight carers. Feedback from staff, residents and two relatives indicated that there was not always enough staff to perform the level of care required. Two residents said the “staff were great, but there were not enough of them”. A relative remarked that “it was not the staffs’ fault that they could not give her relative the time to encourage her to be more independent, they hoist her because it is quicker, and they do not have time to offer to take her to the toilet and so she uses the pad instead”. The poor response to call bells is also indicative that the staffing levels need to be reviewed and increased. Lydfords Care Centre DS0000014016.V249469.R01.S.doc Version 5.0 Page 19 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): 35 and 38. Resident’s finances are appropriately safeguarded by the home’s polices and procedures. The fire, health and safety measures in the home do not safe guard residents and staff from harm. All aspects of resident’s health, safety and welfare need to be protected and promoted. EVIDENCE: There are suitable systems in place to safeguard the resident’s finances. The administrator works full time in the home and is knowledgeable regarding the residents financial status and endeavours to ensure that the policies and procedures in place are adhered to. Policies and procedures regarding gifts and money rewards have all been reissued to staff. Lydfords Care Centre DS0000014016.V249469.R01.S.doc Version 5.0 Page 20 During the inspection, a number of issues were identified in relation to health and safety and fire safety, which require addressing, these include; • • • • • • • • • Fire doors propped open. Wheelchairs being used without the appropriate foot rests and seat belts. Poor maintenance of equipment. Inaccessible call bells. No accompanying risk management found. Poor practice regarding the use of hoists. Broken side to bath resulting in damp. Variable water temperatures found in bedrooms, between 40°c-50°c Windows that are difficult to open and do not stay open. Poor security of the building at weekends and evenings. Risk assessments for individual residents found to be inconsistent and in some cases inaccurate in respect of managing challenging behaviour, moving and handling and nutrition. These areas identified were fully discussed at feedback with the deputy manager and were left as immediate requirements. . Lydfords Care Centre DS0000014016.V249469.R01.S.doc Version 5.0 Page 21 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 3 3 2 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 2 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 2 2 3 2 2 2 STAFFING Standard No Score 27 2 28 3 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X 3 X X 2 Lydfords Care Centre DS0000014016.V249469.R01.S.doc Version 5.0 Page 22 Are there any outstanding requirements from the last inspection? YES 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 OP4 Regulation 12(1)(ab) 14(1)(d) Requirement That the residents admitted meet the registration category of the home and the home can demonstrate that they can meet the assessed needs of the residents. That a comprehensive plan of care is generated from a comprehensive assessment is drawn up for/with each service user.( Previous timescales of 18/10/04 and 13/05/05 not met) That service user’s psychological health and social needs are monitored regularly and preventative and restorative care provided. That appropriate risk assessments are in place with guidance for staff. That records concerning residents fluid and nutritional intake and needs are kept up to date and accurate. That the provision of social and cultural activities are appropriate to the circumstances of all residents and with regard to any disability of residents. That residents are consulted DS0000014016.V249469.R01.S.doc Timescale for action 16/11/05 2 OP7 15(2)(b) (c)12(1) 01/02/06 3 OP8 13(1)(b) 17(1)(a) 01/02/06 4 OP8 13(1)(b) 17(1)(a) (3) 16(2)(m) 16/11/05 5 OP12 01/02/06 Lydfords Care Centre Version 5.0 Page 23 6 7 OP14 OP38OP22 16(2) 13(4)(c) 23(2)(n) about the programme of activities and are enabled to attend the activities on a regular basis. That the room for activities is increased to ensure that all residents who wish to attend can and that it is safe for all those who attend. That all residents are enabled to exercise autonomy and choice. That all call bells are in an accessible position. 16/11/05 16/11/05 8 OP24 23(2)16 (e)(2)(c) 9 OP24 23(2)16 (e)(2)(c) 10 OP25OP38 13(4)(a) (b)(c) 23(2)16 (e)(2)(c) That all specialist equipment used is clean and is checked on a regular basis. That the home provides furniture 01/06/06 and fittings of a good standard and repair for the residents needs.(Previous timescales of 18/10/04 & 31/08/05 not met.) That adjustable beds are 01/06/06 provided for those residents receiving nursing care and an audit conducted for priority of needs. (Previous timescale of 18/10/04 & 31/08/05 not met.) That hot water temperatures are 16/11/05 maintained to the required temperature of 43°c. That each service user has a lockable storage place and is provided with a key for personal effects.( Previous timescale of 18/10/04 & 31/08/05 not met.) That the home is kept clean, hygienic and free from offensive odours. That bed linen is clean and serviceable. That staffing levels are appropriate to the assessed needs of the residents, the size, layout, and purpose of the home at all times. That the practice of DS0000014016.V249469.R01.S.doc 11 OP24 01/06/06 12 OP26 13(3) 16/11/05 13 OP27 18(1) (a) 16/11/05 14 OP38 23(4) 16/11/05 Page 24 Lydfords Care Centre Version 5.0 propping/tying open doors ceases in line with the latest guidence from the fire service. That footrests are in place on wheelchairs when in use to prevent injury to residents. That all residents are moved appropriately and safely. That the security of the home is reviewed to ensure the safety of the residents. That the window identified is restricted.(Previous timescale of 13/5/05 not met) 15 16 17 OP38 OP38 OP38 13(5) 13(4)(a) (b)(c)12 13(4) 16/11/05 16/11/05 01/02/06 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 Lydfords Care Centre DS0000014016.V249469.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection East Sussex Area Office Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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 Lydfords Care Centre DS0000014016.V249469.R01.S.doc Version 5.0 Page 26 - 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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