Inspection on 23/07/07 for Lydfords Care Home

This inspection was carried out on 23rd July 2007.

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

Lydfords Care Home 22/08/09

Lydfords Care Home 11/06/08

Lydfords Care Home 02/05/06

Lydfords Care Home 16/11/05

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 Home 23 High Street East Hoathly Lewes East Sussex BN8 6DR Lead Inspector Key Unannounced Inspection 23rd July 2007 12:30 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 Home DS0000014016.V345892.R01.S.doc Version 5.2 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 Home DS0000014016.V345892.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Lydfords Care Home Address 23 High Street East Hoathly Lewes East Sussex BN8 6DR 01825-840259 01825 840997 lydfords@fshc.co.uk Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Tamaris (South East) Limited (a wholly owned subsidiary of Four Seasons Health Care Limited) 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 Home DS0000014016.V345892.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The maximum number of service users to be accommodated is fifty (50). That service users should be aged sixty five (65) or over on admission. 2nd May 2006 Date of last inspection Brief Description of the Service: Lydfords 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 accommodation is divided into 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 property. 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. Current fees charged per week for residents funded by a placing local authority range from £355 to £486; this does not include the nursing contribution. Fees for self-funding residents range from £695 to £737 for nursing care and £603 to £640 for personal care. Previous inspection identified that fees do not include the cost of toiletries, hairdressing, massage, chiropody, newspapers and outside activities such as visits to the theatre. Full information about the fees payable, the service provided, the home’s Statement of Purpose and the latest inspection report by the CSCI are available from the Acting Manager. Lydfords Care Home DS0000014016.V345892.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. An unannounced site visit took place on 23rd July 2007. The visit included speaking with the Manager, three members of staff, three relatives and three people who live in the home. Some judgements about the quality of life within the home were taken from observation and conversation. Some records and documents were looked at. A tour of the house and garden was undertaken. All of the above have been used within the inspection process and some information has been included within this report where appropriate. Presently there are forty-seven residents accommodated with three vacancies. Married couples currently occupy three of the home’s shared rooms whilst the fourth accommodates one person. Comments made by residents and their relatives spoken with at the time of this visit included: ‘My (relative) is very happy’ ‘I like it here’ ‘We were able to look around before my (relative) came in; we had written information but only the brochure – I would have found more detail helpful’ ‘The staff are nice’ ‘The staff are a bit short and there is some agency but my (relative) likes them, they are very good’ ‘Once they took fifteen minutes to answer the call bell’ ‘The (noise of the) call bell annoys my (relative)’ ‘I don’t always get the help I need getting in and out of bed’ ‘My (relative) enjoys the activities provided and is taken on trips out, they do more now than they did at home and this has perked (them) up’ ‘I’ve been to a show’ ‘I like to sit in the dining room to be with people’ ‘The food is good’ ‘It might be a good idea to put up a board for the menu’ ‘The room is nice and has had a nice new carpet’ ‘I have no complaints at all’ What the service does well: Procedures are in place to ensure that the home is suitable to meet prospective residents’ needs. Individuals enjoy living in a home, which is run in their best interests by a competent manager. They enjoy living in a comfortable, warm and homely environment. Residents are treated with respect. Arrangements are in place to maintain their privacy and dignity. Lydfords Care Home DS0000014016.V345892.R01.S.doc Version 5.2 Page 6 Residents are protected by the procedures in place for the administration of medication. Residents’ needs are met by appropriately recruited and trained staff who understand and anticipate their wishes. The views of residents are listened to, taken seriously and acted upon. Residents are recognised as individuals and are able to exercise some choice over their lives. They enjoy their lifestyle within the home and are able to keep in contact with their family and friends if they wish. Residents benefit from a choice of a varied diet. 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 contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Lydfords Care Home DS0000014016.V345892.R01.S.doc Version 5.2 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 Home DS0000014016.V345892.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3, 4, 5, 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Procedures are in place to ensure that the home is suitable to meet prospective residents’ needs. Written information about Lydfords is available for individuals before they decide to move in, although they may benefit from being offered this pro-actively by the home. EVIDENCE: The home provides a detailed Statement of Purpose and Service Users Guide in addition to a brochure, which contain information that prospective residents need to make an informed choice of where to live. Relatives spoken with said that they had received written information about the home. One individual stated that they had only received the brochure and that more detailed information would have been helpful. The manager explained that both the statement of purpose and the service users’ guide were available to prospective residents and their representatives to look at if they requested it, Lydfords Care Home DS0000014016.V345892.R01.S.doc Version 5.2 Page 9 although this was not automatically sent out. Individuals spoken with confirmed that they were able to visit and look around the home before they moved in. The manager said that residents are assessed before they moved in, in order to ensure that the home is suitable to meet their needs; assessments undertaken are recorded in detail. Previous inspection identified that self-funding residents were invited for a trial period to ensure suitability of the home; the placing local authority reviewed their residents after six weeks to ensure that the placement was successful. The manager stated that some residents had developed dementia whilst being at the home; the inspector was assured that this included some short-term memory loss but no cases of wandering or severe disorientation. It was said that individuals’ nursing and personal needs were prominent. The home does not currently provide intermediate care, although respite care can be offered if vacancies are available. Lydfords Care Home DS0000014016.V345892.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10, 11 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are treated with respect. Arrangements are in place to maintain their privacy and dignity. Residents’ personal, health and social care needs are met, although some may benefit from a review to confirm this. Residents are protected by the procedures in place for the administration of medication. EVIDENCE: Residents have an individual plan of care, which have been developed from assessments undertaken prior to their admission to the home. Care plans identify the support required from staff to meet residents’ personal and health care needs. This includes spiritual needs, activities and hobbies. Residents and/or their representatives are involved in developing social histories. Risk assessments are undertaken for a range of issues such as, pressure sores, nutrition, pain, continence, smoking and moving and handling. Hand-written notes are kept of the day-to-day support provided. Keyworker diaries are recorded, as are communications with relatives. All the information seen had been reviewed and updated. Lydfords Care Home DS0000014016.V345892.R01.S.doc Version 5.2 Page 11 Records seen confirmed that a range of health and social care professionals are accessed where necessary to support staff to meet residents’ needs, such as GP, physiotherapist, chiropodist, dentist, optician and dietician. The manager said that massage was also available. Residents have support from the District Nurse where appropriate. The manager stated that some residents have lowgrade pressure sores and specialist equipment is provided. Residents’ nutrition is monitored; they are weighed regularly and any weight loss or gain is recorded. Detailed food and fluid charts are kept where necessary. One resident stated that they didn’t always get the help they needed getting in and out of bed. The manager explained that although help was offered, this was sometimes declined. Staff manage all residents’ medication for them; an easily monitored system is used wherever possible. One clinical room seen was clean and tidy. Medication is stored appropriately. Medication records are completed appropriately and kept with photographs of residents for identification purposes. A sample of staff signatures checked matched on administration records and the staff signature list seen. Some homely remedies are kept together with written confirmation from the GP that these items can be used with individuals’ prescribed medication. The manager stated that, as Lydfords provides nursing care, the home uses a registered agency for the disposal of waste medication. Previous inspection identified that there are policies and procedures in place for the storage, administration, disposal and receipt of medication; the temperature of the fridge and room are checked and recorded daily. Positive interaction between staff and residents was observed throughout the inspection. Residents and relatives spoke highly of the staff team. Staff are friendly and polite to residents and knock on their bedroom doors before going in. Lydfords aims to provide residents with a home for life; individuals nearing the end of their lives are supported to spend their last days in familiar surroundings with people they know. The manager demonstrated a good understanding of the needs of residents and their families at this time. Lydfords Care Home DS0000014016.V345892.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are recognised as individuals and are able to exercise some choice over their lives. They enjoy their lifestyle within the home and are able to keep in contact with their family and friends if they wish. Residents benefit from a choice of a varied diet. EVIDENCE: The routines of the home are generally flexible. Those spoken with enjoyed their lifestyle within the home. The home employs a full time activities coordinator for five days per week. A programme of activities is planned a week in advance. Residents enjoy events such as bingo, games, picnics, exercises and hoopla, sing-a-long, quizzes, arts and crafts, monthly trips to the local day centre and mini-bus trips out. One resident said that they had been taken to see a show. One visitor confirmed that their relative enjoyed the activities available and that this had had a positive effect. The activity room is a pleasant room with good lighting and plenty of storage areas. The home has a pet cat and budgie. Lydfords Care Home DS0000014016.V345892.R01.S.doc Version 5.2 Page 13 Residents are encouraged to keep in contact with their relatives and friends if they wish. Visitors are welcome in the home and are able to speak with staff and the manager. Those spoken with at the time of this visit confirmed this. Residents spoken with said the quality of the meals was good. Residents are asked for their choice of meals the day before and this is recorded. The manager said that they would consider the suggestion of one relative for a menu board in the dining room. Menus and records together show choices and a variety of meals. Special diets are catered for, such as diabetic, vegetarian, soft and pureed. Lydfords Care Home DS0000014016.V345892.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The views of residents are listened to, taken seriously and acted upon. Individuals are protected from potential abuse, although this could be enhanced by a review of the procedures for accessing personal bank accounts. EVIDENCE: At the time of this visit, residents were at ease talking with staff and those spoken together with relatives had no complaints about the home. Many letters of thanks from relatives complimenting the home for the care provided were seen. Records seen showed that complaints received had been taken seriously and investigated. The home provides a written complaints policy and procedure. The home has policies and procedures regarding adult protection. The manager demonstrated an understanding of the procedures involved regarding the protection of vulnerable adults. Discussion took place regarding three issues. These included an incident that took place earlier this year; it was evident that the home had taken appropriate action in order to protect residents from any reoccurrence. Staff spoken with demonstrated an understanding of the issues regarding the protection of vulnerable adults and stated that training was provided on a six-monthly basis. Lydfords Care Home DS0000014016.V345892.R01.S.doc Version 5.2 Page 15 Issues regarding residents’ finances have been mentioned under the Management and Administration section of this report. Lydfords Care Home DS0000014016.V345892.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23, 24, 25, 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents enjoy living in a comfortable, warm and homely environment, although a review of infection control procedures and equipment within the home would enhance their protection. EVIDENCE: The home is comfortable and homely. Those spoken with said that they enjoyed the environment that the home offered. The gardens are natural, large and are to the side and rear of the property. There is also a patio area. The manager stated that residents had enjoyed creating the hanging baskets of flowers. 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 Lydfords Care Home DS0000014016.V345892.R01.S.doc Version 5.2 Page 17 lounge; also on Orchard unit there are two areas with comfortable chairs, which are used by families and residents. There is also a hairdressing salon, which sometimes doubles as a treatment room for chiropody. Communal areas are attractive with good quality furniture. The accommodation is divided into two units, Firs and Orchard. There are sufficient bathing and toilet facilities. There are four double rooms without an ensuite facility and forty-two single rooms, twenty-four of which have an ensuite bathroom. Individual bedrooms are homely and comfortable and reflect the occupants’ personalities. Individuals have brought personal effects from their home. The manager assured the inspector that residents who shared a room had made a positive choice to do so. One resident stated the room is nice and has had a nice new carpet. There is specialist equipment, and adaptations are provided where necessary for the physically frail. Access over the two floors of accommodation is provided by a passenger lift and stair lift. Air mattresses and cushions are available. It was noted at the time of inspection that one such mattress was constantly buzzing loudly; the manager assured the inspector that this would be attended to. Since the last inspection the home has installed a new bath, a new bath seat hoist and two new overhead hoists for bathrooms. One resident confirmed that previous problems with the bath hoist had now been resolved. Mobile hoists are available. There is a staff call system throughout the home, although it was noted that the designated smoking room did not have a staff call point. The manager explained that there was a call point in the corridor outside the room and only able residents would be left alone. It was noted during the visit that one resident using this room alone was in a wheelchair and would not easily be able to reach the call point in the corridor. The home is warm and well lit and rooms are naturally ventilated. The manager stated that hot water temperatures are checked and recorded weekly to reduce the risk of scalding. At the time of this visit, two hot water outlets were tested by hand and found to be an appropriate temperature to the touch. The manager assured the inspector that the temperature of the hot water from one outlet was being adjusted on the day of this visit following comments made by one resident. Checks for Legionella are undertaken. The home is centrally heated; previous inspection identified that all radiators were found with appropriate guards. All areas of the home seen looked to be clean and tidy. There was an offensive odour in one area of the home; the manager explained that the carpet was cleaned weekly. The sluice areas were found clean with appropriate equipment ready for use, although one contained an offensive odour. One sluice room door was found to be unlocked, wide open and unsupervised by staff. Previous inspection identified that the laundry was small to cope with fifty residents, but Lydfords Care Home DS0000014016.V345892.R01.S.doc Version 5.2 Page 18 staff working in the laundry were well organised and coped well with the levels of laundry in the home. The manager described the systems in place for the maintenance of infection control. The inspector was assured that a box of clean un-named net knickers was waiting to be thrown away and not re-used for different residents. The laundry room was not locked and was unsupervised by staff. Lydfords Care Home DS0000014016.V345892.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ needs are met by appropriately recruited and trained staff who understand and anticipate their wishes, although they may benefit from a review to confirm sufficient staffing numbers. EVIDENCE: On the day of the inspection, there were sufficient staff to support the health and social needs of residents and good interaction between residents and staff was observed. All residents and relatives spoken with spoke highly of staff, although one mentioned that numbers were a bit short and agencies were used. The manager explained that agency staff covered staff vacancies; it was said that agency staff were familiar with the home and the residents; one visitor confirmed that their relative thought the agency staff were good. One resident stated that once staff took fifteen minutes to answer the call bell. One visitor said that the noise of the call bell annoyed their relative. The manager stated that staffing numbers had recently increased to be in line with the increase in residents. Staff spoken with demonstrated a good understanding of their role and confirmed that the recent increase in staffing levels had had a positive effect regarding this. Staff on duty include trained nurses and carers in addition to an activities co-ordinator. Ancillary staff are Lydfords Care Home DS0000014016.V345892.R01.S.doc Version 5.2 Page 20 also employed for catering, laundry, maintenance, administration and domestic duties. The home has a recruitment procedure in place, which aims to protect residents. Recruitment files seen were found to have all the necessary preemployment checks required, such as a Criminal Records Bureau disclosure, evidence of a check regarding the Protection of Vulnerable Adults, two references, a health statement and a PIN number check. New staff complete an induction training that is in line with the National Training Organisation. The training records and certificates seen indicated that ongoing training is arranged that aims to provide staff with the appropriate skills to meet residents’ needs, such as adult protection, infection control, moving and handling and medication. The manager stated that currently updates are in progress for fire, moving and handling and adult protection. It was said that ten staff were trained first aiders and it was planned that this would be increased. The manager explained that domestic staff had training in the control and use of hazardous substances. The cook said that they had been trained in food hygiene. Staff spoken with mentioned the training opportunities available within the home, including training that they found helpful to perform their job competently. The manager stated that five staff had obtained NVQ qualifications, four at level 2 and one at level 3; it was said that in addition five individuals working as carers were trained nurses in their country of origin. Lydfords Care Home DS0000014016.V345892.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35, 36, 37, 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents enjoy living in a home, which is run in their best interests by a competent manager, although they would benefit from full time management cover for the home. Individuals’ protection would be enhanced by a review of the security of the home and the financial systems in place for residents’ monies. EVIDENCE: The manager is experienced and knowledgeable about the needs of older people who require nursing and personal care and has worked in the home within a managerial capacity for between three and a half to four years. The manager stated that they are a qualified nurse and have completed the Lydfords Care Home DS0000014016.V345892.R01.S.doc Version 5.2 Page 22 Registered Manager’s Award. The management structure of the home includes two senior qualified nurses. Discussion took place regarding the current management arrangements for the home. It was said that the home was currently in the process of recruiting a new manager due to the present manager’s impending promotion. The manager assured the inspector that although they had taken up some of their new duties, which meant they were away from the home two days per week and occasionally more, the management cover for the home while they were away was adequate as they were easily contactable by telephone and in the evenings and weekends; in addition two senior qualified nurses were available. It was indicated that this was a temporary arrangement until the new manager was in place and any change in the arrangements would be notified to the CSCI. The residents and staff spoken with indicated that they felt supported by the management team in place. The relatives visiting were aware of the manager and felt able to approach them with any concerns. Regular resident and staff meetings are held and residents feel that the manager takes their views seriously. There are formal quality assurance and quality monitoring systems, which enable the management to objectively evaluate the service and ensure it is run in service users best interests. Questionnaires are sent to residents and their relatives, internal audits are undertaken and representatives of the Care Provider undertake visits to the home. Formal supervision of staff is undertaken and is on-going and members of staff spoken with and records seen confirmed this. The manager stated that this took place every two months. There are procedures in place regarding resident’s finances. Some resident’s are responsible for their own finances where appropriate and lockable facilities are provided. The home holds a small amount of cash on behalf of others; this is not held individually but in one ‘float’. The manager stated that this system has recently been introduced. It was said that one Residents’ Account holds cash on behalf of individuals together. A system is in place for auditing individual residents’ monies, although these are not held separately. Discussion took place regarding the method of accessing one resident’s individual bank account. It was agreed that the current procedure did not adequately protect the individuals concerned. The manager undertook to address this as soon as possible. The manager stated that currently the home does not hold any valuables on behalf of residents, although a system is in place should this be the case. Lydfords Care Home DS0000014016.V345892.R01.S.doc Version 5.2 Page 23 The kitchen is maintained in a hygienic manner. Dried and refrigerated food is stored appropriately. Temperatures for fridges, freezers and hot food are monitored and recorded. Records seen indicated the regular testing and maintenance of systems within the home, such as the fire alarm system, the staff call system, portable electrical equipment, hoists and the lift. Other records have been mentioned previously within this report where appropriate. It was noted at the beginning of the inspection that both the front and back doors were open and unsupervised by staff. The front door bell was not answered for several minutes. The manager explained that the front door was usually supervised but that the member of staff had briefly left that position for a lunch break; it was said that visitors to the home could be seen from the managers office. The manager mentioned that the noise of the front door bell was the same as that of the staff call bell and could only be distinguished by looking at the display on the staff call system. Lydfords Care Home DS0000014016.V345892.R01.S.doc Version 5.2 Page 24 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 2 X 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 3 3 2 3 3 3 2 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 3 3 X 2 3 3 2 Lydfords Care Home DS0000014016.V345892.R01.S.doc Version 5.2 Page 25 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 OP18 OP35 Regulation 13(6) Timescale for action The registered person shall make 31/08/07 arrangements…to prevent service users being harmed or suffering abuse or being placed at risk of harm or abuse In that, a review must be undertaken regarding the method of accessing one resident’s personal bank account. Procedures must protect all the individuals concerned from risk and be recorded. 2 OP26 16(2)(k) The registered person shall…keep the care home free from offensive odours… In that, a review must be undertaken in order to eradicate the offensive odours in one area of the home and in one sluice room. 3 OP26 13(3) The registered person shall make 31/08/07 suitable arrangements to prevent infection, toxic conditions and the spread of infection at the care home. DS0000014016.V345892.R01.S.doc Version 5.2 Page 26 Requirement 31/08/07 Lydfords Care Home In that, in order to reduce the risk to residents, a review must be undertaken regarding residents’ access to sluice and laundry areas. The manager must complete their stated intention to discard any un-named net knickers in order to reduce the risk of items being re-used for a different individual. 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 OP1 Good Practice Recommendations It is recommended that a review should be undertaken to ensure that all residents and/or their representatives should be pro-actively offered the detailed written information about the home that they need, before they decide to move in. It is strongly recommended that a review should be undertaken regarding residents who decline offers of help to confirm that they do receive the personal support they need. It is recommended that the manager complete their stated intention to address the constant buzzing noise of one specialist mattress. It is strongly recommended that a review should be undertaken to ensure that all residents who use the smoking room unsupervised are able to alert staff quickly in an emergency. It is strongly recommended that a review should be undertaken to confirm that the recent increase in staffing DS0000014016.V345892.R01.S.doc Version 5.2 Page 27 2 OP8 3 OP22 4 OP22 5 OP27 Lydfords Care Home numbers is sufficient to meet the needs of the increased number of residents. Issues regarding staffing numbers were contained within requirements made during the previous two inspections of 16/11/05 and 02/05/06. 6 OP31 It is strongly recommended that the process of recruitment for a new manager should be completed as soon as possible in order for residents to be protected by full time management cover within the home. It is strongly recommended that a review should be undertaken with regard to the system in place for holding personal money on behalf of residents in order to ensure that this is held individually and not pooled. It is strongly recommended that a review should take place to ensure that the security of the home is sufficient to protect residents. 7 OP35 8 OP38 Lydfords Care Home DS0000014016.V345892.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Home DS0000014016.V345892.R01.S.doc Version 5.2 Page 29 - 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. 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