Inspection on 03/06/08 for Lymewood Court Nursing Home

This inspection was carried out on 3rd June 2008.

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

Lymewood Court Nursing Home 11/05/07

Lymewood Court Nursing Home 10/02/06

Lymewood Court Nursing Home 12/08/05

Lymewood Court Nursing Home 24/11/04

Lymewood Court Nursing Home 01/07/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 28/09/2008.

CARE HOMES FOR OLDER PEOPLE Lymewood Court Nursing Home Piele Road Haydock St Helens Merseyside WA11 0JY Lead Inspector Lynn Paterson Unannounced Inspection 3rd June 2008 09:30 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 Lymewood Court Nursing Home DS0000005462.V363591.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. Lymewood Court Nursing Home DS0000005462.V363591.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Lymewood Court Nursing Home Address Piele Road Haydock St Helens Merseyside WA11 0JY 01942 270548 01942 271083 lymewoodcourt@schealthcare.co.uk www.schealthcare.co.uk Southern Cross Care Management Limited 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) Mrs Christine Corsair Care Home 46 Category(ies) of Old age, not falling within any other category registration, with number (46), Physical disability (46) of places Lymewood Court Nursing Home DS0000005462.V363591.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category/ies of service only: Care home with nursing - Code N To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP Physical disability, of the following age range: Over 55 years of age Code PD The maximum number of service users who can be accommodated is: 46 11th May 2007 Date of last inspection Brief Description of the Service: Lymewood Court Nursing Home is registered for 46 beds for elderly physically disabled persons. The Home is purpose built in design on a single level for residential services. The grounds are spacious with well-stocked gardens and seating areas and the home affords good off road parking. The Home is situated close to local amenities in Haydock. The Home is privately owned and managed by Southern Cross Care Management Ltd. The Homes Registered Manager is Mrs Chris Corsair. Fees are £470.00 - £551.00 per week. Lymewood Court Nursing Home DS0000005462.V363591.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is two stars. This means that people who use the service receive good quality outcomes. An unannounced visit was carried out over a seven-hour period, and the methods used to access the service include discussion with the people living in the home, their representatives and staff and managers. To ensure that the home is managed in the residents’ best interests, records on staffing and health and safety were looked at. A sample of five care files was assessed in detail to ensure that staff had all the information and guidance they needed to support each individual. A tour of the premises was carried out to assess the environmental standards of the premises and activities of daily life for the people living in the home were observed. The manager completed the Annual Quality Assurance document (AQAA) and returned it to us. This is a self-assessment, which gives us further information about how the home has improved in the past twelve months, plans for ongoing development of the service and any barriers to improvement. What the service does well: The home ensure that people who request accommodation in Lymewood Court receive a full assessment of their needs. This enables staff to decide if they can meet assessed needs prior to the commencement of the placement. The home provides flexible routines for people living in the home to enable them to have choice in their daily life. Comments from residents and their representative’s included“I can do what I want here within reason, the staff let me make my own mind up about how I spend my day” “I visit here frequently and see the residents enjoying activities or being taken out by their friends or staff”. “I like the way we can sit and do nothing if we choose or joining in the activity of the day. Sometimes I just like to watch TV or read and nobody bothers me”. Care plans and daily records reveal that all individual needs are addressed and staff work hard to ensure that people living in the home are provided with care support and stimulation to maximise their independence. Lymewood Court Nursing Home DS0000005462.V363591.R01.S.doc Version 5.2 Page 6 Staff said they enjoyed working in the home and received good support from each other and from their respective line managers. 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. Lymewood Court Nursing Home DS0000005462.V363591.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 Lymewood Court Nursing Home DS0000005462.V363591.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): 1.3.6. Quality in this outcome area is good. Residents are assessed before a placement is offered. This ensures needs can be met by the staff and services within the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Five care plans viewed held full details of pre admission assessments being undertaken. The details on file revealed that individual need; preferences and choices had been discussed to include issues relating to age, disability, gender, religion, belief, heritage and sexuality. The manager or senior RGN carry out all pre placement assessments in order to ensure prospective residents that their individual needs can be met. The statement of purpose and service user guide, are also provided prior to placement, to inform people about the homes staff, service provision and general routines. Lymewood Court Nursing Home DS0000005462.V363591.R01.S.doc Version 5.2 Page 9 Risk assessments are carried out both before the placement and as soon as the placement begins to ensure the health, safety and wellbeing of the residents is maximised. People living in the home confirmed that they had received a needs led assessment prior to being admitted and one resident said she had visited the home and stayed for a little while before making her mind up if she wanted to live there. The home does not currently provide intermediate care. Lymewood Court Nursing Home DS0000005462.V363591.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. Quality in this outcome area is good. Health and social care needs are monitored and met and care planning enables residents to maximise their potential. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Five care plans examined in detail provided clear documented information about assessed need and of how staff would meet this need. In discussion staff were clear about the care needs of the people living in the home and revealed that they were able to talk with each person each day and ask them if they wanted any thing changed to their care plan. Staff said they had good staff handovers and any changes to the care plan or daily routines were fully discussed during handovers. Staff were observed carrying out their care practices showing respect to residents and ensuring their privacy and dignity was intact. Lymewood Court Nursing Home DS0000005462.V363591.R01.S.doc Version 5.2 Page 11 Records show that all social and health care needs are monitored with daily records being maintained. Residents spoken with said they regularly see chiropodist, dentists GP’s etc. and receive good quality care from care staff and nursing staff on the unit. Residents said that all nursing care was carried out either in the privacy of their own room or in the treatment room and they were never made to feel embarrassed. Staff said that the home provide specialist nursing equipment to meet assessed need to include profile beds, pressure relieving equipment and many moving and handlings aids. In discussion staff identified that they are fully trained to carry out care practices to include the prevention and treatment of pressure sores, pain management and care of the dying. Residents spoke with said they liked the staff and felt they worked very hard to make sure the people living in the home were well cared for and comfortable. Comments included“The staff are wonderful, they are kind and treat us so well” “The staff are always busy they never have a moment to themselves but they provide us with good care and comfort”. “The staff are kind and helpful, I have just come here from somewhere else and it already feels like home”. The medication management systems ensure that only qualified nursing staff are allowed to deal with medication. Records, storage systems and other documentation, appeared well managed. Lymewood Court Nursing Home DS0000005462.V363591.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 The home provides flexible routines to enable people to have choice about their daily living. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home utilise the services of a designated activities co-ordinator and residents say she is excellent in arranging various social activities both in and outside of the home. Residents say they enjoy the Bingo and Dominoes and the social outings and in- house entertainment. Residents say they also enjoy being pampered with nail treatment and other “beauty therapies”. Records show that the activities co-ordinator has conducted a survey with the people living in the home to gain their views on what they would like to personalise the activities plan. The activities notice board displayed a variety of activities to include trips out to local pubs, schools, church halls, brass band concerts, residents meeting and the local clergy visitations. Lymewood Court Nursing Home DS0000005462.V363591.R01.S.doc Version 5.2 Page 13 Residents said staff encouraged them to maximise their life by spending time with family and friends and enjoying retaining links within the community. Residents were observed going out with family and friends or entertaining them within the home. There are 2 dining rooms in the home, which are separated by the main kitchen area. This enables meals to be served from both sides and speeds up the process. The dining rooms were comfortable and welcoming with small tables for four people being used. However residents who were asked what the menu was said, “what day is it, Tuesday, them it must be chicken”. Residents said they were not given choices at lunchtime and were generally provided with the same food each week. One lady said she did not much like chicken but ate what she could; another said if I don’t like it I just leave it. One lady advised that she could not eat chicken and was always given a slice of cold Turkey on “chicken days”. Residents said the food was all right but they would like more choice. The menus were viewed and although there was some reference to food content they were not clear about choices of meals. Staff confirmed that choices at lunchtime were not always available but advised that for the evening meal residents were provided with choices of sandwich, pasty or other snacks. All menus should offer choice and be drawn up in consultation with the residents to ensure that all tastes, preferences and dietary needs are catered for, Lymewood Court Nursing Home DS0000005462.V363591.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. The systems in place for the protection of residents from harm and abuse are robust. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The pre inspection questionnaire identified that the home had received no major complaints in the last 12 months. The manager advised that residents and their representatives are able to approach staff and discuss any issue or areas of concern and all concerns would be acted upon promptly. A complaint procedure is in place and residents and their representatives are provided with a copy to enable them to fully understand the process. Residents and their families spoken with said they knew about the compliant system and understood what they would need to do I they had a complaint to make. Staff training records show that they have received training in adult protection and the safeguarding of vulnerable people and discussions with staff revealed that they had good knowledge and understanding of the signs to look for in respect of abuse and how to deal with any issues that may arise. Lymewood Court Nursing Home DS0000005462.V363591.R01.S.doc Version 5.2 Page 15 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): 19.26. Quality in this outcome area is good. The home provides a spacious hygienic safe environment for the people living in there. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A tour of the premises revealed that the home provide a spacious clean environment which is free from unpleasant smells. People living in the home said they feel comfortable and safe in their surroundings and were able to put bits and pieces of furniture, ornaments and pictures in their rooms to personalise them and make them feel more at home. The maintenance programme revealed that the home have refurbished the home in the last 12 months to include 43 rooms of the 46 bedrooms. New Lymewood Court Nursing Home DS0000005462.V363591.R01.S.doc Version 5.2 Page 16 flooring has been provided for both dinging rooms and 8 new heaters have been installed. Garden areas have been tidied and replanted to enable residents to walk around or sit and admire the view. Staff spoken with said the home was generally clean and free from unpleasant smells and if they noticed any faults with fixtures and furnishings they recorded this in the homes maintenance book. They said that the maintenance person would then rectify any faults with immediate effect. Lymewood Court Nursing Home DS0000005462.V363591.R01.S.doc Version 5.2 Page 17 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. Residents are protected through the recruitment procedures followed by Lymewood Court and staff are supplied in adequate numbers and have the training and support needed to carry out their remit. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The pre inspection questionnaire indicated that staff have completed a range of training with the past 12 months and that the home have an ongoing training plan to ensure that staff meet the mandatory training standards and can also develop their knowledge and skills in specialised areas. A selection of staff files looked at contained all the required documentation to include reference checks, past employment history, Criminal Record Bureau (CRB) checks to ensure they are suitable to work with vulnerable people. Staff files also held details of their training and developmental needs and staff said they are provided with plenty of training and are provided with good support to enable them to update their knowledge and skills. Lymewood Court Nursing Home DS0000005462.V363591.R01.S.doc Version 5.2 Page 18 Eight care staff were on duty during the visit with 2 nursing staff also on duty. Staff said they felt the staffing levels were adequate to enable them to meet the needs of the 36 people currently living in the home. Residents and their representatives said that staff were kind and caring and worked extremely hard to meet all differing needs. Comments included“The staff work very hard, they never seem to have a moment but we all get the help and support we need” “The staff are always cheerful and most helpful. They are always ever so busy but they keep going”. “The staff seem to work well together but I don’t know how they manage to care for this many people with so few of them on duty. They are always so kind to my aunt and she says that they give her wonderful care and attention”. Records show the home has good staff retention and use a good skill mix on each shift. Lymewood Court Nursing Home DS0000005462.V363591.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31.33.35.38. Quality in this outcome area is good. The home is managed in a way that maximises the comfort and welfare of the people living there. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered manager has been managing the home for several years and is professionally qualified in nursing care and is awaiting completion of her NVQ4 home management award. Staff say she manages by mutual consent and say they respect her and other members of the management team for their knowledge, skills and open management style. Lymewood Court Nursing Home DS0000005462.V363591.R01.S.doc Version 5.2 Page 20 Staff revealed that there are clear lines of accountability within the home and records show that staff are provided with supervision and support according to their role and line management structure. The pre inspection questionnaire revealed that the home have been supported by their organisation, Southern Cross, to ensure that the policy for the management of residents finances has been reviewed and monies now are held in individual accounts. A selection of financial records and money was inspected and noted to be in good order. Systems are in place to ensure the ongoing monitoring of the service. Staff are monitored in their role and administrative systems reviewed. The manager attends monthly group manager meetings and company training sessions. Southern Cross Operations manager visits the home to undertake monthly reviews and the manager conducts monthly in house audits. Resident’s health safety and welfare are promoted in the home. Records indicate the equipment in the home such as fire system, hoists and electrical wiring etc. is checked and serviced on a regular basis. Staff confirmed that they have completed a range of training in this area to ensure the health, safety and wellbeing of the people who live and work at Lymewood court. Lymewood Court Nursing Home DS0000005462.V363591.R01.S.doc Version 5.2 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 X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Lymewood Court Nursing Home DS0000005462.V363591.R01.S.doc Version 5.2 Page 22 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 OP15 Regulation 12 Requirement Choices of meals must be provided at each meal -time to ensure individual tastes, preferences and dietary needs are met. Timescale for action 10/08/08 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 Lymewood Court Nursing Home DS0000005462.V363591.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Merseyside Area Office 2nd Floor South Wing Burlington House Crosby Road North Waterloo, Liverpool L22 OLG 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 Lymewood Court Nursing Home DS0000005462.V363591.R01.S.doc Version 5.2 Page 24 - 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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