Inspection on 05/08/05 for Lymewood Nursing Home

This inspection was carried out on 5th August 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

Lymewood Nursing Home 26/03/10

Lymewood Nursing Home 04/02/09

Lymewood Nursing Home 06/03/08

Lymewood Nursing Home 25/08/06

Lymewood Nursing Home 09/02/06

Lymewood Nursing Home 10/02/05

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

CARE HOMES FOR OLDER PEOPLE Lymewood Nursing Home Woodhouse Uplyme Lyme Regis DT7 3SQ Lead Inspector Stephen Spratling Unannounced 5 August 2005 09:30 hrs th The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Lymewood Nursing Home D54 D06 S61709 Lymewood V235699 050805 stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Lymewood Nursing Home Address Woodhouse Uplyme Lyme Regis Devon DT7 3SQ 01297 445444 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Lymewood Care Limited Mrs Helen Mary Gray Care Home 37 Category(ies) of DE(E) Dementia - over 65 (37) registration, with number MD(E) Mental Disorder - over 65 (37) of places Lymewood Nursing Home D54 D06 S61709 Lymewood V235699 050805 stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1 You may admit up to five service users with Dementia (DE) aged over 55 years, subject to individual assessment by local care management teams. Date of last inspection 10 February 2005 Brief Description of the Service: Lymewood has been under new ownership since November 2004. The home provides accommodation and personal care, including Nursing, for up to 37 older people (over 65) who have needs that relate to dementia or a mental disorder. The home can admit up to five people between the ages of 55 and 65. Set in a beautiful rural location about two miles from Lyme Regis, Lymewood has a wide selection of accommodation on three floors with attractive accessable gardens. All areas are serviced by a stair lift and some by a passenger lift. There is one main lounge, one dining room, and three smaller lounges. Lymewood also has a small shop and a hairdressing salon. The home offers a programme of activities to suit the service users, which can be enjoyed either in large groups or on “one to one” sessions. Lymewood Nursing Home D54 D06 S61709 Lymewood V235699 050805 stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection carried out by one inspector (Stephen Spratling) from 10 am until 2.40 pm on 5th August 2005. During the day the inspector spoke with the registered manager, the deputy manager, three members of care staff, seven of the people living at the home and the relatives of two residents. The mental frailty of many of the residents who the inspector spoke with prevented them for being able to express clear views about the service they receive. Additionally he looked at the assessments and care plans for three residents; some of the policies and other records kept by the home. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Lymewood Nursing Home D54 D06 S61709 Lymewood V235699 050805 stage 4.doc Version 1.40 Page 6 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Lymewood Nursing Home D54 D06 S61709 Lymewood V235699 050805 stage 4.doc Version 1.40 Page 7 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 Residents benefit from good admission and assessment practice, which ensures that the home is able to meet their needs. The home does not offer an intermediate care service. EVIDENCE: The relative of a very recently admitted resident told the inspector that the home manager had visited their father before agreeing admission and conducted a detailed assessment by speaking with both the relative and his father. The care records of three residents seen by the inspector contained clear preadmission assessment information. Assessment information provided by other health care professional was also seen included in residents’ records. Lymewood Nursing Home D54 D06 S61709 Lymewood V235699 050805 stage 4.doc Version 1.40 Page 8 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8 & 10 Residents benefit from clear plans of care which are developed to help ensure all identified needs are met. By providing good health screening/monitoring and promptly requesting help and advice from other health care professionals, the staff at this home promote the good health of residents. Residents are treated kindly and with respect. EVIDENCE: The inspector looked at the care plans for three residents; all provided sufficient information to help ensure staff know what to do to properly care for the individual residents. All showed evidence of recent and regular, monthly, review by the registered nurses; record of a review conducted involving relatives and care managers from social services were seen to have been done within the past nine months in two of the files. All three records seen contained regularly reviewed professionally recognised health assessment tools, including assessments of resident’s risk of developing pressure sores. Where a risk was found to be high a care plan had been developed and measures to prevent sores, such as using special pressure relieving mattresses, had been put in place. Record of GP, Community Lymewood Nursing Home D54 D06 S61709 Lymewood V235699 050805 stage 4.doc Version 1.40 Page 9 Psychiatric Nurse and other health care professionals visits and advice were seen in records. A GP who has many patients at the home has recently commented to the inspector that he feels the home provides a high standard of care to residents and reports concerns promptly. Residents able to comment said that they think staff treat them with respect, one person told the inspector they like to be on their own and that “staff don’t intrude”. A relative of one residents said that staff are “very patient” an other commented that they think their father is treated with “dignity”. Throughout he day staff were seen responding patiently and respectfully to residents, assisting them to private areas when they needed help with personal care. Lymewood Nursing Home D54 D06 S61709 Lymewood V235699 050805 stage 4.doc Version 1.40 Page 10 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 13 Residents benefit from the contact with family and friends, which is encouraged by the home. EVIDENCE: Staff confirmed that visitors are welcomed to the home at any reasonable time without appointment. Visitor to two residents who spoke with the inspector all said that they are made to feel welcome when visiting. Lymewood Nursing Home D54 D06 S61709 Lymewood V235699 050805 stage 4.doc Version 1.40 Page 11 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) None of these standards were assessed on this inspection. EVIDENCE: Lymewood Nursing Home D54 D06 S61709 Lymewood V235699 050805 stage 4.doc Version 1.40 Page 12 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 & 26 The home is well maintained and kept clean, providing a comfortable homely environment for residents. EVIDENCE: The inspector visited 12 residents’ private rooms; all were clean and several had new carpets and had been recently redecorated, with previously seen damaged plasterwork repaired. The dining room was in the middle of being decorated but still usable for residents. Damage to a stairwell wall seen at a previous inspection has been repaired and a new stair lift fitted from the 1st to the 2nd floor. Painters were seen working on the outside of the building. The deputy manager said that a new boiler and oil tank had been installed in recent months. All shared areas were clean and in a generally good state of repair, the manger said that an unpleasant odour in the entrance hall will be remedied by replacement flooring which had been ordered. Staff and visitors to the home commented that there they have noticed ongoing investment in the building happening at a faster rate since the time since the home has had new owners. The gardens are attractively maintained and accessible to residents, with seating areas provided. Lymewood Nursing Home D54 D06 S61709 Lymewood V235699 050805 stage 4.doc Version 1.40 Page 13 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29 & 30 Residents benefit from being cared for by staff supplied in sufficient numbers and who are trained and competent to their jobs. Recruitment procedures are in place but are not sufficiently robust to maximise protection of residents. EVIDENCE: On the morning of the inspection there was one Registered Nurse and six care assistants on duty. All staff spoken with said they think that there are generally enough care staff on duty to ensure they can care for residents properly without rushing them. Residents able to comment said that they get help when they need and do not have to wait to long. The recruitment records for three care staff were seen by the inspector, one contained all the required pre-employment checks, two were not complete; the manager said that some information may be at the head office but acknowledged that the Criminal Records Bureau (CRB) check for one recently employed carer had not been received before they started work and a Protection of Vulnerable Adults (POVA) 1st check had not been done. This was discussed and information about “1st Checks” provided. One visitor commented that they think “staff really know what they’re doing”. A staff member said they believe more staff are now doing NVQ courses and that the owners are supportive of staff wanting to do training. Staff spoken with told the inspector that they have done a variety of training including, nutrition and caring for people with dementia. Induction and training records were seen in staff members’ record files. Lymewood Nursing Home D54 D06 S61709 Lymewood V235699 050805 stage 4.doc Version 1.40 Page 14 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 36, 37 & 38 Residents benefit from being cared for by staff who are provided with clear guidance, well supported and supervised. Record keeping is generally good but needs some improvement to ensure residents’ best interests are safeguarded. The safety and welfare of residents is protected by the good management systems of the home. EVIDENCE: Staff spoken with described the manager and owners as very approachable and supportive. Two staff members said that the owners will grant any reasonable request for extra resources. Both residents’ visitors spoken with said the manager is very approachable. All the staff members spoken with said they feel well supported by colleagues and managers, indicating guidance and advice is always available. Some staff said they had received formal one-toLymewood Nursing Home D54 D06 S61709 Lymewood V235699 050805 stage 4.doc Version 1.40 Page 15 one supervision from the manager; the manager said she is working on ensuring all staff receive regular formal recorded supervision. A comprehensive policy file introduced January 2005 was available to guide staff in their work. The inspector read the medication policy, this presented clear information covering all the required subject areas. The inspector also looked at the restraint policy and discussed how this may be developed with the manager. Most residents’ records seen were kept in good order though some residents’ assessments and care plans were not clearly identified with the resident’s name on them, as they should be. Registration and current insurance certificates were displayed. The home fire log indicated that all fire fighting, detection and alarm equipment is tested as recommended by Devon Fire Officers. Two extinguishers checked at random showed that they had been serviced within the past 12 months. The inspector saw no unmanaged threats to the health or safety of residents. Lymewood Nursing Home D54 D06 S61709 Lymewood V235699 050805 stage 4.doc Version 1.40 Page 16 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 x 15 x COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x x 3 x x x 3 2 3 Lymewood Nursing Home D54 D06 S61709 Lymewood V235699 050805 stage 4.doc Version 1.40 Page 17 yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 29 Regulation 19 (1) & 17 (2) (4) Schedules 2 and 4 Requirement The registered person must not employ a person to work at the care home unless he has obtained all the information and documents specified in paragraphs 1 to 7 of schedule 2 (particulary Criminal Records Bureau checks). Information specified in Schedule 4 (6) must be available for inspection by the commission in the care home. Timescale for action 05/10/05 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 OP 37 Good Practice Recommendations Individual records should be properly labelled i.e. each care plan sheet should have the residents name on it. Lymewood Nursing Home D54 D06 S61709 Lymewood V235699 050805 stage 4.doc Version 1.40 Page 18 Commission for Social Care Inspection Suites 1 & 7 Renslade House Bonhay Road Exeter EX4 3AY 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 Lymewood Nursing Home D54 D06 S61709 Lymewood V235699 050805 stage 4.doc Version 1.40 Page 19 - 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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