Inspection on 25/02/09 for Lympstone House

This inspection was carried out on 25th February 2009.

CSCI found this care home to be providing an Good service.

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

Lympstone House 20/03/08

Lympstone House 14/09/06

Lympstone House 13/09/05

Lympstone House 08/04/05

Lympstone House 22/09/04

Lympstone House 28/04/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Lympstone House Strawberry Hill Lympstone Exmouth Devon EX8 5JZ     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Teresa Anderson     Date: 2 5 0 2 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 23 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 23 Information about the care home Name of care home: Address: Lympstone House Strawberry Hill Lympstone Exmouth Devon EX8 5JZ 01395270004 01395264504 lympstonehouse@hotmail.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mrs Elizabeth Sylvester,Mr Leonard Roland Sylvester Name of registered manager (if applicable) Miss Caron Bayley Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category physical disability Additional conditions: Date of last inspection Brief description of the care home Lympstone House was last inspected on March 20th 2008. Lympstone House is a privately owned detached period property that has been adapted and extended to provide accommodation and personal care to up to 25 older people. It is situated within walking distance of the small village of Lympstone, which benefits from a frequent train service which links Exmouth with Exeter. The house is set in a large plot with extensive gardens and ample parking. Inside the home there are two lounges, a dining room, conservatory and central Care Homes for Older People Page 4 of 23 care home 25 Over 65 25 0 0 25 Brief description of the care home courtyards. Two purpose built wings on the ground floor provide bedroom accommodation, and the bedrooms on the first floor of the main building are reached by a passenger lift or staircase. Assisted bathing facilities are provided. All the people who come to live here on a long term basis are admitted for an initial one-month trial period. During this time either party may give the other, without reason, 24 hours notice of intention to terminate the contract. This is clearly stated in the homes contract of residence. Some people are admitted for short periods of time for convalescence or respite. Fees charged are available direct from the home. Fees do not include dry cleaning, personal toiletries, newspapers, telephone line rental or calls, transport. Fees relating to transport and escorts are given to people together with information about the home. Care Homes for Older People Page 5 of 23 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This unannounced key inspection was undertaken as part of the normal programme of inspection and the visit to the home was undertaken by one inspector. During our visit, we (the commission) spoke with some people living here, with the manager, the owner and with staff. We also observed interactions between people living here and staff. We looked closely at the care and accommodation offered to two people. We did this to help us understand the experiences of people using this service. This is called case tracking. We looked at peoples written assessments and plans of care, the environment in relation to their needs and at how their health and personal care needs Care Homes for Older People Page 6 of 23 are met. We visited the communal and service areas in the home and saw approximately four bedrooms. Other records seen including those relating to medication and recruitment were inspected. Prior to this inspection we sent surveys to people living at the home and six were returned, and to staff and two were returned. Their feedback and comments are contained within the report. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 23 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 23 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have their needs assessed, so can be sure that the home can meet those needs. Evidence: We looked at care records which show that each person who comes to live here has their needs assessed by a senior member of staff. A standard format is used to help staff to explore important areas. In the main this assessment focuses on physical needs and forms the basis for a care plan about how to meet those needs identified. Once the person has been admitted to the home, a more detailed plan of care is devised. Care Homes for Older People Page 10 of 23 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live here have their care planned and their health and welfare needs met. Medicines are managed safely and people are treated with respect and have their privacy promoted. Evidence: People who live here have their care planned and their health and welfare needs met. Medicines are managed safely and people are treated with respect and have their privacy promoted. In surveys everyone who had completed one told us that they always receive the care and support they need. People, in surveys and during conversations, told us that the staff are kind and that they are very well looked after. People also told us that they get the medical support they need. We looked in care plans and saw that doctors are called to see people when needed. In addition people are helped to remain healthy by seeing for example the dentist, Care Homes for Older People Page 11 of 23 Evidence: chiropodist, district nurse and psychiatric nurse. We also saw that people are assessed to determine for example their risks of developing pressure sores and risk of becoming malnourished. If people need specialist equipment to prevent them getting pressure sores, the district nurses provide this. No one living here has a pressure sore. We saw that people who are assessed at being at risk of becoming malnourished receive extra support with their diet and/or supplementary drinks. Staff told us that they are kept up to date with peoples needs and with any changes through reading the care plans and during handover at the start of every shift. One person said they had never been asked to care for anyone that they did not have information about. We looked at the way medicines are managed and found that they are stored safely and securely. The manager takes responsibility for the overall management of the system and records show that this system ensures that all medicines are recorded accurately, that people get the medicines they are prescribed and on time, and that any medicines not used are returned safely. We checked some medicines against the records held, and found that the records match the numbers counted. We observed staff interacting with some of the people living here. They were extremely polite and helpful, helping to maintain peoples dignity. All personal care given was given in private. People told us that the staff treat them very well, always politely and with care. One person said they spoil me. Care Homes for Older People Page 12 of 23 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live here have their social needs met and are helped to make decisions about their daily lives. They enjoy a healthy and nutritious diet. Evidence: In surveys five of the six people who responded say they usually like the meals, and one person said they sometimes like them. One person told us they had gained weight because of the care and attention given to their diet and another told us they had little interest in food although staff tried to tempt them. The home has a menu which offers variety and choice. People say if they dont like something they can have something else and that they can eat their meals where they choose. We saw that people who need support to eat get this and as a consequence maintain their weight and remain well for longer. In surveys five of the six people who responded say they sometimes usually enjoy the activities organised by the home. One person said they usually enjoy them. We saw from records that activities include visits from the local donkey sanctuary, bingo, quiz, cards and watching films. We spoke with people who told us they tend to like their own Care Homes for Older People Page 13 of 23 Evidence: company and the gardens, when the weather is nice. One person said peace and privacy are more important than arranged activities. People told us their visitors can visit when they like. Care Homes for Older People Page 14 of 23 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living here are listened to and are safe. Evidence: In surveys people told us that they know how to make a complaint and who to speak with if they are not happy. One person told us they had no need to make a complaint and another that if they wanted anything they only had to speak with staff. People also told us that staff always listen and and act on what they say. The home has not received any complaints since the last inspection and neither have the commission. People living here told us that they feel safe and well cared for. Those whom we could not speak with appeared to be relaxed in the company of staff and other people. In a survey we were told that staff are always kind and caring. We saw in training records that staff are about to have their training in safeguarding people from abuse updated. We spoke with some staff about what abuse is and they have a good knowledge of the types of abuse. They also demonstrate that they know what to do if they suspect or observe any form of abuse. Care Homes for Older People Page 15 of 23 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a pleasant, safe, clean and comfortable environment. Evidence: In surveys people told us that the home is always fresh and clean. When we visited we observed it to be this way, and to be odour free. We saw staff observing infection control procedures by for example wearing protective clothing, washing their hands and using the correct equipment. We saw that there are easy to access hand washing facilities and that liquid soap and paper towels are used, as is good practice. The home itself is very homely with lots of flowers and pictures and good quality furnishings. Records show that regular fire checks ensure that the equipment necessary for the containment and tackling of fires is in working order. Care Homes for Older People Page 16 of 23 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples needs are met by staff who are employed in sufficient numbers and who received ongoing training. The homes recruitment procedures help to ensure that people are protected from inappropriate staff. Evidence: This home tends to care for people with low to medium needs. On the day of this inspection there were thirteen people living here. For this number there are three carers on duty in the morning and two during the rest of the day and night. People say that their needs are met and that staff are always or usually available. Staff are described as kind and caring and patient. We looked at the recruitment files for three members of staff. All the checks needed to help ensure that only appropriate staff work here were carried out. These checks included obtaining written references and carrying out a police check. Staff told us that they had an induction before starting work and one told us they had shadowed someone else before working alone. The manager reports that she has recently updated the induction training to ensure that it is based on the Skills for Care induction, as is good practice. Staff also told us that they have regular meetings with the manager and we saw records that staff appraisals are taking place. Care Homes for Older People Page 17 of 23 Evidence: The manager reports that staff training is currently being updated. This includes training in supporting people with challenging behaviour, safeguarding adults and First Aid. Care Homes for Older People Page 18 of 23 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a home that is well managed and safe. Evidence: Since the last inspection the manager of this home has successfully become the Registered Manager (registered with the commission). She has completed the National Vocational Qualification (NVQ) in care at Level 3, is now studying at NVQ level 4 and is registered to commence NVQ level 4 in leadership. She has identified her own learning needs and has arranged for example to update her skills in moving and handling and has also arranged to have training in becoming a trainer in moving and handling. She has acted on all the requirements and recommendations made at the last inspection and these are now met. In addition she has continued with or set up quality assurance systems. For example she has recently sent out surveys to people living here and their relatives to obtain feedback about what the home is doing well and what might be improved upon. She reports she has arranged both staff and Care Homes for Older People Page 19 of 23 Evidence: residents/relatives meetings, and has commenced staff appraisals. In surveys staff say they feel well supported and that they can talk with the manager. They say they have training that meets their needs and helps them to provide better care. The manager reports that the home does not currently keep any monies on peoples behalf. She says there is a safe available if people wish to store money securely and that each person has a lockable space in their bedrooms, in which to keep valuables. Care Homes for Older People Page 20 of 23 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 21 of 23 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 22 of 23 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 23 of 23 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!