Inspection on 08/04/05 for Lympstone House

This inspection was carried out on 8th April 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 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 25/02/09

Lympstone House 20/03/08

Lympstone House 14/09/06

Lympstone House 13/09/05

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 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Lympstone House Strawberry Hill Lympstone Exmouth, Devon EX8 5JZ Lead Inspector Vivien Stephens Unannounced 8th April 2005 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. Lympstone House Version 1.10 Page 3 SERVICE INFORMATION Name of service Lympstone House Address Strawberry Hill, Lympstone, Exmouth, Devon, EX8 5JZ 01395 270004 01395 264504 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) Mrs Elizabeth Sylvester Jackie Lee [not yet registered] Care Home 25 Category(ies) of OP Old Age [25] registration, with number PD Physical Disability [25] of places Lympstone House Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 22.09.04 Brief Description of the Service: Lympstone House is a detached period property set in large gardens close to the centre of Lympstone village and within easy walking distance of all local amenities. There is on-site parking and attractive gardens surrounding the house. The home is registered to provide accommodation and personal care for up to 25 older people. The home is privately owned. There are two lounges, a dining room, conservatory and central 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 either a passenger lift or a stairway. All the corridors have hand rails and there is good access to all areas of the home for those with mobility difficulties. Assisted bathing facilities are provided. Lympstone House Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection began at approximately 10am and finished at 4.30pm. A new manager, Jackie Lee, has recently been appointed, and an application for her registration has been submitted to the Commission. During the inspection 10 residents, 2 members of staff and the new manager were interviewed. There were 22 residents accommodated at the time of this inspection. The rooms on the ground floor were seen during the inspection, including the kitchen, laundry, lounges, dining room, bedrooms and bathrooms. Records seen included assessments and care plans, accident reports, records of medicine administration, and the fire log book. What the service does well: What has improved since the last inspection? What they could do better: The home must improve the assessment arrangements for new residents and make sure that adequate information is obtained before admission. Staff must receive regular training in all aspects of health and safety, especially in fire safety matters. Lympstone House Version 1.10 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Lympstone House Version 1.10 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 Standards Statutory Requirements Identified During the Inspection Lympstone House Version 1.10 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 and 5 Lympstone House’s arrangements for making sure that it is able to meet prospective residents’ needs are not thorough enough. There is therefore a risk that it could admit people whose needs would be better met elsewhere. EVIDENCE: At the last inspection new care plans had been introduced. Unfortunately the home no longer has the template and therefore another care planning system has been purchased and is about to be implemented. The home has not yet had opportunity to test this system yet. In discussion with the manager it was agreed they must ensure that prospective new residents are properly assessed, and to ensure that the home is able to meet their needs. During the inspection some of the residents talked about the process of moving into the home. While some had visited the home before deciding to move in, others had relied on families or representatives to visit and choose a home on their behalf. The manager said she would normally try to visit prospective residents in their own home to carry out an assessment; this would depend on distance and time constraints. In such cases the home obtains information by telephone, or written information from health or social services professionals. Lympstone House Version 1.10 Page 9 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, 9 and 10 Care plans were thorough and provide a good level of information to staff on residents’ care needs. Residents’ privacy is respected at Lympstone House. Arrangements for storing and administering medicines are safe. EVIDENCE: New care plans were drawn up last year giving detailed information on each resident’s needs. In a sample of care plans seen during this inspection needs had been reviewed and care plans amended where necessary to give clear and up-to-date instructions to staff on meeting them. Some residents have been consulted over their care plans. Information from the existing care plans is about to be transferred to new forms. Residents, relatives and staff are to be consulted over the new care plans, which will be presented in such a way that staff can understand and follow the instructions on a daily basis. Lympstone House Version 1.10 Page 10 Privacy screens have been provided in shared rooms, and staff were observed knocking on doors before entering. New staff receive instruction on maintaining residents’ privacy and dignity. The new manager, Jacky Lee has reviewed medicines practice to ensure safe systems are in place. Lympstone House Version 1.10 Page 11 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) 12, 13, and 15 Residents have benefited from recent group activities, which have proved successful. Attention to ensuring that individual needs are met is not so well established. Contact with families and friends outside the home is well supported. Food and nutritional requirements are well provided for. EVIDENCE: The new manager, Jackie Lee, has started to introduce some entertainments and activities in the home. The day before this inspection some musical entertainment was provided in the dayroom. It was well attended, and residents talked about how much they enjoyed themselves. Photographs were taken and these were already on display on the notice board. The manager has also arranged some exercise sessions to music. Some residents have recently started to attend the local Age Concern centre, and participate in Age Concern outings. Jackie Lee said she hopes to introduce more activities in the future. Care plans contain very little information on the social needs of residents Residents interviewed during the inspection said their visitors are always made welcome, and that there are no restrictions on visiting. Jackie Lee said that menus had recently been changed in consultation with residents. In the kitchen there is a list of residents’ preferences, and the cook Lympstone House Version 1.10 Page 12 is encouraged to talk to residents to find out more about their likes and dislikes. Residents were complementary about the meals provided. Some said they like to eat in the dining room while others said they choose to remain in their rooms. The dining room is attractively decorated and furnished. Lympstone House Version 1.10 Page 13 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) 16 Residents know who to talk to about any concerns, and how to make a complaint if necessary. EVIDENCE: Residents said they felt confident they could speak to a member of staff or the manager, if they had any concerns or complaints. All residents have been given a pack of information about the home, and these contain details of the home’s complaints procedures. Lympstone House Version 1.10 Page 14 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, 20, 21, 23, 24, 25, 26 The home offers clean, warm and comfortable surroundings in both private and communal areas. The building is reasonably well adapted and safe. EVIDENCE: During this inspection communal areas, bathrooms, the kitchen and a sample of ground floor bedrooms were seen and found to be clean and comfortable. The gardens are well maintained and residents said that they looked forward to warmer weather when they will be able to sit outside. All bedrooms have en suite facilities. There are 19 single bedrooms and 3 rooms that can be occupied as a single room, or used by couples or friends who wish to share. At the time of this inspection a couple occupied one of the double rooms. There are three specialist bathrooms fitted with appropriate equipment. The home has two lounges, a conservatory and dining room providing choice over where to sit. There is a passenger lift between the ground and first floors. and Lympstone House Version 1.10 Page 15 level access throughout the home enabling people with mobility problems to move around the building as independently as possible. All areas were warm. Thermometers have been fixed around the home to enable staff and residents to check temperatures. Radiators have been covered to prevent the risk of scalding. Lympstone House Version 1.10 Page 16 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, 28, 29 The home has made excellent progress in staff training. Staffing levels, recruitment and induction arrangements ensure that residents’ needs are met by competent staff. EVIDENCE: Two additional care staff plus a manager have been recruited since the last inspection. 4 care staff, 1 manager, 1 cook and 1 cleaner are on duty in the mornings. In the afternoons and evenings there are usually 3 care staff and 1 manager. At night the home employs 2 waking care staff. In addition the owners live on site and oversee the management of the home. Residents expressed complete satisfaction in the number of staff provided, and in their kindness and expertise. Since the last inspection the number of staff with NVQ or nursing qualifications has increased. In addition 9 staff are about to start NVQ training. Police checks have been made on all staff, and file confirm that other required recruitment checks have been done. Lympstone House Version 1.10 Page 17 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) 31, 32, 37, 38 The home’s new manager is improving management arrangements so that residents’ needs and interests are becoming better met. EVIDENCE: A new manager has recently been recruited and her application for registration is currently being processed. During the inspection she provided evidence of a significant number of improvements she has made to the management of the home. Staff files are now complete, rotas are up-to-date, staff training is being developed and new care planning arrangements are about to be introduced. Staff talked about the improvements to the home since the new manager has been appointed and said the atmosphere was happy and open. Records sampled during the inspection included care plans, staff files, staff rotas, the accident book and fire log book. In the last year the level of training in fire procedures was well below that recommended by Devon Fire and Rescue Service. Lympstone House Version 1.10 Page 18 Lympstone House Version 1.10 Page 19 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. Where there is no score against a standard it has not been looked at during this inspection. 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 1 x 2 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 x 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 3 3 3 x 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x 3 3 x x x x 3 1 Lympstone House Version 1.10 Page 20 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 OP38 Regulation 23(4)(d) Requirement Timescale for action 1.6.05 2. OP3 14 The registered person must make arrangements for persons working at the care home to receive suitable training in fire prevention 1.6.05 The registered person must not provide accommodation to a resident unless their needs have been assessed by a trained and suitably qualified person. There must be appropriate consultation regarding the assessment with the resident or their representative. The registered person must confirm in writing that the care home is suitable for the purpose of meeting the residents needs. 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 OP12 Good Practice Recommendations Care plans should include details of residents social needs and interests, and plans drawn up to show how these needs will be met on a regular basis. Version 1.10 Page 21 Lympstone House 2. OP5 Prospective new residents should be encouraged to visit the home, or have a short stay, before a decision to move in permanently is made. If the prosective new residents are unable to visit consideration should be given to visiting the service users in their own home, and to ensure they are given good information about the home. 3. Lympstone House Version 1.10 Page 22 Commission for Social Care Inspection Exeter Office, 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 Lympstone House Version 1.10 Page 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. 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