Inspection on 15/01/09 for Lyndale

This inspection was carried out on 15th January 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

Lyndale 08/01/08

Lyndale 13/08/07

Extracts from inspection reports are licensed from CQC, this page was updated on 07/08/2009.

CARE HOME ADULTS 18-65 Lyndale 2 Alumdale Road Westbourne Bournemouth Dorset BH4 8HX Lead Inspector Jo Pasker Key Unannounced Inspection 15th January 2009 10:00 Lyndale DS0000069815.V373784.R02.S.doc Version 5.2 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 Lyndale DS0000069815.V373784.R02.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 Adults 18-65. 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. Lyndale DS0000069815.V373784.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Lyndale Address 2 Alumdale Road Westbourne Bournemouth Dorset BH4 8HX 01202 764425 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) Purple Care Ltd Mrs Sheila Fairbrother Care Home 9 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (9) of places Lyndale DS0000069815.V373784.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home providing personal care only - Code PC to service users of either gender whose primary needs on admission to the home are within the following category: Mental Disorder, excluding learning disabilities and dementia (Code MD) The Maximum number of service users who may be accommodated is 9. 8th January 2008 2. Date of last inspection Brief Description of the Service: Lyndale is registered as a care home providing residential care for up to 9 people under the age of 65 years old, who are experiencing mental health problems. The home is located in a residential area of Westbourne within a short walk to the beach and close to the community facilities of Westbourne. Local bus services are good and link to both Poole and Bournemouth town centres. Lyndale is an older style, detached house with a large garden for residents’ use to the rear. Accommodation is provided over two floors with 4 single rooms (3 with en-suite) and a shower room on the ground floor and 5 single rooms all with en-suite and a bathroom, on the first floor. Communal areas on the ground floor consist of a large open lounge and dining area and a shared kitchen. Car parking is available directly outside the home or in the surrounding roads. Purple Care Ltd owns the home and the Registered Provider is Mrs Miljana Kiss. The Registered Manager, is Mrs Sheila Fairbrother who oversees the day-to-day running of the home. The fee prices in January 2009 range from £495 to £600 per week for residential care. See the following website for further guidance on fees and contracts: www.oft.gov.uk (Value for Money and Fair Terms in Contracts). Lyndale DS0000069815.V373784.R02.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 2 star. This means the people who use this service experience good quality outcomes. This unannounced key inspection was carried out over approximately 4 hours on the 15 January 2009. This was a statutory inspection and was carried out to ensure that the residents who are living at Lyndale are safe and properly cared for. The Registered Manager, Mrs Sheila Fairbrother, was on hand throughout to aid the inspection process. Information gathered for this report came from several sources including: • Reports made to the Commission for Social Care Inspection by the home. • The annual quality assurance assessment (AQAA) completed by the home. • 7 questionnaires completed by residents, 2 by staff and 2 by healthcare professionals. • Tour of the premises. • Review of a variety of documentation including care records, staff records, maintenance records, policies and procedures. • Discussion with residents and staff. During the course of the inspection 3 residents and 3 staff were spoken with and asked their views on the service provided at the home. What the service does well: The home’s pre admission procedure is good and prospective residents are provided with information about Lyndale and are encouraged to visit, in advance of admission, to establish their impressions of life at the home and the standard of available accommodation. Individual plans and risk assessments are detailed, person-centred and informative ensuring residents and staff are fully aware of how needs and goals are to be met. People are able to make a range of choices about their daily lives. Residents are supported and encouraged to participate in activities, which interest them, to be part of their local community and to maintain links with family and friends so that they have networks of support outside of their home. Lyndale DS0000069815.V373784.R02.S.doc Version 5.2 Page 6 Daily routines in the home promote residents’ independence and there is a flexible approach to mealtimes, which promotes residents’ well-being and enjoyment of their meals. Access to generic and specialist health care services ensure that residents’ physical and mental health care needs are well met. Medication handling, storage and administration ensures that safety is maintained and residents’ independence is promoted. Sufficient staff numbers, appropriate training and recruitment procedures ensure that residents are well looked after, protected from unnecessary risk and have their needs met. What has improved since the last inspection? What they could do better: The staffing rota should provide an accurate reflection of when staff and management members are in the home and also provide full names. Lyndale DS0000069815.V373784.R02.S.doc Version 5.2 Page 7 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. Lyndale DS0000069815.V373784.R02.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Lyndale DS0000069815.V373784.R02.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents are provided with information about Lyndale and are encouraged to visit, in advance of admission, to establish their impressions of life at the home and the standard of available accommodation. EVIDENCE: The home has admitted three new residents since the last key inspection and the pre admission paperwork for all of these people was checked. Assessment forms were thoroughly completed and covered all relevant areas, sometimes also directing people to look at other risk assessments in conjunction with the pre admission, to give a fuller picture of an individual’s needs. A new pre admission checklist form has been implemented and now provides a record of any informal visits and overnight stays by a person, prior to them deciding whether to move into Lyndale. Of the 7 residents who completed the pre inspection surveys, all of them stated ‘yes’ to the question did you receive enough information about the home before you moved in, to help you make a decision. One person said that they had received an “interview before I moved in and full information”. Lyndale DS0000069815.V373784.R02.S.doc Version 5.2 Page 10 Lyndale DS0000069815.V373784.R02.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Individual plans and risk assessments are detailed, person-centred and informative ensuring residents and staff are fully aware of how needs and goals are to be met. People are able to make a range of choices about their daily lives and are involved in decision making within the home. EVIDENCE: The individual plans of 3 residents were seen. All contained detailed information on aspects of personal and social support, healthcare needs, leisure activities and independent living skills. A front sheet for all the individual plans demonstrated that they had all been discussed with the resident and then signed by the person and registered manager. Opportunities to disagree were also documented and the reasons why. Lyndale DS0000069815.V373784.R02.S.doc Version 5.2 Page 12 Staff spoken with were clear about each person’s individual needs and preferences and how to best support people in achieving their goals. Goal plans included attending social groups, seeing family and friends, household activities and personal health goals. Residents spoken with confirmed that they were supported to make their own decisions and this was also reflected in the surveys returned. When asked ‘can you make a decision about what you do each day?’ 4 people responded ‘always’ and 3 said ‘usually’. Health professionals commented that they felt Lyndale ‘always’ supported people to live the life they chose and that the staff were good at “meeting individual’s needs” and “encouraging independence”. Several risk assessments were seen and covered areas such as self-harm, road safety, anger management and fire risks. All assessments identified specific actions to be taken by the person or staff members in positively addressing each risk factor. Lyndale DS0000069815.V373784.R02.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are supported and encouraged to participate in activities, which interest them, to be part of their local community and to maintain links with family and friends so that they have networks of support outside of their home. Daily routines in the home promote their independence and there is a flexible approach to mealtimes. EVIDENCE: All residents attend a variety of other support groups/day centres within the community, which enable them to be with their peer group and take part in a range of activities. A recommendation was made at the last inspection as to how the residents could take more ownership/responsibility of their activity/information board. This had clearly been addressed, as the board was Lyndale DS0000069815.V373784.R02.S.doc Version 5.2 Page 14 full of relevant information, activities and support available and timetables of events. Another recommendation made at the last inspection was that an increased choice of activities should be available to ensure that residents are actively engaged more often. The AQAA submitted prior to this visit stated that a summer holiday had been arranged by the home and 6 residents and 2 staff had taken part in this. People spoken with said they had enjoyed the trip and were looking forward to another one this year. An activities book has also been started by the home and now provides a daily record of what activities are offered, who joins in and when they choose not to. Residents continue to attend appointments and activities themselves by getting public transport or going with their care manager. However, the registered provider has plans to provide a dedicated vehicle for the use of residents, as soon as the registered manager passes her driving test. Friends and family are warmly welcomed at Lyndale and people are able to use the portable office phone to make and receive calls in private when needed. Staff and health professional survey comments felt that Lyndale provided “a friendly, homely” and “very positive” environment and a real “sense of community”. The residents have suggested all meals provided and a suggestion list is available at all times. Acceptable alternatives are provided to anyone who does not like or is unable to eat the main meals of the day. The home is also knowledgeable about different dietary needs according to cultural or health reasons and provide for these sensitively. Generally staff prepare the food but residents are always encouraged to join in, particularly as part of their goal plans. Theme nights have also been introduced and are proving very popular, enabling residents to enjoy foods from different cultures and traditions, such as Shrove Tuesday pancakes and Chinese food. Lyndale DS0000069815.V373784.R02.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff have a good understanding of residents’ care needs and support is offered in a way that promotes independence and respects personal preferences. Access to generic and specialist health care services, ensures that residents’ physical and mental health care needs are well met and medication policies and procedures are well managed. EVIDENCE: The care records of 3 people who live at the home were looked at and found to contain appropriate assessments forming the basis for care plans and daily records, describing the care of each person. There was also evidence that these had been discussed with and signed by the person. The home continue to ensure that individuals’ health care needs, both mental and physical, are properly monitored and appointments made as appropriate. Lyndale DS0000069815.V373784.R02.S.doc Version 5.2 Page 16 Residents’ records continue to show evidence of liaison with generic and specialist health care services, for example general medical practitioners, care managers, cognitive therapists and psychiatrists. All medicine storage, recording and administration sampled, was well managed in accordance with the home’s policies and procedures. 5 residents self medicate and all had an appropriate risk assessment in place for this and staff responsible for the administration and handling of medication had received appropriate training. The controlled drugs cupboard is now also securely fixed to the wall, meeting a previous requirement made. Lyndale DS0000069815.V373784.R02.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a good complaints system, which ensures that any concerns are fully investigated and residents given an opportunity to raise any issues. Policies and practice to safeguard residents from potential abuse and harm are also promoted. EVIDENCE: Residents said that they knew how to complain and felt confident that if they had concerns or complaints, they would be listened to and taken seriously. All 7 people who completed a survey, stated ‘yes’, they knew ‘who to speak to if you are not happy’. The home has a clear complaints policy and procedure available to everyone and no complaints had been received by the home or the Commission since the last inspection. All staff have received training on the safeguarding of vulnerable adults, meeting a previous requirement made and the home has a written policy and procedure in place to support this. Staff were able to describe different types of abuse and the appropriate action to take, according to local policy, if any abuse of a resident was suspected. Since the last inspection the home has received no allegations of abuse. Lyndale DS0000069815.V373784.R02.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The standard of the environment at Lyndale is good, providing residents with an attractive, homely and safe place to live. EVIDENCE: Lyndale has a programme of on going maintenance and all of the environmental issues identified in the last report have since been addressed. A hand washing sink has been installed in the kitchen and new extractor fans fitted in the shower room and kitchen. The home appeared clean and fresh and all residents surveys returned also supported this. Hand towels are in use throughout the home but are changed and washed each day, in accordance with infection control procedures. The laundry remains adequately equipped and well run. Staff continue to receive infection control training as necessary. Lyndale DS0000069815.V373784.R02.S.doc Version 5.2 Page 19 Lyndale DS0000069815.V373784.R02.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 & 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Sufficient care staff are employed and receive the training and support needed to ensure that they are able to meet the residents’ needs. Good recruitment procedures and practice also protect people from the risk of unsuitable staff working at the home. EVIDENCE: Staff rotas demonstrated that there were sufficient staff on duty to meet the needs of the residents and this was observed in practice during the inspection. It was recommended that the surnames of all staff are documented on the rota, along with the hours of work of the registered manager and attendance of the provider at the home. It was observed that the member of staff on duty demonstrated a good awareness of people’s needs and personalities and was enthusiastic about her work. Staff felt that they provided a good standard of care to residents and were properly supported by the management and training provision. Lyndale DS0000069815.V373784.R02.S.doc Version 5.2 Page 21 It was noted in the last report that despite having several male residents, there was an all female staff team and it had proved difficult to recruit a suitable male employee. However, since then male staff have been employed, ensuring that people have a more equal choice of care. Two new staff files were viewed and found to contain all the required documentation. A suitable induction process is also in place and ensures that new staff work under supervision where necessary. All staff files seen contained evidence of training certificates and the registered manager and another staff member had recently attended training on the Mental Capacity Act. Some of the further training planned for the year included infection control, mental health, first aid, safeguarding adults, food hygiene and risk assessment. All staff have a minimum of level 2 NVQ in care or equivalent and everyone is also attending training for NVQ 2/3 award in business administration. Further information on available training can be accessed through the following websites: www.picbdp.co.uk www.skillsforcare.org.uk Lyndale DS0000069815.V373784.R02.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a registered manager and a quality assurance system in place that makes sure the running of the home is based upon the needs and interests of the residents. Practices in the home ensure that the health, safety and welfare of all are promoted and protected. EVIDENCE: The registered manager is Mrs Sheila Fairbrother, who has been the manager since the last inspection and subsequently registered by the Commission in September 2008. She demonstrated a good knowledge of the residents needs and appeared to be efficient and competent throughout the inspection. Lyndale DS0000069815.V373784.R02.S.doc Version 5.2 Page 23 The home submitted an annual quality assurance assessment (AQAA) prior to the inspection, identifying what they feel they do well, what they have improved during the last 12 months and their plans for improvement over the next year. There are various internal audits in place within the home, including medication, health and safety and the handling of resident’s money. Questionnaires are given to residents and involved professionals once a year to gain feedback on the service provided and copies of these were seen. Residents’ meetings are held on a monthly basis and a copy of the annual development plan has also been seen. There are good processes in place for regular staff supervision and the management of health and safety. Certificates seen were up to date and all fire safety measures undertaken, with the most recent fire risk assessment dated April 2008. Lyndale DS0000069815.V373784.R02.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Lyndale DS0000069815.V373784.R02.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action 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 YA33 Good Practice Recommendations Actual staffing levels should be accurately recorded on the staff rota to reflect what is happening in practice and document the full name of all people working in the home. Lyndale DS0000069815.V373784.R02.S.doc Version 5.2 Page 26 Care Quality Commission South West Region Citygate Gallowgate Newcastle upon Tyne NE1 4PA National Enquiry Line: Telephone: 03000 61 61 61 Email: enquiries.southwest@cqc.org.uk Web: www.cqc.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 Lyndale DS0000069815.V373784.R02.S.doc Version 5.2 Page 27 - 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. 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