Inspection on 22/08/05 for Lyndale

This inspection was carried out on 22nd 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 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 08/02/07

Lyndale 27/01/06

Lyndale 10/11/04

Lyndale 08/07/04

Similar services:

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

Chirnside House

Keer Sands Residential Home

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

CARE HOMES FOR OLDER PEOPLE Lyndale 9 Rawlinson Road Southport Merseyside PR9 9LU Lead Inspector Claire Lee Unannounced 22 August 2005 nd 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. F53 F03 S17248 Lyndale V226630 220805 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Lyndale Address 9 Rawlinson Road Southport Merseyside PR9 9LU 01704 543304 01704 539226 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) Mr Richard Thomas Burdett Mrs Sheila Roberts Care Home 25 Category(ies) of OP Old age 25 registration, with number of places F53 F03 S17248 Lyndale V226630 220805 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users to include up to 25 OP 2.The service should at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection Date of last inspection 10th November 2004 Brief Description of the Service: Lyndale is a privately owned Care Home providing 25 registered places for nursing older people. The registered provider/owner is Mr Richard Burdett and the registered manager Mrs Sheila Roberts. Lyndale is a large detached converted house situated in a quiet residential area of Southport close to the town centre and Hesketh Park. Local amenities can be accessed by the local transport services, which are close to the home. The home has 23 single rooms, 8 with an ensuite facility and 1 double room. All areas of the home are accessible by the use of a passenger lift, stairs and a chairlift to the mezzanine levels (no lift access) on the first and second floor. There is a spacious attractively decorated lounge and this room is also used as a dining area. Bedrooms are of a good size and colour schemes are very pleasant. Bathrooms are well equipped to assist those who are less independent and there are handrails and a ramp to the main front door. A call system operates with an alarm facility throughout all areas. Residents are able to enjoy the homes large enclosed garden during the warmer months. F53 F03 S17248 Lyndale V226630 220805 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over 3 days, a total of 8 hours. It was an unannounced visit and was carried out as part of the regulatory requirement for care homes to be inspected at least twice a year. There has been no cause to visit the home since the last inspection in November 2004. For this inspection a partial tour of the home was conducted and care records and other nursing home records were viewed. Discussion took place with the owner, manager, care and trained staff, administrator, 2 relatives and 8 residents. Satisfaction cards were also left at the home for residents and relatives to complete at their leisure. What the service does well: Lyndale has a very pleasant relaxed atmosphere and residents and relatives interviewed confirmed that it is managed efficiently and staff provide a good standard of care. The routine of the home is based very much around resident wishes and relatives are encouraged to become involved and visit when they would like. A relative said, “it is a real home and could not be better”. The care is delivered by staff who are enthusiastic and motivated. There have been some changes to the workforce however the home now has a stable team and staff confirmed that Mr Burdett and Mrs Roberts provide a very good level of support with an ‘open door’ policy. Residents’ needs are assessed to ensure the home can care for them. Following admission a plan of care is drawn up and this records in good detail key areas including nursing, general welfare and social care. The documentation is organised, easy to read and generally subject to regular review thus ensuring records are up to date. Care staff are prompt to report any problems as they arise and care files evidenced hospital appointment and medical referrals at the appropriate time. F53 F03 S17248 Lyndale V226630 220805 Stage 4.doc Version 1.30 Page 6 Staff were observed as being very polite and offering good levels of assistance to residents with their personal care and with meals. A resident said, “the staff are always polite and help me where they can, I can’t ask for anything more.” The home is very well maintained and colour schemes attractive. Mr Burdett ensures all areas are decorated to a high standard and it is the attention to detail that makes the environment so pleasant. Residents commented on the time staff spend cleaning the home and all areas was observed to be spotlessly clean. 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. F53 F03 S17248 Lyndale V226630 220805 Stage 4.doc Version 1.30 Page 7 The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. F53 F03 S17248 Lyndale V226630 220805 Stage 4.doc Version 1.30 Page 8 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 F53 F03 S17248 Lyndale V226630 220805 Stage 4.doc Version 1.30 Page 9 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 Pre admission assessments carried out by the manager are detailed and help ensure that the home can meet the needs of the residents. EVIDENCE: All residents have an individual care file. Assessment documentation for 4 residents was seen and this had been completed in good detail. Information recorded included nursing and general health areas, for example skin care, nutrition, mobility, continence, sleep pattern, mental awareness, history of falls and family background. Supporting information was also available from hospital staff and social services. A relative confirmed that he had been fully involved with his wife’s admission. He also stated that the ‘settling in’ period was going well and staff were being very helpful. F53 F03 S17248 Lyndale V226630 220805 Stage 4.doc Version 1.30 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8,9 and 10 Residents health, personal and social care needs are addressed in care plans and care needs are met effectively. This ensures a good overall standard of care in the home. Medicines are administered according to the home’s policy and procedure. Staff were observed providing care and assistance to residents in a polite and sensitive manner. EVIDENCE: Residents have a care file and their needs are recorded in a plan of care. This information is drawn up from the initial assessment and from other health professional sources, for example social services. The care files are very organised, easy to read and staff interviewed had a good understanding and knowledge of residents’ needs. Care documentation was generally subject to regular review to ensure the information was up to date. Care plans involved the residents and/or their relatives who sign on their agreement. Consideration should be given to reviewing this agreement with the resident and/or relative when any change is made to the care provision. Supporting care documentation includes a waterlow score (an assessment tool for assessing pressure relief), nutritional and manual handling assessment. Residents are also weighed. General risk assessments for health and safety issues are F53 F03 S17248 Lyndale V226630 220805 Stage 4.doc Version 1.30 Page 11 completed; this includes the use of bed rails and where a resident is at risk of falls. It is also recommended that this be reviewed more frequently to reflect any change. Residents interviewed were happy for the manager to organise their care and said they were kept informed of any changes. A relative confirmed that the communication with the staff was very good and she was kept up to date with her mother’s care. GP visits are organised on behalf of the residents and these and other health professional appointments were recorded in the care files seen. A resident said, “I only have to ask and the staff help me to see my doctor.” Wound care management is provided however there were no residents who required this input at this time. Residents with diabetes were being carefully monitored by staff and the cook discussed their individual dietary needs. Resident spoken with were complimentary regarding the supportive and caring approach by staff. Comments included, “staff are very kind” and “staff are so helpful.” Discussion with residents confirmed that staff offer a good standard of privacy and are respectful of their individual wishes especially around personal care. Staff were observed assisting residents with their meals and also spending time chatting with them, good interaction was noted. A relative said, “the staff are very attentive and there is always a pleasant friendly atmosphere.” A number of medicine sheets were seen and these were completed to a satisfactory standard. No residents were self-medicating however they can undertake this practice following a risk assessment. The morning medicine round is completed prior to 8am by the night staff. Consideration should be given to administering these medicines later in the morning to ensure residents are not woken unnecessarily. F53 F03 S17248 Lyndale V226630 220805 Stage 4.doc Version 1.30 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13 and 15 There is a sociable atmosphere in the home and residents interviewed were happy with the daily routine. Social activities are well managed thus creating a positive atmosphere and visitors are made welcome. The home offers a well-balanced choice of nutritious meals. EVIDENCE: Residents interviewed said they enjoyed living at Lyndale, they commented on the relaxed ‘feel’ to the home and the staffs’ willingness to provide all comforts. A resident said, “I am able to go to bed when I want and also choose what I want to eat.” Another resident reported, “I decide whether I want to go to the lounge or stay in my room, the staff do not mind.” Activities are arranged ‘in house’ and residents also recently enjoyed an excursion on a barge. Film shows and musical entertainment are also arranged. A resident discussed a recent holiday with an ex member of staff which she really enjoyed. The home has an attractive garden and residents enjoy sitting out during the warmer months. Visitors were seen popping in at different times and meeting with residents in the lounge or in their bedroom. A relative brought in her dog during the morning and the hairdresser was providing a service. Residents are able to take their meals in their own rooms or in the lounge if preferred. The serving trays had attractive flower arrangements and lunch was nicely served. Some alterations have been made to the menu and the home F53 F03 S17248 Lyndale V226630 220805 Stage 4.doc Version 1.30 Page 13 now offers a choice of 2 hot meals at lunchtime. This is when the main meal of the day is cooked. Discussion with a number of residents confirmed that the food was good, always served hot and on time. The cook has a certificate in Advanced Food Hygiene and caters for special diets where appropriate. Satisfactory records were seen for environmental checks for food, fridge and freezer temperatures and the home had a good supply of fresh produce. Staff were helping residents with their meal in a sensitive a manner. F53 F03 S17248 Lyndale V226630 220805 Stage 4.doc Version 1.30 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 The home has a complaint procedure and residents were confident that their concerns would be listened to and acted upon. EVIDENCE: The complaint procedure for the home was on display in the main hall. Staff complete a complaint log should a complaint or a concern arise. Residents stated that they were happy with existing arrangements in the home and that they could always speak to a member of staff if they had any worries. No recent complaints have been received. Good effective lines of communication between residents, relatives and staff were noted and a resident said, “I have no grumbles at all.” F53 F03 S17248 Lyndale V226630 220805 Stage 4.doc Version 1.30 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,20,21,25 and 26 The home offers very comfortable ‘homely’ accommodation and all areas are well maintained. This contributes to a good quality of life for the residents. EVIDENCE: Lyndale is based over 4 floors. Accommodation is provided on the ground, first and second floor. The layout of the home is suitable for an older person and a chair lift is in place to access rooms on the mezzanine levels on the first and second floor. The manager to ensure residents can use the chairlift and assesses their dependency needs prior to admission. All areas are decorated to a very good standard and colours schemes are attractive. Residents interviewed were complimentary regarding the overall maintenance and the speed in which handy man jobs are undertaken. Emergency lighting is provided through out and subject to regular service checks. Where there is a need radiators have covers to minimise the risk of injury to the resident. External grounds are well maintained and there is car parking space to the front. F53 F03 S17248 Lyndale V226630 220805 Stage 4.doc Version 1.30 Page 16 The bathrooms are located on the first and second floor. These have bath chairs to assist residents who are less independent and checks of hot water temperatures are recorded to ensure water is delivered at a safe temperature. All areas of the home were spotlessly clean and residents confirmed that this is always the case. Housekeeping staff ensure rooms are cleaned daily and it was evident that they take great pride in maintained this high standard. Laundry is washed and ironed each day and returned promptly to the residents. Colourful bedspreads provide a nice touch to each bedroom. F53 F03 S17248 Lyndale V226630 220805 Stage 4.doc Version 1.30 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission 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 and 30 Sufficient numbers of staff were on duty to care for the residents however procedures for the recruitment of staff are not robust and do not provide the safeguards to offer protection to people living in the home. Some staff had not received the necessary training to ensure competency in their role. EVIDENCE: The off duty for the month of August 2005 was seen and these evidenced the numbers of staff on duty. Residents were pleased with staffing arrangements and felt their were enough staff about to help them. A registered nurse is on duty 24 hours a day with 6 staff in the morning, 4 in the afternoon, 3 in the evening and 1 at night. On occasions agency staff may be used however the permanent staff generally pick up any shortfalls. A number of care staff start their shift at 7am to assist the night staff with the serving of breakfasts. Residents interviewed were pleased with the staff and comments included, “lovely people”, “very friendly”, “nothing is too much trouble.” With regards to recruitment procedures, 3 staff files of new staff recently appointed were viewed. These evidenced completed job application forms, health declarations, visa status for oversees workers, job description and contract of employment. 2 written references had been obtained prior to appointment however they did not evidence the necessary police checks with regard to clearance from the Protection of Vulnerable Adults (POVA) register. This is a requirement prior to employment in order to protect residents from known abusers and was brought to the manager’s attention. Once POVA clearance is received, staff must then be supervised until a satisfactory F53 F03 S17248 Lyndale V226630 220805 Stage 4.doc Version 1.30 Page 18 Criminal Record Bureau (CRB) check at enhanced level is obtained. CRB checks only from previous employers were available. Some staff require training in safe working practice including manual handling, first aid, food hygiene, infection control and fire awareness. Courses are to be arranged over the next 6 months. Staff have an induction with the manager and competency in basic nursing skills is taught to new care staff who have no experience. A registered nurse discussed the good induction she received from the manager that included mentorship during the first 2 weeks. She stated that she felt “fully supported in her work.” F53 F03 S17248 Lyndale V226630 220805 Stage 4.doc Version 1.30 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 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) 33 and 38 Mr Burdett completes regular monitoring reports to ensure that the home is run in the best interests of residents. General safety certificates for equipment and services to the home including the fire log book were in date. This promotes the health and safety of the residents. EVIDENCE: Mr Burdett completes a written report following a visit to the home to inspect the building and meet with residents, relatives and staff. This quality assurance check ensures the home is running well and the report is then forwarded to the local Commission office. An up to date record was seen for the safety checks of the gas, electric, portable appliances testing, lift, manual handling equipment, fire prevention equipment and legnionella compliance. The fire alarms are tested weekly ‘in house’ by the staff. F53 F03 S17248 Lyndale V226630 220805 Stage 4.doc Version 1.30 Page 20 F53 F03 S17248 Lyndale V226630 220805 Stage 4.doc Version 1.30 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME 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 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 3 3 3 x x x 3 4 STAFFING Standard No Score 27 3 28 x 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x x x 3 x x x x 3 F53 F03 S17248 Lyndale V226630 220805 Stage 4.doc Version 1.30 Page 22 NO 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 Requirement All staff must recive a POVA first check and clearance prior to commencing employment and CRB at enhanced level Staff are to receive training in safe working practice areas including manual handling, first aid, infection control, food hygiene and fire awareness Timescale for action ongoing 2. 30 18 1.3.06 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. 2. 3. Refer to Standard 7 7 9 Good Practice Recommendations To review the plan of care with the resident and/or their relative To review health and safety risk assessments To administer the morning medicines after 8am F53 F03 S17248 Lyndale V226630 220805 Stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection Burlington House, South Wing, 2nd Floor, Crosby Road North Waterloo Liverpool L22 0LG 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 F53 F03 S17248 Lyndale V226630 220805 Stage 4.doc Version 1.30 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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