Inspection on 11/02/06 for Lynden

This inspection was carried out on 11th February 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Lynden 10/07/08

Lynden 15/06/06

Lynden 24/05/05

Lynden 04/11/04

Lynden 03/06/04

Lynden 23/02/04

Lynden 09/10/03

Lynden 28/10/02

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

CARE HOME ADULTS 18-65 Lynden 18 Thornton Road Morecambe Lancashire LA4 5PE Lead Inspector Mrs Jennifer Dunkeld Unannounced Inspection 11th February 2006 10:00 Lynden DS0000009678.V270535.R01.S.doc Version 5.1 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 Lynden DS0000009678.V270535.R01.S.doc Version 5.1 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. Lynden DS0000009678.V270535.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Lynden Address 18 Thornton Road Morecambe Lancashire LA4 5PE 01524 420762 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) Mrs Kathryn Lesley Regan Mr Robert John Murray Care Home 11 Category(ies) of Learning disability (11) registration, with number of places Lynden DS0000009678.V270535.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 24th May 2005 Brief Description of the Service: The Lynden has been registered for a number of years to care for up to 11 adults with a learning disability The home is a large terraced property in Morecambe, situated close to the promenade. There are two lounge/dining rooms for the use of the people who live at The Lynden There are 9 single bedrooms and 1 flat, which has a double bedroom. A married couple currently occupy the flat. There is a patio to the rear of the home where the residents may sit out, weather permitting. Lynden DS0000009678.V270535.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was the second of two to be carried out this year. The inspection was unannounced, in that neither the people who provide the service nor the residents and staff were aware that it was to take place on the Saturday 11th February 2006 at 13.45 The inspection lasted 3hrs The inspection was carried out to ensure the home complied with the National Minimum Standards for Adults. A large part of this inspection was spent talking with the residents and observing the staff at work. In the report there are references to the “tracking process”, this is a method whereby there is a focus on a small group of residents. All records relating to these individuals are examined, along with the rooms they occupy in the home. Residents are invited to discuss their experiences of the home; this is not to the exclusion of the other residents who contributed in many ways. All the residents spoken with said they liked living at The Lynden. One man said ‘They staff are lovely and we all get on well’. Another said ‘I like living here and we are going on holiday’ When asked ‘what would you do if you were unhappy about something?’ the general response was ‘tell Kath or the staff ‘ There were two care staff on duty at the time of the visit. One of the care staff was going out for the afternoon with two of the residents. The other member of the care staff who had worked at the home a number of years said that she was in charge for the afternoon she was busy preparing drinks and a meal for the residents. The inspector gained the impression that the quality of life for the residents was as they choose it to be and therefore met their needs. The member of staff spoke with the residents in a respectful manner and offered choices to people. The Inspector spoke with the staff on duty who was positive about the home and the care on offer. The home’s records that are required to be maintained were viewed by the inspector, who was able to confirm these were maintained in a manner to protect the residents. Lynden DS0000009678.V270535.R01.S.doc Version 5.1 Page 6 What the service does well: What has improved since the last inspection? What they could do better: The service provider must ensure that fire doors at top of stair well and the one leading into the kitchen are not wedged open as this practice would lead to the spread of fire should one break out. Lynden DS0000009678.V270535.R01.S.doc Version 5.1 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. Lynden DS0000009678.V270535.R01.S.doc Version 5.1 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 Lynden DS0000009678.V270535.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of these Standards were assessed as the Key standards were evidenced as being met during the previous visit to the home. EVIDENCE: Lynden DS0000009678.V270535.R01.S.doc Version 5.1 Page 10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 9 The people who live at The Lynden know that their needs will be met and they have a life style of their choosing. They are enabled to take calculated risks in order to develop and achieve their goals. EVIDENCE: The plans of care viewed as part of the ‘Tracking Process’ covered all aspects of care, reflecting peoples individual needs. They include risk assessments as appropriate ensuring people are enabled to take calculated risks but are protected from harm. For instance some people are capable of going into the community unescorted and so on a regular basis. Other residents have been risk assessed as needing staff support to enjoy the locality and this is provided, ensuring people have their rights to access the community upheld. Indeed during this inspection 2 residents were out shopping with a member of staff. The risk assessments seen covered aspects of care such as; Moving and handling Falls And Nutrition Lynden DS0000009678.V270535.R01.S.doc Version 5.1 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 15 & 16 The rights of the residents are respected ensuring they are content in their home. There is strong evidence that the residents are enabled and encouraged to have appropriate personal and family relationships resulting in people feeling happy and fulfilled in life. EVIDENCE: Two of the residents have married each other while living at The Lynden. They had known each other for a large part of their lives but had restricted contact while living in their previous setting. The providers and staff at The Lynden enabled the relationship of the two people to develop according to the wishes of the individuals concerned. Discussions with the two residents in their flat, which forms part of the home, outlined their happiness in life, with comments such as ‘We are very happy here’ and ‘The staff are very kind’ Another resident spoke the visits his cousin makes to see him and how the staff ‘always make him a cup of tea’. Lynden DS0000009678.V270535.R01.S.doc Version 5.1 Page 12 The residents spoken with as part of the ‘Tracking process’ stated that the staff respect their rights and that they are free to come and go as they choose within a risk assessment framework. One man said he’d been out on his own shopping that morning and also said that he sometimes goes to the Isle of Man by himself. Two residents were out with a member of staff for the majority of this inspection. Each resident is offered a key to their own bedroom door ensuring his or her privacy is respected. They also have a key to the front door reflecting the respect for them as individuals with a right to be able to enter their home without having to ring the doorbell. The residents are on the electoral roll and choose whether or not to vote at election times. Lynden DS0000009678.V270535.R01.S.doc Version 5.1 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 The people who live at The Lynden are supported to ensure their physical and emotional health needs are met. The staff provide personal support to people in a way that suits the residents needs and preferences meaning that, residents remain satisfied and contented in their care. EVIDENCE: The care files are well organised and the information contained in them covers all aspects of care ensuring all physical health and emotional needs are met according to the individuals needs and preferences. A record is maintained of ‘Professional visits’ including health professionals such as; District nurse, GP. Each file has a form entitled “When I die” ensuring that the arrangements upon death are according to the individual’s needs and preferences. However these forms have not as yet been completed. The provider should arrange for each resident to be consulted as to their requirements. Lynden DS0000009678.V270535.R01.S.doc Version 5.1 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 23 The home provides a homely environment where people are safe. The homes policies and procedures are robust and ensure people are protected from abuse. EVIDENCE: The homes policies in relation to the protection of adults from abuse are in line with the Department of Health Guidance ‘No Secrets’ The carer in charge of the home during this visit explained that if an allegation of abuse was made to her she would report it to Kath (service provider) immediately. The carer was aware of the homes policy. She added that all staff have a booklet covering all aspects of care including protecting people from abuse. The homes external doors are kept locked to prevent intruders. The homes types of lock ensure that the residents can exist the building in an emergency without the use of a key. Each resident has a copy of the homes complaints procedure, which is available in pictorial format to enhance peoples understanding. The residents said that if they were unhappy about something they would ‘tell Kath or the staff and they would sort it out for them’ Lynden DS0000009678.V270535.R01.S.doc Version 5.1 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 The Lynden provides people with a homely and comfortable environment. There is an intention for the home to be safe. EVIDENCE: Since the last inspection the furnishings in the two lounge/dining areas have been replaced enhancing the homes appearance. The residents said they liked the new chairs. They pointed out that they also have new TV’s. Whilst the home is generally a safe environment, the practice of wedging fire doors open could put people at risk should a fire break out. This issue in relation to the kitchen door has been raised during a previous inspection. Whilst recognising that staff when preparing meals wish to able to hear if they are needed. However this a situation that the provider needs to address, maybe there is a need for additional staff at these times of day. One residents bedroom wall has a damp patch which needs to be repaired and then redecorated to her choosing. Lynden DS0000009678.V270535.R01.S.doc Version 5.1 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 36 Generally a good compliment of trained staff are employed within the home and residents needs are met to a satisfactory standard. EVIDENCE: Two carers were on duty during this inspection, neither were employed as Senior carer. However the member of staff who had been in employment the longest said she was taking charge. The other carer took 2 residents out for the afternoon, which was pleasing to see. The one in charge was preparing the meal and caring for the remaining 5 residents. However the 5 remaining residents were able to summon assistance should they require it. The care staff stated that they receive formal supervision on a regular basis. The residents stated that the ‘staff are good’ ‘We can have a laugh with the staff’ and ‘The staff are good to us’ The carer stated that the homes provider is always willing to listen to concerns. Lynden DS0000009678.V270535.R01.S.doc Version 5.1 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 39 The residents are verbally consulted about the quality of services on offer within the home ensuring they are confident that their views matter. EVIDENCE: The residents told said that they have meetings ‘sometimes’ to discuss various issues such as holidays and also to share their thoughts about the service they receive. The records of these meetings are held on each person’s individual file and were seen during this inspection. During this inspection the residents spoke freely and confidently with the staff about various topics such as what they would like for tea. The three files viewed as part of the ‘Tracking Process’ had a questionnaire entitled ‘Consumers Survey’ however only one of the three files had a completed questionnaire the others were blank. The form reflects a good intention to ensure people are formally consulted. There is a need to put this form to use ensuring the opinions of the residents are recorded. Lynden DS0000009678.V270535.R01.S.doc Version 5.1 Page 18 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 X 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 x 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 X STAFFING Standard No Score 31 X 32 X 33 X 34 X 35 X 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score X X X 3 x LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 4 16 3 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X 3 X x X X 2 X X X X Lynden DS0000009678.V270535.R01.S.doc Version 5.1 Page 19 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. 2. Standard YA24 YA24 Regulation 23(4)(a) 23(2)(b) Requirement The service provider must ensure that fire doors are not wedged open. The service provider must ensure the bedroom that has a damp patch on the wall is repaired and decorated. Timescale for action 28/02/06 31/03/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Lynden DS0000009678.V270535.R01.S.doc Version 5.1 Page 20 Commission for Social Care Inspection North Lancashire Area Office 2nd Floor, Unit 1, Tustin Court Port Way Preston PR2 2YQ 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 Lynden DS0000009678.V270535.R01.S.doc Version 5.1 Page 21 - 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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