Inspection on 22/11/05 for Lynden Hill Clinic

This inspection was carried out on 22nd November 2005.

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 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

Lynden Hill Clinic 05/12/06

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE Lynden Hill Clinic Linden Hill Lane Kiln Green Nr Twyford Berkshire RG10 9XP Lead Inspector Katy Brown Unannounced Inspection 22nd November 2005 10:40 X10015.doc Version 1.40 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 Hill Clinic DS0000065131.V264042.R01.S.doc Version 5.0 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 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. Lynden Hill Clinic DS0000065131.V264042.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Lynden Hill Clinic Address Linden Hill Lane Kiln Green Nr Twyford Berkshire RG10 9XP 0118 9401234 0118 9401424 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) Lynden Hill Clinics Limited Miss Geraldine Gabriel McHugh, Mr Vithal Suvarna, Mr Ali Mohammed Lori, Mrs Carole Anne Easton Miss Geraldine Gabriel McHugh Care Home 26 Category(ies) of Old age, not falling within any other category registration, with number (26), Physical disability (26) of places Lynden Hill Clinic DS0000065131.V264042.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection N/A Brief Description of the Service: The Lynden Hill Clinic cares for 26 older people. It is set in a private residential area within reasonable driving distance to Maidenhead and Reading town centres. The home provides support for residents that require intermediate care and also long term placements for residents that require residential/nursing care. A physiotherapy unit is operated within the home and a hydrotherapy pool is also available on site. There are a number of alternative therapies that are offered to the residents during their short or long term stay. The home is on three floors and there is a passenger lift to all levels. There is a variety of aids and adaptations around the building to allow residents to move about more independently. All the bedrooms are single occupancy; however, some rooms that are used for intermediate care are double rooms and provide accommodation for residents relatives or representatives during their rehabilitation. All the bedrooms have ensuite bathroom and toilet facilities. Lynden Hill Clinic DS0000065131.V264042.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Lynden Hill Clinic was previously registered as an independent hospital and was regulated by the Healthcare Commission. The home now provides a service to residents requiring intermediate care and long term placements and transferred its registration to the CSCI in June 2005. The inspection took place over nine hours. There have been no additional visits made to the home since the last inspection. A tour of the premises took place and staff records, residents’ care records and some of the homes records were inspected. Six residents, two relatives and two members of staff were spoken to during the visit. The manager and matron were also spoken to. What the service does well: What has improved since the last inspection? This is the homes first inspection with the CSCI. Lynden Hill Clinic DS0000065131.V264042.R01.S.doc Version 5.0 Page 6 What they could do better: 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 Hill Clinic DS0000065131.V264042.R01.S.doc Version 5.0 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 Outcomes Statutory Requirements Identified During the Inspection Lynden Hill Clinic DS0000065131.V264042.R01.S.doc Version 5.0 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 the following standard(s): 2 & 3. All residents that are admitted to the home receive an assessment of care needs prior to their admission and are provided with a copy of the terms and conditions. EVIDENCE: The residents’ that were spoken to said that they had not visited the home prior to their admission; however, some relatives had been provided with an opportunity to do so. The staff at the home complete a pre-admission assessment and a comprehensive care needs assessment for all the residents. The residents confirmed that they had been given a copy of the service users guide, which informed them of the services provided and information about the terms and conditions of the home. Individual records are kept for each resident and an inspection of the records for five residents, confirmed that they had completed care needs assessments in place and terms and conditions had been provided. Lynden Hill Clinic DS0000065131.V264042.R01.S.doc Version 5.0 Page 9 Lynden Hill Clinic DS0000065131.V264042.R01.S.doc Version 5.0 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 the following standard(s): 7, 8 & 10. The residents are treated with respect and their healthcare needs are adequately met. The residents that receive intermediate care do not have plans of care in place. These residents could suffer from harm, as not all staff might be aware of the residents’ needs or risks to them. EVIDENCE: Individual plans of care are available for the residents requiring long-term support; however, the residents that require intermediate care do not have completed plans of care in place. The completed plans of care that were seen for residents living at the home were detailed and contained information about their healthcare needs, dietary requirements, personal care needs, likes and dislikes and hobbies and interests. Risks that have been identified had completed risk assessments in place. In the past, formal reviews of care have not taken place; however, the manager and matron of the home have identified this deficit and are taking action to ensure that this is now achieved. The residents’ say that they are aware of the content of their plans of care and that their personal care needs are met by the staff at the home. Lynden Hill Clinic DS0000065131.V264042.R01.S.doc Version 5.0 Page 11 Discussion with the residents, relatives and the staff indicated that the healthcare needs of the residents were being met. The G.P. visits the home every week and the residents say that the staff are proactive when they are feeling unwell or require help and advice. The home provides a number of alternative therapies for the residents and residents confirmed that they do take the opportunity to explore the wide range that is available to them. The matron of the home says that the communication between the staff and the G.P is good and contributes effectively to the residents’ healthcare provision. The residents say that they are happy at the home and that the staff treat them extremely well. They also say that their personal care needs are managed sensitively and that staff are never rude or disrespectful towards them. This was a view that was also expressed by relatives. Lynden Hill Clinic DS0000065131.V264042.R01.S.doc Version 5.0 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 the following standard(s): 12, 13 & 14. The residents receive a service that meets their social and cultural needs and they are able to exercise choice and control over their lives. Relationships with family and friends are maintained and encouraged. EVIDENCE: The manager advised that one of the directors of the home has now taken responsibility, for the review and co-ordination of the activities that are provided for the residents. The matron confirmed that activities include both internal and external opportunities and that a residents meeting has been planned to generate a discussion between the residents, to assess, which type of activities they would prefer and whether the current activities are appropriate to their needs. The manager and the matron confirmed that the home is able to meet the cultural and religious needs of the residents and they are able to take communion at the home if they wish. Church services are held in a private area when required. There is also a convent within the neighbouring grounds and the matron confirmed that the residents are permitted to visit the convent and take part in the services if they choose to. During a discussion with the residents, concern was raised regarding the isolation and feelings of loss that are experienced by some residents that receive long-term care at the home. One resident spoke of establishing relationships with people receiving intermediate care and then feeling emotionally upset and lonely when they leave after a few weeks. Although Lynden Hill Clinic DS0000065131.V264042.R01.S.doc Version 5.0 Page 13 there are currently five residents that have been placed at the home for longterm care, they do not meet regularly as a group and staff have not encouraged them or facilitated opportunities for them to bond together. Currently, there is not a key worker system in place to enable residents to receive personal care and emotional support from an individually named member of staff. The manager and the matron confirmed that this is being reviewed. The residents say that they are able to receive visitors when they choose and that visitors are always made to feel welcome. Staff support residents’ to maintain contact with friends and family and a telephone and use of the internet is available to all the residents. Visits by friends and relatives are encouraged at the home and staff and the manager confirmed that they always try to make visitors feel welcome. A relative has been staying with his wife at the home while she receives intermediate care; he spoke very highly about the staff and the services that are provided. The matron and the manager have recently planned to arrange meetings for the residents to enable them to have a say in how the home is run. Lynden Hill Clinic DS0000065131.V264042.R01.S.doc Version 5.0 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 the following standard(s): 16 & 18. Residents and relatives are confident that their complaints will be taken seriously and investigated properly. The policies, procedures and care practices at the home protect the residents from abuse. EVIDENCE: Residents and relatives that were spoken to say that although they had not made a complaint, they would feel comfortable if the need arose. They say that they believed that their complaint would be taken seriously. All the residents have a copy of the complaints procedure and the staff keep a record of complaints that are made. There is a clear audit trail in place and the progress of a complaint is easy to follow. The CSCI has not received any complaints in respect of this service The manager confirmed that all staff that are working at the home, have received satisfactory pre-employment checks and the residents say that they feel safe and protected within the environment. The home has a policy for abuse and has adopted the Berkshire inter-agency procedures. However, the policy does not cross reference to the Berkshire procedures and the staff at the home, do not currently have the contact details for the local authority vulnerable adults co-ordinator and are not able to contact them directly if they wish to report any concerns. The manager and the matron have agreed to review this. The manager confirmed that all staff receive training in abuse and systems are in place to ensure that appropriate records are kept for allegations or incidents of abuse. Lynden Hill Clinic DS0000065131.V264042.R01.S.doc Version 5.0 Page 15 Lynden Hill Clinic DS0000065131.V264042.R01.S.doc Version 5.0 Page 16 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 the following standard(s): 19 & 26. Residents live in a clean and safe environment. EVIDENCE: The residents say that they are happy with the environment that they live in and that it is clean, well decorated and maintained. They say that the furniture is comfortable and the garden is spacious and they enjoy the use of the facilities. The general appearance of the home is satisfactory and presents as warm and homely. The premises are clean and there are no offensive odours throughout the building. There are policies and procedures available for infection control and the manager confirmed that staff receive training in health and safety. Lynden Hill Clinic DS0000065131.V264042.R01.S.doc Version 5.0 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 consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27. There are a sufficient number of staff that are suitably trained to care for the residents. EVIDENCE: The residents and the relatives say that there are sufficient numbers of staff that work at the home and they are not kept waiting for lengthy periods of time when they require support. The staff rota indicates that that there are seven members of staff during the morning, five staff during the afternoons and evenings and three waking staff at night. The manager confirmed that that each shift provides a number of qualified nurses that provide specialist care for the residents. The home also has domestic staff that attend to the household tasks. Domestic staff that were spoken to were clear about their roles and do not provide a personal care service for the residents. Lynden Hill Clinic DS0000065131.V264042.R01.S.doc Version 5.0 Page 18 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 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33 & 35. The home is run based on the views and opinions of the residents and safeguards are in place to provide support with their finances. EVIDENCE: The residents do not yet attend regular meetings; however, they are provided with opportunities to express their views and opinions. Residents are provided with a comment card/ questionnaire prior to their discharge from the home. The questionnaire is designed to seek the views and opinions of the residents regarding their stay at the home. Questionnaires that were sampled indicated that the residents were satisfied with the service and would recommend the home to other people. The manager does not take sole responsibility for any of the resident’s finances. The residents, relatives or representatives are responsible for the management of finances and individual safe deposit boxes are available in their rooms. There is a safe at the home for the storage of valuable items. Lynden Hill Clinic DS0000065131.V264042.R01.S.doc Version 5.0 Page 19 Individual financial records and receipts are kept for the residents’ purchases and then invoices are generated each month. Lynden Hill Clinic DS0000065131.V264042.R01.S.doc Version 5.0 Page 20 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x 3 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 1 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 x COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x x 3 x 3 x x x Lynden Hill Clinic DS0000065131.V264042.R01.S.doc Version 5.0 Page 21 Are there any outstanding requirements from the last inspection? N/A 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 OP7 Regulation 15 Requirement The registered person ensures that all residents are provided with plans of care and that they are reviewed. Timescale for action 22/12/05 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 The registered person ensures that the residents that receive long term care at the home are encouraged to integrate and form relationships. A key-worker system should also be introduced at the home. The registered person ensures that the abuse policy for the home cross references to the Berkshire inter-agency procedures and that staff are provided with the contact details for the local authority vulnerable adults coordinator. 2 OP18 Lynden Hill Clinic DS0000065131.V264042.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Berkshire Office 2nd Floor 1015 Arlington Business Park Theale, Berks RG7 4SA 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 Hill Clinic DS0000065131.V264042.R01.S.doc Version 5.0 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. 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