Inspection on 05/12/06 for Lynden Hill Clinic

This inspection was carried out on 5th December 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 22/11/05

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 Mrs Rhian Williams-Flew Unannounced Inspection 5th December 2006 12:35 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.V317425.R01.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 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.V317425.R01.S.doc Version 5.2 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) www.lynden-hill-clinic.co.uk Lynden Hill Clinics Limited 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.V317425.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. That the home can provide a service for up to five people under the age of sixty-five years. 22nd November 2005 Date of last inspection Brief Description of the Service: The Lynden Hill Clinic can provide care with nursing for up to 26 people. The categories of registration are for older people and/or people with physical disabilities. They are also able to provide care for up to five people under the age of 65 years but within the overall registered number. The home primarily provides support for residents who require intermediate care. There are a small number of residents who require continuing residential or nursing care. A physiotherapy unit is operated within the home and a hydrotherapy pool is also available on site. There are also occupational therapy services. There are a number of alternative therapies offered to the residents. The home is set in a private residential area. It is best accessed in a vehicle. The home is on three floors and there is a passenger lift to all levels. There are a variety of aids and adaptations to allow residents to move around the home independently. All the bedrooms are single occupancy. They have en-suite showers or bathrooms and toilet facilities. The fees in this home range from £950.00 - £3195 .00 There are different fee rates for different services. The fees quoted below are based on a seven-day stay. The lowest fee rate covers a package called a convalesce stay. For longer-term residents the fee rates range between £1000 and £1400. The orthopaedic/spinal package is approximately £1800; this includes all physiotherapy, hydrotherapy and occupational therapy. The neuro-rehabilitation package costs £3195; this includes physiotherapy, neuro-occupational therapy, massage, speech therapy and consultation with a professor of neurology. Lynden Hill Clinic DS0000065131.V317425.R01.S.doc Version 5.2 Page 5 There are additional costs for all packages of care, these include, medical consumables (other than medication by prescription), therapies, chiropody, hairdressing, additional catering, newspapers, clothing, laundry and drycleaning, the cost of telephone calls as well as items required of a luxury or personal nature. There are also charges for specialist medical equipment for example, pressure relieving mattresses, cushions, and mobile bells. These are invoiced in addition to the care fees. The home provides both a Statement of Purpose and Service User Guide. The Registered Manager states in the Service User Guide that the most recent Commission for Social Care Inspection report is available in the home should residents or potential residents wish to see it. Lynden Hill Clinic DS0000065131.V317425.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The accumulated evidence used to inform this report includes a provider quality assurance self assessment completed by the Registered Manager of the service; our inspection records held at the local office of CSCI; an unannounced site visit on 5 December 2006 and twenty CSCI surveys returned by residents or their representatives. The site visit took place between 12:35 hrs and 21:00 hrs and was conducted by one inspector. During the unannounced site visit conversations were held with some of the members of staff on duty; a tour of the service was made; a sample of case files were case tracked and some records concerning the management of the service were reviewed. The matron was present throughout the site visit and the Registered Manager was present from late afternoon. The inspector sought the views of the majority of the longer terms residents and the views of a few of the intermediate residents. The preferred term of reference for the people who live in this home is residents. As part of this unannounced inspection the quality of information given to people about the care home was looked at. People who use services were also spoken to, to see if they could understand this information and how it helped them to make choices. The information included the service users guide (sometimes called a brochure or prospectus), statement of terms and conditions (also known as contracts of care) and the complaints procedure. These findings will be used as part of a wider study that CSCI are carrying out about the information that people get about care homes for older people. This report will be published in May 2007. Further information on this can be found on our website www.csci.org.uk. What the service does well: This home provides relevant and up-to-date information about the services it provides and its contracts of care are clear and detailed. New residents are only admitted to the home if they have received a full assessment of their needs either by the referring professionals or the matron of a home. Residents who receive intermediate care receive an excellent service. They receive physiotherapy, occupational therapy and hydrotherapy from suitably qualified professionals. The promotion of independence for these residents is high. The residents in this home clearly indicated their complete satisfaction with the attentiveness and responsiveness of staff. Members of staff are very committed to providing a high quality service. Autonomy and choice for Lynden Hill Clinic DS0000065131.V317425.R01.S.doc Version 5.2 Page 7 residents are promoted. This was particularly evidenced through the procedures for the self-administration of medication and choices of food. The residents in this home are well protected by a robust complaints procedure and a staff team who have all received training in safeguarding vulnerable adults. The Registered Manager also evidenced that her recruitment procedures for permanently employed staff and self employed staff are robust and comply with the requirements of the Care Standards Act. The environment of the home is suitable for the residents who live there. A programme of refurbishment and maintenance is in place. The provisions of the aids and equipment within the home is excellent and are regularly reviewed by the Registered Manager to ensure they meet the needs of the residents. The satisfaction rating amongst residents with regard to the cleanliness of the home was extremely high. The members of the housekeeping staff are clearly committed to ensuring high standards. The home has a full complement of staff. They are suitably qualified and receive regular training to ensure their practice is up-to-date. The Registered Manager is qualified and competent to run the home. She has ensured that there are good systems of quality audit and assurance in place. She has also ensured that there are policies and procedures for all departments and services within the home to ensure its efficient management. What has improved since the last inspection? A previous requirement has been met as residents care plans are reviewed at regular times. The Statement of Purpose and Service User Guide have been updated to reflect the changes in the provision of service. This is good practice. All members of staff have received training in the safeguarding of vulnerable adults. This includes housekeeping and catering staff. Through the homes own quality assurance programme, changes have been made to the homes environment. Some of these changes have been in response to the changing needs of the residents. The specific changes have included the installation of en-suite wet rooms and showers instead of bathrooms. The matron has recently undertaken specific training in the supervision of staff and has implemented formal supervision for all staff with the aim of achieving this at least six times a year. Lynden Hill Clinic DS0000065131.V317425.R01.S.doc Version 5.2 Page 8 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. The summary of this inspection report can be made available in other formats on request. Lynden Hill Clinic DS0000065131.V317425.R01.S.doc Version 5.2 Page 9 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.V317425.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3 & 6 Quality in this outcome area is good. Lynden Hill Clinic does provide detailed information about the services it provides. The contracts of residency do specifically detail costs and any additional fees. Both short-term and long-term residents are assessed prior to their admission. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Statement of Purpose and Service User Guide have recently been updated. The Statement of Purpose primarily provides the information required by the regulations of the Care Standards Act. This document did not contain the arrangments made for dealing with complaints from residents although, it is published in the Service User Guide. Both documents need to include the information that residents can refer a complaint they might have to the Commission for Social Care Inspection at any stage and not just if they are not Lynden Hill Clinic DS0000065131.V317425.R01.S.doc Version 5.2 Page 11 satisfied with the way the provider has dealt with a complaint. The Registered Mananger assured at the site visit that these amendments would be completed promptly. The Registered Manager was able to provide evidence of the different types of contracts, which detailed the terms and conditions of residency for each of the category of resident they provide care for. The contract for permanent residents details the fees charged for the provision of the room, food, light, heat, nursing care, personal telephone and television. The contract clearly details the additional charges. There are three contracts for short-term residents for example, convalescence, post-operative care and neurological care. These three contracts specify the services provided for the costs charged. Of the residents spoken with, all confirmed that either they or their representatives had a written copy of their contract of residency and the Registered Manager confirmed that copies of these contracts were present in the home. Approximately 75 of the residents of this home are only there for a shortterm period of time. For these residents the homes admission criteria identifies that the referring hospital or doctor provides as much information as possible to enable the home to decide if they are able to meet the persons needs and offer them residency. The assessment record of three such residents were reviewed. It was evident that there was sufficient information in order for the home to make an assessment as to whether they could meet the persons needs. For the long-term residents the assessment of their need is carried out by the matron or senior sister usually during a home or hospital visit. The assessment records of five long term residents were reviewed. They contain sufficient information for the home to make an assessment as to whether they could meet the persons needs. The records also contained information about the residents preferences. This home does provide intermediate care for a significant number of residents. The home has specific rehabilitation facilities and equipment to promote the return to independence for these residents. The home has physiotherapists, occupational therapists and complementary therapists on its staff (or who are available on the sessional basis). They have specific dedicated facilities including a physiotherapy and hydrotherapy area. The comments from intermediate care residents who participated in the rehabilitation programme were extremely positive. Lynden Hill Clinic DS0000065131.V317425.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is good. The satisfaction rating from residents who receive care at this home is high however, the care plans do need to reflect the care given. The medication procedures in the home are safe however, the homes medication policy must reflect current practice in the home. The privacy and dignity of the residents in this home is a paramount principle that all staff uphold. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A previous requirement has been met as there was evidence that care plans are reviewed at regular times. However, there were some lapses for residents whose needs were changing more rapidly. Information could not be located in the designated areas of the care plans. This finding supports the verbal confirmation of the matron that, members of staff need to be monitored to ensure consistency in the way they complete information and where it is recorded. Lynden Hill Clinic DS0000065131.V317425.R01.S.doc Version 5.2 Page 13 The care plans for three of the short-term residents were reviewed and were found to cover the basic and specific needs of the residents. All the details required by regulation should be evidenced. The care plans for five of the long-term residents were reviewed. It was within these records that accessing information was more problematic. It is imperative that the residents plans provide detailed information about their current needs and how care staff are to implement actions to meet these needs. Evidence from the surveys completed by a significant proportion of residents indicate their complete satisfaction with the attentiveness and responsiveness of the staff. Comments such as, “ Always here when needed”; “If urgent attention is needed it I always provided”; “Extremely well looked after”. They indicate that they feel their needs are well met. In discussion with the matron she confirmed that all members of staff are very committed to providing a high quality service in order to meet all the residents needs however, evidencing how this is achieved through the written care plans is not as good. As she is aware of the deficit matron has already commenced monitoring and mentoring of the nursing and care staff to improve the quality of the written information. The medication procedures in the home have changed since a previous inspection. Each resident has a locked and secure cabinet within their room where their medicines are kept. If a resident expresses a wish to administer their own medication an assessment of their ability to do this is conducted and recorded. Medication administration records are kept for residents who selfadminister their medication. If residents choose to or, are not able to administer their own medication the nursing staff administer the medication from the residents own medication cabinet and complete the medication administration records. Any use of controlled drugs are only administered by registered nurses and they are stored within the clinical room in an appropriate cabinet. The controlled drugs register was reviewed and was found to be used appropriately and correctly. A policy (dated June 2006) with regard to the receipt, recording, storage, handling, administration and disposals of medicines was reviewed and found not to reflect the current practice in the home. The Registered Manager has given her commitment to revising this document by the end of December 2006. All of the service users spoken with and, those who responded to the surveys clearly identified that they felt that they were treated with respect and their dignity and privacy were always protected. There was a very high satisfaction rating in the questionnaires returned. Lynden Hill Clinic DS0000065131.V317425.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is good. The opportunities for the intermediate care residents are well met. The longer term residents needs with regard to social activity could be better met in an individualised way. Autonomy and choice for all residents is promoted and respected. Residents nutritional needs are well met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: For the intermediate care residents their focus of activity is primarily concerned with physiotherapy, occupational therapy, hydrotherapy and participating in any complimentary therapies they might feel beneficial. The responses in the surveys from these residents indicated that they felt their needs were always met. Comments such as, I have wonderful care and physiotherapy; the surgeon who performed my operation recommended the clinic as the most suitable place for me to receive the treatment I require. The social contact and activities the longer term residents are provided with include specific sessions of occupational therapy and physiotherapy throughout Lynden Hill Clinic DS0000065131.V317425.R01.S.doc Version 5.2 Page 15 the week but their comments indicated that they would prefer more individualised activities. The longer term residents are a much smaller group (during the inspection they numbered six) and their tastes and preferences for activities are diverse and difficult to meet within a small group. In discussion with the Registered Manager and matron they both saw the validity of individualised activities for the longer term residents. The home has recently canvassed the opinions of these residents about activities and social contacts. The Registered Manager should consider ensuring that the care plans for these residents include detailed reference to their preferences for activities and stimulation and how these are to be met in a more individualised way. The opportunities for all residents to receive visitors is a given at the home. If residents are undergoing specific treatments then visitors are encouraged to wait until the therapy session has ended. Some of the longer term residents were able to comment on visits to the local community. This is an activity they particularly enjoy and would welcome more opportunity to do. Others were content to visit the grounds of the home (which are extensive) for a daily walk. They also spoke of their enjoyment at receiving visitors. The home is able to meet the religious needs of all the residents if they require this. Residents are also able to exercise other choices and control over their lives. During the inspection members of staff were noted to be encouraging but respectful of the persons wishes as to whether they wanted to participate in a specific event. Approximately 65 of the respondents to the survey said that they always liked the meals presented to them. The remaining residents said they usually liked the meals. Some of the respondents commented that they were still recovering their appetite after surgery. A very small minority felt the choice did not always meet their preferences, but this was a matter of personal taste. A significant proportion of the comments received indicated that the food was, exceptionally good, a wonderful choice adapted to your needs, food is very good. Residents who were spoken with confirmed that if they had a preference for food, other than that indicated on the menu, the chef always accommodated their request. They also confirmed that if they required a snack meal outside of identified mealtimes this was also provided for. The home has a dining room where most of the residents are encouraged to take their meals. This provides a good opportunity for social contact amongst all the residents, both intermediate care and longer term care. As one resident commented, patients are encouraged to take meals in the dining room as soon as they feel well enough to have contact with other patients. Lynden Hill Clinic DS0000065131.V317425.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is excellent. The home has robust policies and procedures with regard to complaints and safeguarding vulnerable adults. All staff have received up-to-date training. Residents in this home can have confidence that there are systems in place and members of staff will know how to protect them. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All of the residents who completed CSCI surveys commented that they knew how to make a complaint. The home has a complaints procedure and aim to resolve complaints promptly. The Registered Manager confirmed there had been one comment about service delivery since the previous inspection which was quickly resolved to the satisfaction of the resident. The home does keep a record of all complaints and the details of any investigations conducted. Residents comments include, have no needs to complain; I give the clinic 99/100. The Registered Manager has confirmed that all members of staff including housekeeping and catering staff have received training in the protection of vulnerable adults since the previous inspection and, are familiar with the safeguarding adults procedures for Berkshire. Lynden Hill Clinic DS0000065131.V317425.R01.S.doc Version 5.2 Page 17 She has also confirmed that the home has an up-to-date policy with regard to the protection of adults. The Commission for Social Care Inspection have received no complaints regarding this service since the previous inspection neither have there been any referrals to the safeguarding of vulnerable adults service. Lynden Hill Clinic DS0000065131.V317425.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 22 & 26 Quality in this outcome area is excellent. This home is well equipped, clean and comfortable. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Registered Manager confirmed in the providers self-assessment that ongoing refurbishments have been made to improve the facilities in the home. These include the installation of new shower rooms and wet rooms; new television facilities; improvements to the landscaping of the garden; installation of window blinds and more housekeeping time. The installation of the new shower rooms and wet rooms is an ongoing project. These changes have been implemented as a result of assessing the needs of the people who use the home. Lynden Hill Clinic DS0000065131.V317425.R01.S.doc Version 5.2 Page 19 The comments from the residents who already have these new facilities was very favourable, particularly the wet rooms. The Registered Manager has also confirmed that refurbishments of carpeting and furnishing in some of the communal corridors and residents rooms will proceed in the next 12 months. This home is designated as a care home with nursing and therefore the amount of aids and adaptations within the home are greater than other care homes. The staff spoken with confirmed that the level of equipment provided is sufficient to meet the needs of the residents who live in the home and they have sufficient space in which to use the equipment. A significant majority of the beds at the home are fully adjustable. Every room has a call system which the Registered Manager has confirmed is regularly checked to ensure its complete operation. If residents require a mobile call system this can be provided. The physiotherapy department is separate from the main care home and is fully equipped. There is also a designated assessment kitchen used by the occupational therapist. The home also has a passenger lift which was noted to be very smooth in its operation. This is of particular relevance for people with mobility needs. The Registered Manager has confirmed in the provider self-assessment that the home fully complies with the requirements of the local fire service and environmental health department. 100 of the residents who responded to the survey said that the home is always fresh and clean. Comments such as, The cleaners are most efficient and often have to return several times if the patient is having medical attention. They are always friendly and cheerful, The home is constantly cleaned. The home has systems in place with regard to the control of the spread of infection to ensure the safety of the residents and members of staff. The home contracts with external laundry services and complies with the requirements of hygiene. Lynden Hill Clinic DS0000065131.V317425.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is good. This home has sufficient staff to meet the residents needs. They also receive regular and relevant training to ensure their skill levels are maintained. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Registered Managers provider self assessment confirms that there are sufficient staff to meet the needs of the residents who live in the home. The home is almost fully staffed; a few additional care staff are presently being recruited. The Registered Manager confirmed that all staff are employed to comply with the requirements of the Care Standards Act. The home also contracts with a number of self-employed individuals who are therapists. The Registered Manager ensures these people have undergone satisfactory vetting procedures to protect and safeguard residents before they fulfil their contractual obligations. The Registered Manager has also confirmed that at least 50 of the care staff have achieved their NVQ level 2 in care delivery and two other care staff will be attending this training in the near future. Lynden Hill Clinic DS0000065131.V317425.R01.S.doc Version 5.2 Page 21 The surveys returned by the residents unanimously praised the attentiveness and care delivered by the staff at the home. Comments such as, the staff are very helpful and caring, staff are always ready to answer any questions we may ask, the staff are most attentive they listen to what you say about your symptoms with understanding and suggest solutions to make your postoperative pain and your inability to fully function as easy as possible. The residents spoken with commented on the attentiveness, friendliness, kindness and care members of staff show towards them. A very small percentage of residents commented that they occasionally have a little difficulty understanding staff members whose first language is not English but not sufficiently so that they could not communicate their needs and wishes. The Registered Manager provided evidence of the individual training plans for all the staff employed in the home. The range of training provided is comprehensive and relevant to the needs of the residents who live in the home. Lynden Hill Clinic DS0000065131.V317425.R01.S.doc Version 5.2 Page 22 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 & 38 Quality in this outcome area is good. Residents can be confident that the Registered Manager is qualified, competent and experienced to run the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Registered Manager has confirmed that she has achieved her Registered Managers Award since the previous inspection. Her individual training plan demonstrates that she has maintained up-to-date knowledge with regard to the safety and management of the home and resident focused training. There is a matron appointed to manage the care delivery provided to the residents. Liaison between the matron and Registered Manager is good. The residents Lynden Hill Clinic DS0000065131.V317425.R01.S.doc Version 5.2 Page 23 spoken with were very positive about the role performed by both people. They commented on their responsiveness and willingness to address any matters raised. The home does have quality assurance and quality monitoring systems in place in order to seek the views of the people who use the service and live within the home. The residents spoken with confirmed that their views are regularly sought. Staff meetings are held to ensure that the views of staff are canvassed and information is communicated. The home has a number of departmental groups that regularly meet to monitor specific aspects of the management of the home. The matron has recently undergone training with regard to the supervision of staff and has recently implemented a system of supervision of all care staff. She has given her commitment to providing at least six supervision sessions for each member of staff throughout the year. The Registered Manager confirmed that she and matron would hope that another senior member of staff will also receive the training in the supervision of staff to enable matron to have support in supervising the staff team. The Registered Manager only safeguards the money of one resident. The home has robust procedures in place to ensure that this money is handled and managed, as procedures require. There are written transactions and, receipts are given to the resident. The Registered Manager has confirmed that all members of staff have received moving and handling training and fire safety training. All the catering staff have received food hygiene training. Key members of staff have received training in infection control and have provided cascade training to the other members of the staff team. A significant number of staff have received first aid training however, the home is not able to meet the standard of a qualified first aider being present in the home at all times. However, the Registered Manager has given her commitment to ensuring this standard is met in January 2007 which is the earliest that such training can be provided. The Registered Manager confirmed in the provider self-assessment that the health and safety of service users and staff are safeguarded with regard to the safe disposal of hazardous substances; the regular servicing of boilers and central heating systems; the maintenance of electrical systems and electrical equipment; the regulation of water temperatures in the risk of legionella; the maintenance of the safe environment throughout the home and the security of the premises. There is a deficit with regard to safeguarding hot surfaces. The home has risk assessed all radiator surfaces and has started a programme of works to cover all radiators. However, it was evidenced that some of these covers were not securely fastened, potentially creating another risk. Lynden Hill Clinic DS0000065131.V317425.R01.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 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 2 3 3 X X 4 HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 4 17 X 18 4 3 X X 4 X X X 4 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 X 2 Lynden Hill Clinic DS0000065131.V317425.R01.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. 1. Standard OP7 Regulation 15 Requirement Timescale for action 31/01/07 2 OP38 13(4) 3 OP38 13(4) The Registered Manager must ensure that the care plans reflect the current needs of the residents. This is particularly relevant when a residents needs are changing quickly. The Registered Manager must 31/01/07 ensure that staff receive training in first aid to ensure that there is a qualified first aider at all times. The Registered Manager must 31/01/07 ensure that hot radiator surfaces are risk assessed and safeguarded. This protection must be installed correctly without creating additional risks. Lynden Hill Clinic DS0000065131.V317425.R01.S.doc Version 5.2 Page 26 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 OP1 OP9 OP12 Good Practice Recommendations The Registered Manager carries through her commitment to include the information about complaints in the Statement of Purpose and Service User Guide. The Registered Manager carries through her commitment to amending the medication policy to reflect the current practice. The Registered Manager ensures that the activities and interests of the longer term residents are reflected in their care plans and their needs and wishes are met in more individualised ways as this is the preference of the residents. Lynden Hill Clinic DS0000065131.V317425.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Oxford Office Burgner House 4630 Kingsgate Oxford Business Park South Cowley, Oxford OX4 2SU National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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.V317425.R01.S.doc Version 5.2 Page 28 - 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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