CARE HOMES FOR OLDER PEOPLE
Lyndhurst, 120 Manchester Old Road, Middleton, Manchester, M24 4DY. Lead Inspector
Tracey Devine Unannounced 10th July 2005 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. Lyndhurst, F06 F56 S25481 Lyndhurst V236677 10.07.05 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service Lyndhurst, Address 120 Manchester Old Road, Middleton, Manchester, M24 4DY. 0161 643 9222 0161 653 8060 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) Lyndhurst Care Limited. Mrs Beverley Eagleton Care Home Only 33 Category(ies) of Old Age 33 registration, with number of places Lyndhurst, F06 F56 S25481 Lyndhurst V236677 10.07.05 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Within the maximum registered number 33 there can be up to :- 33 Older People (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 2nd November 2004 Brief Description of the Service: Lyndhurst Care provides care and accommodation for 33 older persons. The home is situated near to the centre of Middleton, and is close to shops, the bus terminus, pubs and leisure facilities. The home was opened in 1990 and has been extended to include purpose built rooms to the rear of the house. The home is two storey and has the provision of a passenger lift. Accommodation is provided in 29 single rooms and 2 double bedrooms. Ten of the bedrooms have the provision of en-suite toilet facilities. Three lounge areas (including a designated smoking area) are provided, plus a separate dining room. The home is well maintained both internally and externally. The gardens are attractively landscaped and accessible to service users. Ramped access is provided to one of the patio doors. Car parking is available to the rear and side of the home. Lyndhurst, F06 F56 S25481 Lyndhurst V236677 10.07.05 Stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection took place on Sunday 10th July 2005 by one inspector. The inspector arrived at 8.00am and left the home at 11.00am – a period of 3 hours. Time was spent time talking with 6 residents to see what they thought of the home, if they felt to be well looked after, and what they did during the day (how they kept occupied), if they liked the food and the staff. The inspector spoke with the Provider (Mr Jolly) and the deputy about how the routines of residents were respected, how they organised activities, and looking at some records which the home is required to keep about each resident and how they need to be looked after. The particular areas (standards) looked at on this inspection were: the records kept about residents, how residents spent their time; how they felt to be looked after, what the food was like, how staff supported residents, and if there were enough staff looking after residents. What the service does well: What has improved since the last inspection?
The Provider (Mr Jolly) has made sure that everything we asked him to do at the last inspection has been done. This means that paper towels and liquid soap is now in all communal toilets which promotes infection control, the person giving out medication now makes sure they sign the record immediately that they give out medication, and although Mr Jolly spends a lot
Lyndhurst, F06 F56 S25481 Lyndhurst V236677 10.07.05 Stage 4.doc Version 1.40 Page 6 of time at the home, he now records a formal visit once per month showing that he has asked residents and staff what they think of the home and the care provided. 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. Lyndhurst, F06 F56 S25481 Lyndhurst V236677 10.07.05 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Lyndhurst, F06 F56 S25481 Lyndhurst V236677 10.07.05 Stage 4.doc Version 1.40 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 standard(s) 3, standard 6 was not inspected as the home does not provide intermediate care The assessment process in place provides staff with sufficient information to ensure that they are able to meet residents needs. EVIDENCE: All service users admitted to the home receive an assessment of their needs prior to admission. For residents funded by the local authority this assessment is undertaken by their care manager. For residents funding their care privately, this assessment is undertaken by the Manager (Beverley Eagleton) of Lyndhurst. A number of assessments were evidenced and seen to contain all relevant information. Lyndhurst, F06 F56 S25481 Lyndhurst V236677 10.07.05 Stage 4.doc Version 1.40 Page 9 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) EVIDENCE: None of the key standards were inspected on this inspection. inspected at the next inspection. They will be Lyndhurst, F06 F56 S25481 Lyndhurst V236677 10.07.05 Stage 4.doc Version 1.40 Page 10 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, 14, 15 In the main, the care planning system in place ensures that residents’ needs and preferences are known to all staff promoting residents choices, and upholding their preferences for how they wish to live. The social activities on offer at the home promote residents intellectual and physical abilities ensuring that they feel stimulated and happy with life within the home. The meals in this home are good offering both choice and variety and catering for special dietary needs. EVIDENCE: Most of the care plans in place clearly evidence the needs of the residents. They are detailed and up to date, and show the preferences residents have for rising, retiring, use of room, religious needs, social interests, food likes/dislikes, preferred name, preference for bath or shower. A number of care plans still need to be fully completed, and the Manager has these set to one side. It was noted that of these at least 1 had been started some 8 weeks ago when the resident moved into Lyndhurst. Whilst it is normal for a short period of time to elapse from admission to drawing up a care plan allowing the staff to assess and gather further information regarding a resident, a period of 8 weeks for the care plan not be fully completed is too long.
Lyndhurst, F06 F56 S25481 Lyndhurst V236677 10.07.05 Stage 4.doc Version 1.40 Page 11 6 residents were spoken with, some whom had been at the home for a long time, and a newer resident. All said they enjoyed living at the home making comments such as “its lovely here”, “the staff are smashing”, “the food is lovely”, “you can do whatever you want here”, “the staff are marvellous, you can’t grumble”. Residents said they felt to be able to live as they wanted to, rising as they wish, staying up late, moving around the home and sitting wherever they want. The home provides a range of activities, and in response to a recent resident and relative questionnaire which highlighted that residents and relatives felt that activities could be done better, the Provider (Mr Jolly) has restructured the Deputy’s role to include specific time each morning for activities to take place. The deputy informed the inspector that she had recently attended another care home to look at how they organise activities in order that she could incorporate some of their good ideas into the range provided at Lyndhurst. She said she endeavours to undertake more one to one activity such as taking someone into Middleton town centre for a coffee and a cake, or to take them to do some shopping. An activity programme is on display in the entrance hall but this is not current. A review of the activities is being done. A small note book is kept in which the deputy records what she has done, and with who, on a daily basis. Whilst this gives some information it does not provide an overview of the activities offered at Lyndhurst. Regular singers attend the home, and a service with communion is undertaken by a local vicar once per month. Recent events include a summer fayre, which was enjoyed by residents – several residents said it “was a lovely day”. Coming up are trips to the local pub for lunch (twice in the next month), a birthday party, VE and VJ celebrations. To promote events, posters are displayed in the entrance hall near to the visitors book, and in the Newsletter produced regularly which is available to all residents and relatives. Lyndhurst has a lovely garden and good sitting out area to the rear. Garden benches and tables with umbrellas for shade are supplied, attractive flowers and foliage in place, level access provided and a patio area making it a safe and attractive area for residents to sit in. On the day of this inspection residents were seen to freely access this area from the dining room. Visitors are welcomed into the home and the visitors book evidences this. Residents spoken with said they could see visitors in their rooms if they wished, and many said they do so. Lyndhurst, F06 F56 S25481 Lyndhurst V236677 10.07.05 Stage 4.doc Version 1.40 Page 12 The cook has been employed at the home for a long time, and is well known to the residents and they to her. The menu in place is varied and nutritious with a good choice of food each day in place. The main meal of the day is served at lunchtime. Choices are available at tea time, and a member of staff ask each resident what they would like from the choices available. Residents were very complimentary about the food and the portions they received, making comments such as “plenty to eat and drink”, food “very good”. This inspection took place on a Sunday. Residents were seen to have the choice of a cooked breakfast, or their normal one of cereals, toast, tea/coffee. Lunch was a traditional roast with usual trimmings, and tea was a selection of different meals (hot and cold). Desserts are served with the lunchtime meal and the tea time meal. Special occasions are catered for i.e. birthdays celebrated with a cake and sherry, Bonfire night is celebrated with the provider setting off fireworks, and residents having parkin and treacle toffee, Pancakes served on Shrove Tuesday etc. Lyndhurst, F06 F56 S25481 Lyndhurst V236677 10.07.05 Stage 4.doc Version 1.40 Page 13 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) EVIDENCE: None of the key standards were inspected on this inspection. inspected at the next inspection. They will be Lyndhurst, F06 F56 S25481 Lyndhurst V236677 10.07.05 Stage 4.doc Version 1.40 Page 14 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) EVIDENCE: None of the key standards were inspected on this inspection. inspected at the next inspection. They will be Lyndhurst, F06 F56 S25481 Lyndhurst V236677 10.07.05 Stage 4.doc Version 1.40 Page 15 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 Sufficient staff are employed at the home ensuring that the needs of residents are met. Positive relationships have formed between staff and residents providing residents with a feeling of being valued. EVIDENCE: The rota evidenced sufficient staff are on duty at any one time. The staff are a stable and experienced group of carers, and interactions observed between staff and residents were seen to be positive, humorous and respectful. Residents spoken with said the staff “were marvellous”, “kept really busy, but always have time for you”, “they let me be as I want to be”. The rota did not detail the position of each member of staff such as who was a senior, who was a day carer, who was a night carer etc. This needs to be added. Lyndhurst, F06 F56 S25481 Lyndhurst V236677 10.07.05 Stage 4.doc Version 1.40 Page 16 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) EVIDENCE: None of the key standards were inspected on this inspection. inspected at the next inspection. They will be Lyndhurst, F06 F56 S25481 Lyndhurst V236677 10.07.05 Stage 4.doc Version 1.40 Page 17 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 N/A HEALTH AND PERSONAL CARE Standard No Score 7 x 8 x 9 x 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3
COMPLAINTS AND PROTECTION x x x x x x x x 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 Standard No 16 17 18 Score x x x x x x x x x x x Lyndhurst, F06 F56 S25481 Lyndhurst V236677 10.07.05 Stage 4.doc Version 1.40 Page 18 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 12 Regulation 15 Requirement A care plan must be drawn up and fully completed in a shorter period of time following admission to Lyndhurst. The rota must identify the role of each worker ie senior carer etc Timescale for action 29th July 2005 29th July 2005 2. 27 18 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 12 Good Practice Recommendations The activities programme needs to be updated, and a better record kept of the range of activities provided. Lyndhurst, F06 F56 S25481 Lyndhurst V236677 10.07.05 Stage 4.doc Version 1.40 Page 19 Commission for Social Care Inspection Turton Suite, Paragon Business Park, Chorley New Road, Horwich, Bolton, BL6 6HG. National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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