Inspection on 04/02/09 for Lyndhurst Grove (1)

This inspection was carried out on 4th February 2009.

CSCI found this care home to be providing an Excellent service.

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Lyndhurst Grove (1) 09/01/07

Lyndhurst Grove (1) 20/12/05

Lyndhurst Grove (1) 30/03/05

Lyndhurst Grove (1) 20/07/04

Lyndhurst Grove (1) 03/02/04

Similar services:

22 Sandown Road

The Highlands

Dilston College Of Further Education

West View House

Prince Bishop Court

Park View (15)

Craigmore House

1 Lanark Close

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Lyndhurst Grove (1) Lyndhurst Grove (1) Low Fell Gateshead Tyne & Wear NE9 6AU     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Lee Bennett     Date: 0 4 0 2 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 26 Information about the care home Name of care home: Address: Lyndhurst Grove (1) Lyndhurst Grove (1) Low Fell Gateshead Tyne & Wear NE9 6AU 01914823104 01914823104 ntawnt.lyndhurst@nhs.net Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Northumberland, Tyne & Wear NHS Trust care home 6 Number of places (if applicable): Under 65 Over 65 1 learning disability Additional conditions: Date of last inspection Brief description of the care home 6 A bit about the care home Lyndhurst Grove is a home run by the National Health Service. 6 people can live here. It is a large house, set in it’s own garden. There are stairs to some parts of the home. This can make it difficult for some people to get upstairs. Bathrooms and toilets are easy to get in and out of. Everyone has there own bedroom. Nobody has to share. There is a car here for people to use. This means people can get out and about. Care Homes for Adults (18-65 years) Page 4 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This is what the inspector did when they were at the care home The Inspector talked to the people who live at the home. The inspector looked documents that have to be kept. He looked at: Care plans. Staff files. Medicine records. Some of the homes policies and procedures. (Policies are rules about how to do things. Procedures tell people how to follow the rules.) The inspector looked around the home. Care Homes for Adults (18-65 years) Page 5 of 26 This was to make sure it was safe and comfortable. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 7 of 26 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 8 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Detailed assessments of need are in place before a persons admission, and updated regularly, to make sure the home and the staff team can meet peoples identified needs. Evidence: All of the people living here have done so for some time now, with the last person moving here three years ago. Before these people moved here information was obtained from a social worker to ensure that their needs could be properly met at the home. This is so the manager had sufficient information about each person, and could make a judgment about whether the staff had the right skills and the home was physically suitable for the people concerned. The assessments provided by social workers include information about diversity needs, such as those relating to disability, gender, race and culture. For example, where people have particular religious beliefs, there attendance at church is assisted where necessary. Care Homes for Adults (18-65 years) Page 9 of 26 Evidence: After a person moves here their needs are periodically reviewed and if necessary reassessed. This is done with the involvement of a social worker, or other care professional, as well. For example, one person has had their needs looked at by a Speech and Language Therapist. This is to make sure Lyndhurst Grove remains the right place for people to live, and that staff have clear information to guide their care. It is from these reviews and reassessments that plans of care are developed. These reviews are undertaken at regular intervals or when a persons needs change. Social Workers have reassessed each service users needs, as the Council is reviewing this care home as a whole. These assessments have not been passed on to the manager of the home. There is also clear information available about the home and the terms and conditions about each persons stay. This has been done in an easy read format, that includes picture prompts. This is so people are kept well informed about what it is like to live here. Care Homes for Adults (18-65 years) Page 10 of 26 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people living here benefit from well planned care. This means that both service users and staff are well informed about what care is to be offered. Evidence: To help guide the care that staff offer to the people living here, a care plan file is compiled. All of the people living here have had one developed. These are all written up, evaluated and reviewed by the manager and a key worker; a member of staff who works with a named service user and takes a lead on the planning and delivery of care. Staff are currently working through these to make sure they are up to date. The care files contain extensive and detailed information on each persons needs, and are written in a person centred way. The care practice that we observed generally reflected the guidance in the care plans, although some aspects need to be updated, particularly in respect of catheter and pressure care. Closely linked to care planning arrangements are risk assessments. Again, these are Care Homes for Adults (18-65 years) Page 11 of 26 Evidence: written up by a key worker when there is an identified area of risk, either to the service user, or to others by that persons behaviour or needs. They follow a standardised format, and detail the area of risk, consider the benefits of certain risks being present, and outline how unnecessary risks are to be managed. We found that areas of risk were being documeneted for most aspects, but where needs had recently changed will need to be reviewed. Both care plans and risk assessments are a formal way of documenting decisions about improtant matters affecting a persons care and lifestyle. There are also occasional group meetings held. The people living here are clearly able to express their views and (sometimes with guidance) come to decisions about the things that affect them. Importantly, there is currently a review of this service being held by Gateshead Council, and the views expressed to us are that the people living here wish to remain so, and to continue living as a group. Care Homes for Adults (18-65 years) Page 12 of 26 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people living here are assisted to spend their time in an active and fulfilling way. This can help promote each persons sense of wellbeing. Evidence: On the day of the inspection, several of the people living here were spending their time at council day services. One person was having a day off, and was relaxing at home before going out to the shops. The people living here lead an active lifestyle and attend day services through the week, go out and about with staff, and often meet up with family and friends. They also have their own vehicle to help get further afield. Some of the people living here told us about the things they like to do, the holidays they have been on, and their plans for things to do this year. As well as going out and about or being occupied whilst in the home, contact with Care Homes for Adults (18-65 years) Page 13 of 26 Evidence: friends and relatives can affect the quality of life enjoyed by people. Most people living here have regular family contact, and visitors are made welcome. As well as having rights to keep up family contacts and to lead a varied and fulfilling lifestyle, the people here retain rights around how they are helped, and what staff do when they put themselves at risk of harm. To help meet these rights there is some guidance in care plans and risk assessments. The information in these is largely up to date. Furthermore, staff were able to explain to us clearly the individual needs of each person living here, any risks they may face, and how these are managed. Meals form an important part of peoples daily routine and lifestyle, and are normally taken as a group as the people living here usually get on well. This is an important time for people to talk about their day, and share their experiences with staff. The dietary needs of each person are detailed in their care plans, and there is a record kept of meals planned and provided. Where help and prompting is needed staff were able to explain the help they offer, with clear guidance also being available in each persons care plan file. This is so staff follow good practice guidelines, as this can often have important health implications for the people living here. Care Homes for Adults (18-65 years) Page 14 of 26 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Each individuals personal care and healthcare needs are well supported by systems that ensure privacy is respected and that health and welfare is monitored and maintained. Evidence: The people living here have their personal and healthcare needs outlined within their case files. Their needs are supported and met, where appropriate, in private. Specialist support and input has been sought and obtained where necessary, and multidisciplinary input (such as that from the Speech and Language Therapist, or with diet and nutrition) is made available. As well as making sure healthcare advice is sought, the registered manager, and other staff in the team, help the people living here to access healthcare treatment. This is so people get the help and healthcare they need to keep well. The results of healthcare visits and routine monitoring is recorded within each persons care file. This can help ensure that staff follow any advice and guidance that has been made by the healthcare professional. Care Homes for Adults (18-65 years) Page 15 of 26 Evidence: Linked to these health and personal care arrangements is the support given with medication. Due to their levels of need, service users are not able to administer their own medicines, and designated staff will help in this area. The staff here have had medication administration training (the safer handling of medication course). This has been supplemented by in-house guidance and competency testing. The medicines themselves are stored in a locked cupboard to keep them safe. There is only a small amount of loose stock, the rest being held in a monitored dosage system. This is where tablets are placed into a blister pack system by the pharmacist. Once given out staff write down who has had what medicine on printed administration records. A brief check of some of the medicines used here was carried out by us. All of the medicines we looked at were properly accounted for. Care Homes for Adults (18-65 years) Page 16 of 26 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Clear systems help protect people from neglect, abuse and self-harm. Evidence: A clear, written complaints procedure is available at the home. There have been no complaints reported to us since the last inspection. The people living here are aware of how to raise concerns and complaints, both in the home and to external agencies, such as Social Services and ourselves. The staff here have also received training on adult safeguarding and abuse awareness matters. Both the care providers and the local councils adult protection procedures are available here for staff to refer to. Care Homes for Adults (18-65 years) Page 17 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Lyndhurst Grove provides a homely and comfotable environment, but further adaptations are needed to meet peoples current and changing needs. Evidence: Lyndhurst Grove is an adapted, detached house, that allows for easy access for people who are physically frail or disabled to the ground floor only. As there are stairs to the first floor access here is limited. As a result of one persons changing needs, a temporary arrangement where they used the dining room as a bedroom was agreed with us. However, it is a year now that this has been the case, and adaptations (such as a through floor lift) need to be progressed to maintain access to all parts of the home for this person. This person is also having to use another persons private ensuite bathroom, which is an invasion of his privacy. As a whole the people living here are becoming less active and more frail, so such adaptations will enable them to remain here much longer than might otherwise be the case. Overall the home is domestic in style, and each persons bedroom has been personalised to suite their tastes. The home is clean throughout and there is good odour control. Care Homes for Adults (18-65 years) Page 18 of 26 Evidence: Lyndhurst Grove is a comforable home, and the people living here appear relaxed and at ease in their surroundings. Care Homes for Adults (18-65 years) Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people living here are supported by a well trained and qualified staff team. Evidence: There has been one new staff member recruited here since the last inspection. We were not able to see the staffing records as these are held elsewhere, however this has been agreed with us, and are periodically checked on a random basis. These checks have found that Northumberland, Tyne and Wear NHS Trust has robust preemployment checks in place, including checks for criminal convictions, against the Protection of Vulnerable Adults List, and reference checks from previous employers. Overall staffing levels and team members have remained reasonably stable and at the time of the inspection, six out of the eight support staff were qualified to NVQ level 2 in care [or higher]. Another member of staff is a Psychology graduate. The staff here also undertake periodic training on topics relating to safety and care. We found that all staff had received a one day mandatory course, covering topics such as first aid, health and safety, fire safety and moving and handling. Other topics have included infection control, catheter care conflict resolution and breakaway techniques. Training is one of the topics discussed at each staff members supervision session. Care Homes for Adults (18-65 years) Page 20 of 26 Evidence: These are one to one meetings that are held between a staff member and manager to discuss their performance, training needs, personnel and personal matters. Actions are agreed where necessary. These occur on a regular basis, to allow staff to feel supported and informed about developments at the home. Care Homes for Adults (18-65 years) Page 21 of 26 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users benefit from a well managed home, where quality and health and safety matters are regularly checked. This can help ensure the service remains focused on the needs and safety of the people who live here. Evidence: Lyndhurst Grove is overseen, on a full time basis, by the registered manager. She is supported by a deputy manager. The registered manager is qualified to NVQ level 4 in care and has also obtained an NVQ in management. As well as ensuring her own knowledge and practice remains up to date, the registered manager undertakes a number of quality checks and audits to ensure the standard of care is up to current good practice levels. More senior managers also carry out monthly inspections. Just as the quality of the care provided is checked, so are matters affecting health and safety. Therefore regular checks on the building are carried out, water and fridge / Care Homes for Adults (18-65 years) Page 22 of 26 Evidence: freezer temperatures are monitored, and working practices that could present a risk are looked at, and safe ways of working (for instance by the use of lifting aids) introduced. There were no hazards to health and safety observed. The chemical information sheets obtained to inform staff of what to do if they have an accident with a chemical product are mostly up to date, but one substance used did not have a corresponding data sheet (sterilizing tablet), although one was obtained via the internet during the inspection. Care Homes for Adults (18-65 years) Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 1 42 13 (4) C The registered person must 29/04/2007 arrange for COSHH data sheets to be available for all hazardous chemical products stored and used in the home. Care Homes for Adults (18-65 years) Page 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 29 23 Suitable adaptations must be made to the home. This is to ensure service users can access all shared areas of the home and their own bedrooms. This is to ensure service users can access all shared areas of the home and their own bedrooms. 26/06/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 25 of 26 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 26 of 26 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!