Inspection on 13/12/05 for Lyngate Care Home

This inspection was carried out on 13th December 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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

Lyngate Care Home 24/11/08

Lyngate Care Home 22/07/08

Lyngate Care Home 01/04/08

Lyngate Care Home 17/10/07

Lyngate Care Home 24/05/06

Lyngate Care Home 23/05/05

Lyngate Care Home 14/12/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Lyngate Care Home 236 Wigan Road Bolton Lancashire BL3 5QE Lead Inspector Sue Evans Unannounced Inspection 13th December 2005 09:45 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 Lyngate Care Home DS0000059303.V263910.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Lyngate Care Home DS0000059303.V263910.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Lyngate Care Home Address 236 Wigan Road Bolton Lancashire BL3 5QE 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) 01204 62150 Lyngate Health Care Limited Mrs Ann Marie Else Care Home 41 Category(ies) of Old age, not falling within any other category registration, with number (41) of places Lyngate Care Home DS0000059303.V263910.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The Home is registered for a maximum of 41 service-users to include: Up to 41 service-users in the category of OP (Older People) The service should employ a suitably qualified and experienced Manager who is registered with the Commission for Social Care Inspection. 23rd May 2005 Date of last inspection Brief Description of the Service: Lyngate is a privately owned care home providing care and accommodation for up to 41 older people. The home is situated in a residential area of Bolton approximately 1 mile from the town centre. There are bus routes, shops, a bank, and other community facilities close by. The home is on three floors and it has 29 single bedrooms and 6 doubles. Twenty four of the rooms are en-suite. There are four lounge/dining rooms and an activities lounge. Three of the lounges have kitchenettes where residents and visitors can make drinks. There is a garden at the front of the home and a car park at the back. The home is fitted with suitable adaptations and equipment such as a passenger lift, assisted baths and showers, portable hoists, and grab rails. In addition to care staff, the home employs an activities co-ordinator, cooks, kitchen assistants, domestic staff, and a maintenance worker. Lyngate Care Home DS0000059303.V263910.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out by 2 inspectors over 1 day for a period of 7 hours each. The time was spent watching what went on in the home, talking at some length to 6 residents and more briefly with others, talking to a visiting relative, interviewing 2 staff members, examining some key records, and interviewing the manager. One inspector ate lunch with the residents. This inspection was the second to take place in the current inspection year. In order to gain a fuller picture of the home, this report needs to be read in conjunction with the report of the previous inspection of May 2005. Following the May inspection, additional visits were made to the home, in August and October, when checks were done to see whether the home had met the requirements that had been made. Not all requirements had been met but the home was making significant progress towards achieving minimum standards. What the service does well: The manner in which staff members care for residents means that they feel that their privacy is upheld. Residents said, for example, that staff members knocked on their bedroom doors before going into their rooms. This was observed during the inspection. One resident said, “They look after you well, I wouldn’t want to be anywhere else”. Staff spoke with residents in a natural, friendly way. Residents and a visiting relative said that staff members were always courteous and friendly. One resident said, “Staff speak to people nicely”. Residents said that they did as they chose throughout the day. The home employs an activities co-ordinator who helps residents to add interest to their daily lives by offering them a variety of activities. Flexible arrangements for visiting mean that residents can continue to see their family and friends as they wish. Lyngate Care Home DS0000059303.V263910.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? What they could do better: Care plans and risk assessments have been improved. However, some need a little more work to ensure that they are accurate and up to date, and that staff have the guidance they need to meet residents’ needs. Pre-employment checks for staff need to be more thorough so that residents are not put at risk. In order to further promote the welfare of residents, medicine records need a little improvement. To ensure that residents are being supported by a well trained staff team, there is a need to make sure that all staff members have undertaken the required training. The manager needs to look at how the home might be run more efficiently for the benefit of residents. For example, mealtime routines need looking at to see how dining can be made more pleasant for residents. For example, residents should be able to eat at the time and place they choose, and they should not have to wait too long between courses. In order to promote the safety of residents and staff, the home needs to attend to several health and safety matters. Lyngate Care Home DS0000059303.V263910.R01.S.doc Version 5.0 Page 7 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Lyngate Care Home DS0000059303.V263910.R01.S.doc Version 5.0 Page 8 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 Lyngate Care Home DS0000059303.V263910.R01.S.doc Version 5.0 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 3 The Service Users’ Guide contains useful information about the home. It gives prospective residents, and others, information that can help them decide whether the home is suitable. Residents’ needs are assessed before they move into the home. EVIDENCE: Standard 1 was also assessed during the inspection in May 2005. Standard 6 is not applicable as this home does not provide intermediate care. At the time of the last inspection, the Statement of Purpose had contained all the necessary information so it was not looked at this time. The Service Users’ Guide had been updated. It contained useful information about the home. There was evidence on residents’ personal files of needs being assessed by Social Services before a person was admitted to the home. Records also Lyngate Care Home DS0000059303.V263910.R01.S.doc Version 5.0 Page 10 showed that the home carried out its own assessments covering areas such as falls, moving and handling, physical health, and pressure areas. Lyngate Care Home DS0000059303.V263910.R01.S.doc Version 5.0 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Care plans and risk assessments have improved and they contain more detailed guidelines for staff about how residents’ needs are to be met. Some care plans need a little more work to ensure they are accurate and up to date. There has been an improvement in health care monitoring which means that residents’ changing needs are identified more quickly. Medication storage and procedures are generally satisfactory and promote good health and safety. However, there is a need to be more vigilant about record keeping in respect of PRN medication. Care practices in the home mean that residents feel that they are treated with respect and that their privacy is upheld. EVIDENCE: Standards 7, 8 and 10 were assessed during the inspection in May 2005. As requested at the last inspection, residents’ records had been re-organised. Care plans had been improved and they contained much more specific information and guidelines for staff. However, a little more work was needed on some of them to ensure clarity. Lyngate Care Home DS0000059303.V263910.R01.S.doc Version 5.0 Page 12 Of the three care plans that were looked at, one contained information that accurately matched with the information given by the resident about how he was helped and cared for. The other two care plans needed reviewing to ensure that they were accurate and up to date. For example, it was observed that one resident needed help at lunchtime to cut up her meat. One of the staff members who was spoken with confirmed that she sometimes needed this assistance. This was not described in the care plan. This care plan also contained vague information such as “needs to be weighed regularly” rather than specifying a timescale. There was also a need to ensure that staff members were fully aware of the contents of the care plans. For example, one person’s care plan stated that she needed to use a plate guard and apron at mealtimes but it was observed that at lunchtime she was supplied with neither. There was also a need to add more details to this resident’s care plan about District Nursing involvement in monitoring blood sugar levels. Risk assessments covered areas such as moving and handling, falls, and pressure areas. Again there was a need for some of the information in them to be more accurate, and in one case there was a need to complete a risk assessment for a bed lever. Residents’ personal files contained details of their contacts with health professionals. Records showed that, since the last inspection, residents’ weights had been recorded monthly. Staff members demonstrated an understanding of pressure sore prevention and knew what signs to look for. They said they would report any concerns to a senior staff member. A reporting sheet had also been devised to ensure that any matters of concern, for example skin reddening, were referred to District Nurses more quickly. Pressure area assessments had been completed and, in line with good practice, reviewed monthly. However, in the case of one resident whose risk assessment score had significantly changed, there was no evidence to show whether the home had sought advice about whether, for example, the person needed any pressure relieving equipment as a preventative measure. It was noted during the additional visit of 16/8/05 that, as advised during the May inspection, all accidents were being recorded in the accident book. The manager said that one of the deputy managers took responsibility for monitoring and analysing accident records. Medicines that were kept in the home were securely stored. Medicines needing cold storage were kept in a refrigerator. There was separate storage for controlled drugs. The medication administration records (MAR) were generally accurately completed but it was noted that in two instances, where daily notes referred to PRN medication being given, this had not been recorded on the MAR. There was also an instance of laxatives being given but they were not included on the Lyngate Care Home DS0000059303.V263910.R01.S.doc Version 5.0 Page 13 medication list, nor was there any reference in the residents’ personal records to show that the GP had agreed the use of the laxatives. There was a separate register for controlled drugs which was appropriately completed with running records of the quantity of medication held. Residents were satisfied that their privacy was respected, for example they said that staff members knocked on their bedroom doors before entering. This was seen during the inspection. During the inspection, staff members spoke with residents in a natural, friendly way. Residents and a visiting relative said that that staff members were always courteous and friendly. One resident said, “Staff speak to people nicely”. Residents felt that the standard of care was good. One said, “They look after you well, I wouldn’t want to be anywhere else”. A visiting relative felt that his mother was well looked after. Lyngate Care Home DS0000059303.V263910.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Residents have choice about their daily routines, spending their time doing whatever they prefer. The activities co-ordinator offers individual and group activities to add some interest and variety to residents’ lives. Flexible arrangements for visiting mean that residents can continue to see their family and friends as they wish. Residents are able to have some choice and control over their lives if they have the capacity to do so. Menu choices have improved, and residents are offered a varied, balanced diet. However, the mealtime routines could be more efficient so that residents do not have to wait too long between courses. EVIDENCE: Standards 12 and 15 were also assessed during the inspection in May 2005. Staff members and residents said that people could choose what time they got up or went to bed. The residents who were spoken with said that they did as they chose throughout the day and that they could choose whether to stay in their rooms or use one of the lounges. Lyngate Care Home DS0000059303.V263910.R01.S.doc Version 5.0 Page 15 The home had an activities co-ordinator who offered both individual and group activities. There was a varied activities programme planned for the festive season. Details were displayed around the home and included a Christmas party with visiting entertainer, Christmas Bingo, lunch out at Smithills, a carol service, buffets, and a New Year party. Some residents were also planning to attend a lunch and a play at a local high school. Some residents liked to follow their own individual interests such as reading, crosswords, and watching television. It was noted that the home had a supply of large print books. Representatives of a local Church visited regularly to offer Communion to residents. Residents said that they could have visitors at any time. One resident said that visitors were always offered a drink, and those that had travelled a long way were sometimes offered a meal. Residents made choices about their lives if they had the capacity to do so. The choices they made tended to be in respect of their daily lifestyles within the home. One resident said that she knew that she could see her personal records if she wanted to. However, some residents seemed to be unaware of this. The manager said that this was discussed at review meetings. Relatives mostly tended to take control of residents finances, with small sums being passed to the home to cover day to day sundry expenses. Residents were able to bring some their personal possessions into the home with them. The manager said that relatives tended to act on behalf of residents. No one had an independent advocate. The menus showed that mealtime choices were now being offered daily. Records of the meals chosen by each person were kept. Staff members said that either the cook or a care assistant went round to residents every day to tell them what the menu choices were. Two residents confirmed that there was a choice but three people said that they were not usually asked. One commented that the food was good but “you get what you’re given”. A staff member was also observed to ask residents whether they wanted a pudding, but she did not specify what the pudding was. The manager was advised to display menus in prominent places, perhaps by using display boards, so that people have a reminder as to the choices on offer. One inspector ate lunch with the residents in one of the ground floor dining rooms. The meal was satisfactory. However, as was the case at the time of the last inspection, there was a long wait between courses being served, and several residents complained about the wait. Several people who needed support to eat their meals had to wait until the others had finished, before being given their meal. Some residents had been asked to have their lunch in the sun lounge. They said that their table had been moved in there the day before but not moved Lyngate Care Home DS0000059303.V263910.R01.S.doc Version 5.0 Page 16 back. They were unhappy with this because the room was cold, and one person described it as a “junk room”. The manager was asked to make sure that residents ate in the dining area that they preferred. Use of this extra dining room was no doubt also an added factor in the waiting time between courses. The manager was asked to review mealtime routines to look at ways that the dining experience could be made more pleasant for residents. This would need to include a review of staffing numbers at mealtimes and also about the way they are deployed. Perhaps some pleasant background music would be appreciated. The manager is advised to ask residents and staff for ideas about how mealtimes can be organised to make them more relaxing and less fraught. Lyngate Care Home DS0000059303.V263910.R01.S.doc Version 5.0 Page 17 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Improvements have been made to the way complaints are handled. Protection policies and procedures, and staff understanding of adult protection, ensure that the home has the means to be able to respond properly to any suspicion or allegation of abuse. However, the manager needs to seek opportunities for the newer recruits to attend formal training. EVIDENCE: Standard 16 was also assessed during the inspection in May 2005. Since that last inspection, improvements have been made in the way complaints are dealt with. It was noted that the complaints procedure had been amended to make it clear that complainants had the right to complain directly to the CSCI if they wished. The complaints records showed that letters had been sent to complainants explaining what action had been taken to address their complaint and prevent a re-occurrence. Two residents said that if they had any complaints they would see the manager. They felt that she would listen to them and look into their concerns. The home had written procedures covering adult protection and whistle blowing. The staff members who were consulted understood their responsibilities in reporting any suspicions of abuse. One staff member said that she had been on an external training course in adult protection. One said that she had not Lyngate Care Home DS0000059303.V263910.R01.S.doc Version 5.0 Page 18 been on the course but that the topic had been covered during induction training. The manager said that the longer standing members of the staff team had been on the adult protection course but newer recruits needed to go on it. In the meantime, the manager needs to check out staff understanding of their responsibilities through team meetings and 1 to 1 supervision meetings. This will be looked at further at the next inspection. Lyngate Care Home DS0000059303.V263910.R01.S.doc Version 5.0 Page 19 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None None of the above standards were assessed this time. EVIDENCE: Standards 19, 20, 21, 22, 23, 24 and 26 were assessed during the inspection in May 2005. Lyngate Care Home DS0000059303.V263910.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Care staffing levels have improved since the last inspection but they must be kept under constant review to ensure that residents’ needs are met. The home is supporting staff members towards achieving a target of having at least 50 of care staff trained to NVQ level 2. Failure to carry out all the required pre-employment checks on staff can potentially put residents at risk. In order to ensure that residents are being supported by a well trained staff team, there is a need for clarification about the training that staff members have undertaken. EVIDENCE: Standards 27, 29 and 30 were also assessed during the inspection in May 2005. The rota showed that, in addition to care staff, the home employed domestic, catering, and maintenance staff. There was also an activities co-ordinator. Since the last inspection an extra care assistant had been provided from Monday to Friday and residents and staff felt that this had resulted in an improved service. However, staff still appeared to be stretched at lunchtimes resulting in residents having to wait for meals. The owner and manager need to keep staffing levels under constant review, to ensure that they are adequate, taking into account the changing numbers and needs of the residents, and the layout of the building. Lyngate Care Home DS0000059303.V263910.R01.S.doc Version 5.0 Page 21 Planned rotas had not always been amended to show changes in hours actually worked. This needs to be done. Of the 19 care staff employed in the home (including 15 care staff and 4 deputies), 9 had achieved NVQ level 2, and 2 were due to start the course. The home has therefore almost achieved the target of at least 50 of care staff being trained to at least NVQ level 2. One of the deputies had also achieved NVQ level 3. At the time of the last inspection a requirement was made in respect of recruitment records and the need to ensure that staff do not take up their posts without the necessary CRB (Criminal Records Bureau) disclosures and POVA (Protection of Vulnerable Adults) register checks (or POVA first checks). On checking the recruitment documents for two recently recruited staff members, it was noted that the home had addressed this requirement and had obtained a CRB or POVA first for these staff members. The home had also obtained proof of identity but there was no photograph. Application forms did not give a full employment history with dates, and where the person had previously worked with vulnerable adults, the reasons for leaving had not been stated. Any gaps in employment need to be explored. Some references did not clearly state the designation of the referee so it was difficult to establish whether they were an employer. Regulations specify that of the 2 required written references one of them must, where applicable, include a reference from the person’s last period of employment which involved work with children or vulnerable adults. Health questionnaires had been completed but there was no signed declaration from staff that they were physically and mentally able to carry out the duties outlined in the job description. The home was using induction booklets for new recruits. As required at the time of the last inspection they included the date that each induction topic was completed. Staff members gave examples of some of the training that they had undertaken. These included NVQ level 2, moving and handling, first aid, fire safety, health and safety, infection control, and adult protection. Records showed that there was a mixture of external and internal training. Records for 6 staff members showed that little, or none, of the mandatory training had been done. Some records suggested that several topics had been covered on the same day, and some records suggested that over 20 topics had been covered in one month. It was difficult to tell, from looking at training records, which staff members had undertaken certificated training in the mandatory topics. The manager was therefore asked to produce a training plan listing the staff members’ name and designation, list all the mandatory topics first and show the date each staff member had done the training on that topic, and state the name of the training provider and whether the course was certificated. The home also needs to list other specialist courses. Lyngate Care Home DS0000059303.V263910.R01.S.doc Version 5.0 Page 22 A copy of the training plan must be sent to the CSCI. looked at again during the next inspection. Staff training will be Lyngate Care Home DS0000059303.V263910.R01.S.doc Version 5.0 Page 23 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 The manager needs to look at how the home might be more efficiently run for the benefit of the residents. The opinions of residents, and others, have been sought to help the home to review quality, and a written improvement plan has been produced to show residents and others how their views are being used to improve the service. Residents’ personal allowances are looked after appropriately. To ensure that the health and safety of residents and staff is fully promoted, a number of health and safety matters need attention. EVIDENCE: Standard 33 was also assessed during the inspection in May 2005. Lyngate Care Home DS0000059303.V263910.R01.S.doc Version 5.0 Page 24 Staff members described the manager as being approachable and supportive. She has been registered with the CSCI for approximately 2 years. She was previously the Care Manager in the home for over 10 years. The manager is currently undertaking the Registered Managers Award. She said that she was finding the course helpful and was learning new things. She said that, because of the time being spent on the course, she had not been undertaking any other training. Discussion took place about the need to keep abreast of current care issues by attending relevant training and reading appropriate material. Discussion also took place about the general running of the home and the need to actively seek ways to improve efficiency, and ultimately improve the service for residents. For example, the manager was asked to consult with the staff team to seek suggestions about how the mealtime experience for residents might be improved (see also the section of this report under Daily Life and Social Activities). Since the last inspection, the owner of the home had completed a detailed quality audit on the home that included the use of anonymous satisfaction questionnaires. The outcomes had been summarised into a report which included an action plan for improvement. In most cases, relatives looked after residents’ finances. The home only looked after residents’ personal allowances. These cash sums were locked away. There were records of incoming and outgoing sums. The cash held on behalf of two residents was checked against their balance sheets and found to be in order. Several safety records were checked and found to be satisfactory. These included passenger lift, gas soundness, and portable hoists. Records showed that the home had a controlled waste contract. The electrical installation inspection was carried out on 29/11/05 and the report stated that some matters required attention. The home therefore needs to inform the CSCI of the action taken to rectify these matters. The Fire Book showed that fire drills were carried out monthly. Weekly checks were made of the fire alarms and automatic doors. However, there was no record to show that the emergency lighting and fire fighting equipment were routinely checked. The home was advised to obtain a fire precautions register that clearly sets out the tests that are needed and the required intervals for testing. The last recorded water temperature test was on 8/11/04 and it only covered the storage temperature. The home needs to test the temperature at the outlets to ensure that they are around 43 degrees centigrade. Lyngate Care Home DS0000059303.V263910.R01.S.doc Version 5.0 Page 25 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 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 X X X X X X X X STAFFING Standard No Score 27 3 28 2 29 1 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 X X 2 Lyngate Care Home DS0000059303.V263910.R01.S.doc Version 5.0 Page 26 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 OP7 Regulation 15 Timescale for action The registered person needs to 09/02/06 amend the 2 specified care plans to ensure that they accurately reflect all the support needs of the residents. The registered person must 13/12/05 ensure that staff members are working to care plans. The registered person must 09/02/06 complete a bed lever risk assessment for the identified resident. The registered person must 13/12/05 ensure that PRN medication is recorded on MAR sheets, and that all medication, including laxatives, has been included in the medication list. Records should indicate where the GP has agreed the use of laxatives. The registered person needs to 09/02/06 review mealtime routines to ensure that residents can dine at the time and place that they wish, and do not have to wait too long to be served. Planned staff rotas must be 13/12/05 amended to reflect the actual DS0000059303.V263910.R01.S.doc Version 5.0 Page 27 Requirement 2. 3. OP7 OP7 15 13 14 13(2) 4. OP9 5. OP31OP15 12 16 6. OP27 17 Lyngate Care Home 7. OP29 19 times worked. The registered person must 31/01/06 ensure that a robust system of pre-employment checking is carried out. This includes: 1. Checking the designation of each person supplying references. 2. Of the 2 required written references one of them must, where applicable, include a reference from the person’s last period of employment involving work with children or vulnerable adults. 3. Obtaining a full employment history and exploring gaps in employment. 4. Determining the reason for leaving when a person has previously worked with vulnerable adults or children. 5. Obtaining declarations from staff members to confirm that they are physically and mentally able to perform their duties The registered person must inform the CSCI in writing, by the date in the end column, of the steps taken to address these matters. The registered person must 28/02/06 produce a staff training plan listing each staff members’ name and designation, all the mandatory topics, the date each staff member has done the training on that topic, and the name of the training provider and whether the course was certificated. Other specialist courses also need to be listed. DS0000059303.V263910.R01.S.doc Version 5.0 Page 28 8. OP30 18(1)(c) Lyngate Care Home A copy of the training plan needs to be forwarded to the CSCI by the date in the end column. 9. OP38 13 The registered person must 31/01/06 supply the CSCI with written confirmation that the remedial work to the electrical installation system has been completed, and that the system is safe. The registered person needs to 13/12/05 ensure that the emergency lighting and fire fighting equipment are checked at the required intervals. The registered person must 13/12/05 arrange for records to be kept to show that the water temperature has been checked at the outlets. 10. OP38 23(4) 11. OP38 13 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 OP8 Good Practice Recommendations In respect of the resident whose risk assessment score has significantly changed, the registered person is asked to seek advice about whether there is a need for pressure relieving equipment. Given that some residents were unaware of the menu choices open to them, the registered person is advised to display menus in prominent places, perhaps by using display boards, so that people have a reminder of the choices on offer. The registered person needs to provide the newer recruits with opportunities to undertake adult protection training. The registered person is advised to regularly include adult protection on agendas for team meetings and 1 to 1 supervision. The home needs to continue to encourage care staff to complete NVQ level 2 so that at least 50 of them have DS0000059303.V263910.R01.S.doc Version 5.0 Page 29 2 OP15 3. 4. 5. OP18 OP18 OP28 Lyngate Care Home 6. OP31 achieved the qualification. The manager is part way through the NVQ level 4 course and she needs to continue to progress with this until completed. Lyngate Care Home DS0000059303.V263910.R01.S.doc Version 5.0 Page 30 Commission for Social Care Inspection Bolton, Bury, Rochdale and Wigan Office 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 © 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 Lyngate Care Home DS0000059303.V263910.R01.S.doc Version 5.0 Page 31 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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