Inspection on 22/07/08 for Lyngate Care Home

This inspection was carried out on 22nd July 2008.

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 01/04/08

Lyngate Care Home 17/10/07

Lyngate Care Home 24/05/06

Lyngate Care Home 13/12/05

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 08/11/2008.

CARE HOMES FOR OLDER PEOPLE Lyngate Care Home 236 Wigan Road Bolton Lancashire BL3 5QE Lead Inspector Judith Stanley & Avril Frankl Pharmacist Inspector Unannounced Inspection 22nd July 2008 09:30 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.V368229.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Lyngate Care Home DS0000059303.V368229.R01.S.doc Version 5.2 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 01204 657441 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.V368229.R01.S.doc Version 5.2 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. 1st April 2008 Date of last inspection Brief Description of the Service: Lyngate care home provides care and accommodation for up to 41 older people. The home is situated approximately 1 mile from Bolton 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. A brochure describing the home’s services is available and the provider gives other information about the home to new and prospective residents and their families verbally and they are also offered a copy of the home’s Service User Guide (Residents Information Guide). The current weekly charge for accommodation and services range from £349.93 to £355.08 with additional charges being made for hairdressing, chiropody, extra toiletries, newspapers, holidays and trips out. Lyngate Care Home DS0000059303.V368229.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means that people who use this service experience adequate quality outcomes. This was the second key inspection carried out at this home since April 2008. The first one was on the 1st and 2nd April 08 where there were serious concerns raised about medication. This was followed by a random inspection on 19 May 08 when the inspectors visited to check that the problems found on 1 and 2 April 08 regarding poor practices in medication had been addressed. These concerns had not be addressed and resulted in the CSCI serving a Statutory Requirement Notice on 3 June 08. We inspected this home again on 22 July 08 and found that the Statutory Requirement Notice had been met. We received a written response to the Statutory Requirement Notice on 16 June 08 that set out the improvements to be made. The local council had suspended placements to the home from April 2008 until they could be confident that significant improvements had been made. Every inspection at this home has been an unannounced visit, and has been carried out by the lead inspector for the service and the same CSCI pharmacist inspector. The inspection was conducted over 6 hours. Throughout the course of the day inspectors looked at some records the home keeps on residents (care plans) staff training, medication, meals and mealtimes and other records the home needs to keep to ensure that the home is being run properly. A tour of the premises was also conducted. Staff and residents were spoken with during the course of the day. The inspectors were assisted by the home’s manager, the homeowners and by a team of consultants who are overseeing the running of the home at this time. Both inspectors gave full feedback to all parties, as was the request of the owners of the home. Comment cards, asking residents, relatives and staff what they thought about the care provided were sent prior to the inspection. Four residents returned comment cards, one said, “It’s a nice place”. Another said “Sometimes staff are very busy and I have to wait a bit but a don’t mind. Mostly the meals are ok, there are some things I don’t like. I am happy here we are always laughing”. Three relatives returned comment cards. All indicated that the way things were done in the home was usually all right. One said, “There has been Lyngate Care Home DS0000059303.V368229.R01.S.doc Version 5.2 Page 6 a lot of new/temporary staff so the knowledge of individual residents is perhaps not as good as it could be. The activities are good and cater for residents who are housebound as well as those who can get out. The quality of the food is not always good and the choices appear limited”. Only one member of staff returned a comment card and indicated that in the main that the overall way in which the home was run was satisfactory, We would normally send out to the manager an Annual Quality Assurance Assessment form to complete (AQAA). This was done for the April 08 inspection and we used that information for this inspection. What the service does well: What has improved since the last inspection? There had been significant improvements with in the home with reference to the recording in the care plans, progress notes, staff training and environmental issues and in the general running of the home. The recording and administration of medicines has improved and the residents’ health is no longer at risk due to poor medicines practices. We found that all requirements made in the Statutory Requirements Notice had been met. The consultants working with the home submitted an improvement plan to the CSCI in June 2008 and at the inspection of 22 July 2008 this was on schedule. In addition to the requirements from the last inspection, it was highlighted by the consultants the area of priority with in the home are: Medication administration in its entirety, health and safety, training of staff and competency, improvement of the environment, care planning and associated documentation and consultation and inclusion in respect of residents and families, staff and other health care professionals. Lyngate Care Home DS0000059303.V368229.R01.S.doc Version 5.2 Page 7 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Lyngate Care Home DS0000059303.V368229.R01.S.doc Version 5.2 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.V368229.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2,3 and 4 were assessed. Standard 6 does not apply at Lyngate as the home does not offer an intermediate care service. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are assessed prior to admission so ensuring the home is able to meet their identified needs. EVIDENCE: We chose three care plans for inspection. There had been no new admissions in to the home since April 2008 due to placements being suspended by the local council. However on checking the three files selected there was evidence that pre admission assessments had been carried out prior to residents moving in to the home. We checked to see that the three residents whose files we selected had a contract/statement of terms and conditions in place regardless of whether they Lyngate Care Home DS0000059303.V368229.R01.S.doc Version 5.2 Page 10 were self-funding or funded by social services. All three contacts were available for inspection. A supplementary document is to be introduced that will provide residents and their supporters with more information about terms and conditions within the home. There are several people living at the home with a dementia related illness. Most of the staff had completed training in this specialised area of care. Further training and updates for staff are planned. Lyngate Care Home DS0000059303.V368229.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9, and 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents can be sure their health and welfare will be protected and promoted by the safe management and administration of medication. EVIDENCE: We continued working with the same three care plans. Advice has been given from the consultancy team. improvements were noted, for example the daily progress notes are now kept separately from the drugs book and staff had started to write more relevant information on them. The care plans had been updated as required but attention is needed to the recording of some information such as bathing records. For one resident the records showed that the last bath given was on the 26 June 08 there was nothing else recorded to say the resident had refused a bath or strip wash, therefore on day of the inspection (22 July 08) it appeared this resident had not been bathed for nearly a month. Also there was no weight recorded since 9 June 08. Lyngate Care Home DS0000059303.V368229.R01.S.doc Version 5.2 Page 12 Another resident whose file we were working with had an appointment to attend the eye unit at the hospital this was not documented on the out patients notes. It was noted that work had started to improve the overall layout of the care plans and the consultancy team were overseeing this. The care plans, when not in use are now securely stored and keys for the filing cabinet are handed over to the senior on change of shift. There was evidence to show that residents health care needs were being met and that doctors, district nurses and other community services were contacted and visited the home as required. After the last inspection there were serious concerns that medicines were handled poorly and that residents’ health was at risk. A Statutory Requirement Notice was issued to make sure that improvements in medication practice were made to improve residents’ safety. As part of this inspection the pharmacist inspector looked at medicines kept by the home for some residents together with records about those medicines to make sure these requirements had been met. Staff in the home had worked very hard to make sure that medicines were handled safely and residents were not at risk. We found that all the requirements in the notice had been met. A new medication system had been introduced by the home and all staff had training in how to use the system. The said they were happier using this system and they felt confident that they could give medicines properly. We looked at how well records about medicines were kept. We found that all areas of recording were clear and accurate. The records showed that medicines were given as prescribed and that all medicines could be accounted for. At previous inspections we had concerns that residents were not given their medicines at the correct times, because drug rounds took a long time, which could have put their health at risk. On this inspection we saw that almost all morning medicines were given by 9:45am and that lunchtime medicines were given at lunchtime. We saw that staff were now following the prescribers directions and giving medicines as prescribed. When the medicines were not given as prescribed staff usually recorded the reason for the variation or omission. We also saw that if the doctor had changed the dose or form of medication this was well recorded. We also noted that no medicines were unavailable for administration. Lyngate Care Home DS0000059303.V368229.R01.S.doc Version 5.2 Page 13 When residents were prescribed a variable dose of medicine staff recorded exactly what dose had been given. There was no information as to when to give the higher or lower dose. We also saw that the recording of administration of some creams, which were prescribed, “as required”, was poor. There was no information as to which part of the body to apply the cream to. It is important to have clear directions when there is a choice of dose or areas of application to make sure the residents get the proper treatment. We looked to see if controlled drugs were handled safely, we saw they that were kept in a secure controlled drugs cabinet and the controlled drug register showed that they could all be accounted for. Those residents who were able to comment and feedback on returned comment cards, indicated staff respected their privacy and dignity. During the inspection, staff were observed to treat residents with respect and consideration. It was noted that the use of hospital screening was used when staff used the hoist to transfer a resident from a chair to a wheelchair; this offered a degree of dignity to the resident. During feedback it was discussed why were there kylies (covers that soak up urine) on the chairs in the ground floor lounge. These are not very dignified. It would create a better impression if these were removed, as it tends to highlight that all residents have a continence problem, which of course is not the case. With a proper toileting programme and the correct continence products the use of kylies may not be necessary. It is imperative that the owners and manager of the home sustain the improvements noted when the consultancy team withdraw. Lyngate Care Home DS0000059303.V368229.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15 were assessed Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident’s interests and links with visitors are encouraged, ensuring residents live as normal life as possible. EVIDENCE: The home has a hobby therapist who is very enthusiastic about her role. Through discussion with residents she plans and then delivers a wide range of activities. These include, cards, bingo, arts and crafts, reminiscence, one to one chats, gentle exercise, entertainer and suitable trips out of the home to garden centres, meals outs, mystery tours and trips to other suitable venues. Residents are also encouraged to peruse their own interests such as word search puzzles, knitting etc. Residents with religious beliefs are encouraged and enabled to maintain links. Care plans contain details of residents preferred religion. Lyngate Care Home DS0000059303.V368229.R01.S.doc Version 5.2 Page 15 The home has an open visiting policy. There are no restrictions on the time people visit, evidence of which is highlighted in the visitor’s book. The only time restrictions would be imposed is when requested by a resident. It should be noted that a number of residents have memory and communication difficulties so were unable to confirm they were able to exercise choice. Nevertheless observation of care practice indicated residents could make some choices for example with regard to meals, rising and retiring and how and where they spent their day. From feedback obtained on the returned comment cards and during discussions with the staff, the inspector got mixed responses about the meals served. This was also mentioned at the last inspection, however the same menus are still being served. For breakfast there is a choice of cereals or porridge, toast and preserves and tea or coffee. A cooked breakfast is available on request. As previously stated some residents have communication difficulties and would not be able to asked for a cook breakfast. If these residents were shown what options were available they may be able to make a choice. Lunch is the main meal of the day. Consideration needs to be given to the planning of meals and the dining arrangements. On the day of the inspection the choices for lunch were bacon hotpot or shop bought chicken pies, with creamed potatoes and vegetables, followed by dessert. The cook serves the meals from a hot trolley. On the ground floor there are several people that needed assistance with feeding. Residents on the ground floor are currently dining in two dining rooms and staff are rushing between the dining rooms to serve out food and to assist residents, at one stage only the cook was in the main dining area. It may be beneficial if one of the lounge/dining rooms was made into just a dining room and to use the other for a lounge only, this would mean that staff would be in one area and could assist residents more. The inspector noted that some residents were left to their own devices but would have benefited from some staff assistance. A lighter afternoon tea is served and residents were having chicken nuggets, chipped potatoes and baked beans. This was the second time chicken was offered that day and consideration needs to be given as to the suitability of the menu and whether this is an appropriate meal for residents. From observations at this inspection and at other inspections convenience foods are purchased rather than homemade. The cook will always make sandwiches if someone prefers them. Hot and cold drinks and snacks were available during the day and residents are offered supper before retiring. Lyngate Care Home DS0000059303.V368229.R01.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 were assessed. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents knew how to complain and were confident the manager would deal with any complaints or concerns appropriately. EVIDENCE: A complaints procedure is in place. There has been one minor complaint since the last inspection, which was promptly dealt with. The complaints procedure was displayed, however the CSCI office address will require updating. This information will also need amending on all resident’s information. There has been no adult safeguarding referrals made since the last inspection and most staff had now undertaken training in the protection of vulnerable adults. Lyngate Care Home DS0000059303.V368229.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19,21,24 and 25 were assessed. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Lyngate is maintained to a satisfactory standard making it homely and comfortable for residents to live in. EVIDENCE: There had been continuous improvements made within the home since the last inspection. The lower ground floor lounge had been refurbished and residents spoken with who use that lounge were happy with the improvements. The improvement plan submitted in June 2008 states that the rolling programme of maintenance is progressing including work to the bathrooms, which are to be redecorated and refurbished as necessary. In the interim Lyngate Care Home DS0000059303.V368229.R01.S.doc Version 5.2 Page 18 period it was noted that some work had been actioned in the bathroom near the lounge area. Some bedrooms were inspected. Most resident’s bedrooms doors were closed but on this occasion they were not locked unless the residents had locked the door themselves. Residents were free to wander back to their room as and when they choose. Bedrooms were clean and comfortable and had been personalised with their own belongings brought with them from home. As mentioned at the last inspection in one residents room the drawers were broken, these were still in the state of poor repair and must be repaired of replaced. The on going improvements to the home must be sustained and will be looked at during the next inspection. Infection control procedures were in place and staff were seen wearing different protective clothing for the different tasks they were carrying out. Odour control had improved with in the home due to new systems put into place by the consultancy team. This must be maintained and the home must be kept free from any offensive odours. The laundry is on the lower ground floor and does not intrude on the residents. The home has CCTV cameras covering the outer doors only. As discussed at all previous inspections, the system for entering and leaving the home needs to be addressed. The door buzzer is constantly being rung and staff are having to come away from what they are doing to open the door to let visitors and staff in and out of the home. Also the tannoy system asking staff to come to the nurse station or to another part of the home is constantly relayed around the home. The use of an internal telephone system on each floor may be considered less intrusive. Lyngate Care Home DS0000059303.V368229.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staffing levels are satisfactory ensuring consistency of care for people living in the home. The residents were cared for by staff that had been safety recruited and vetted prior to commencing work. EVIDENCE: The staff rotas were available for inspection and showed the numbers of staff covering each shift. Consideration needs to be given to the number of hours and the numbers of shifts some staff are covering. Staff spoken with agreed that the home was running better and was more organised now that the consultancy team had moved in. Staff training for NVQ is progressing well 47 of staff had achieved NVQ level 2 or above in care and four members of staff are near to completion of NVQ level 2. This will take the home up to 70 of staff with a relevant qualification. The files of two staff employed looked at showed all the necessary recruitment checks had been undertaken. Both contained a written application form, two references, Criminal Records Bureau (CRB) check and verification of identification. Lyngate Care Home DS0000059303.V368229.R01.S.doc Version 5.2 Page 20 Staff training had improved and mandatory training for staff is on going. The improvement plan submitted indicated the management would review the training programme by 30 June 2008 and will produce a training matrix to show what training staff have had and what is required. The inspector will check this at the next inspection to ensure that this is in place and staff are continuing to receive training as necessary. Lyngate Care Home DS0000059303.V368229.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 and 38 were assessed. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents can be confident their health, safety and welfare will be promoted and protected by safe working practices. EVIDENCE: The consultancy team has spent time working with the manager of the home helping with the paperwork, introducing the new medication system and the general day to day management and running of the home. The manager has many years experience in working with and caring for older people and is currently working to complete the Registered Managers Award. Lyngate Care Home DS0000059303.V368229.R01.S.doc Version 5.2 Page 22 The manager has a good understanding of the residents living at the home and their individual needs. As observed at the inspection the manager always finds time to sit with the residents and have a chat. The manager has changed some of her working practices and with the involvement and support of the consultancy team significant changes were apparent. The manager operates an ‘open door’ policy so that she may be approached at any time by residents, staff and relatives. Records required by regulation were available for inspection and the appointment of an administrator has been a great help. Systems for self-monitoring with in the home had improved. A residents meeting was called by the consultants on 26 June 2008 which brought forward some positive comments and things that the residents would like to see introduced. The staff meeting was not as positive and the minutes of the meeting indicated that staff morale was low. These meetings are to take place on a regular basis. Regular audits are to take place and the consultancy team will oversee these. The owner of the home completes a monthly written report as required and these were available for inspection. Some of the residents have handed over to the manager, for sake keeping, small amounts of money. We checked the monies of the three residents whose files we had been working with. The money was in order and balanced against the recorded monitoring sheets. The system for the storage of the money could be improved as the home was using envelopes from which money was coming out of. Plastic zip wallets would be better so as to keep the residents money contained. A new health and safety policy is to be written and will consider the layout and working of Lyngate. All staff are to receive training in health and safety. Observations showed that areas of health and safety had significantly improved. We used the same AQAA from the April inspection, which provided us with a list of maintenance and associated records. These were checked during the inspection of April 2008 and were up to date and certificates were valid. Any accidents, injuries and incidents were recorded and the CSCI are informed as necessary. Since the involvement, advice and guidance from the consultancy team the home has undergone significant changes and plans for the future look good. It is imperative that these changes are sustained if and when the consultancy Lyngate Care Home DS0000059303.V368229.R01.S.doc Version 5.2 Page 23 team withdraw their services or the owners of the home feel they no longer need their input. Lyngate Care Home DS0000059303.V368229.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x 3 3 3 x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 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 2 x 2 x x 2 x 3 STAFFING Standard No Score 27 3 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 x 3 x 3 x x 3 Lyngate Care Home DS0000059303.V368229.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action 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 OP7 Good Practice Recommendations Work on the care plans should be continued and all necessary information recorded to ensure these are a good working tool that provides staff the with the information they need to offer good quality care. Consideration needs to be given over some of the choices of the meals served and to layout of the dining areas so that staff be are available to assist those residents that need help with their meals. The rolling programme of maintenance should continue, including work on the bathrooms to ensure the care home is kept in a good state repair. 2. OP15 3. OP19 Lyngate Care Home DS0000059303.V368229.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Manchester Local office 11th Floor West Point 501 Chester Road Manchester M16 9HU National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Lyngate Care Home DS0000059303.V368229.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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