Inspection on 13/02/06 for Lynmere Nursing Home

This inspection was carried out on 13th February 2006.

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

Lynmere Nursing Home 06/12/06

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 Lynmere Nursing Home 278 Buxton Road Great Moor Stockport Cheshire SK2 7AN Lead Inspector Unannounced Inspection 13th February 2006 09:05 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 Lynmere Nursing Home DS0000064700.V278244.R01.S.doc Version 5.1 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. Lynmere Nursing Home DS0000064700.V278244.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Lynmere Nursing Home Address 278 Buxton Road Great Moor Stockport Cheshire SK2 7AN 0161 456 2634 0161 456 2634 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) RMD Care Services Ltd Susan Jackson Care Home 20 Category(ies) of Old age, not falling within any other category registration, with number (20), Physical disability (20), Physical disability of places over 65 years of age (20) Lynmere Nursing Home DS0000064700.V278244.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. No more than 20 service users to be admitted to the home No service users under 45 years of age to be admitted into the home Maximum number of service users 20, these to include Old Age, not falling within any other category (20), Physical Disability (20), Physical Disability over 65 years of age (20) Date of last inspection Brief Description of the Service: Lynmere is a care home that provides 24 hour nursing care and accommodation to 20 adult service users over the age of 45. Many of the service users accommodated at the home have high physical dependency needs. The home has recently been purchased by RMD Care Services Ltd. Lynmere is situated on the main road A6 in the Great Moor area of Stockport. The home is close to local shops, churches, a park and bowling green and local public houses. Local bus services are available close by and a train station is five minutes walk away. The main entrance to the home has small borders of flowers and there is a relatively secluded small garden. Car parking facilities are also provided. The home is a single storey building that was purpose built about 20 years ago. All bedrooms are single rooms. En-suite facilities are not available. The home provides a choice of assisted bathing facilities including a shower. There is one large lounge, which also contains a dining table. A wide variety of adaptations and aids are provided to assist in the nursing of the service users accommodated. The home is a non-smoking environment. Lynmere Nursing Home DS0000064700.V278244.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over four hours on the 13th February 2006 by one inspector. Since the last inspection the home has been purchased and a new registered manager and responsible person were in post. The transition has been smooth and residents, relatives and staff felt the sale of the home had not diminished the quality of the home’s service. A brief tour of the home took place and care records and staff employment and training records were seen. Three of the 20 residents, one visitor (close relative) and three staff were spoken to. Ten relative comment cards, ten resident comment cards were left at the home. Several of these were returned and these contained positive comments. Verbal feedback of the findings from the inspection was given to the manager and the proprietors of the home at the end of the visit. What the service does well: The home offers a service mainly to older people many of whom were very dependent and frail. The emphasis of the service is to ensure residents are comfortable and a number of residents were in bed at this visit. Residents who were in bed were clean and appeared comfortable in freshly made beds. The home was very peaceful. Residents spoken with said they liked living in the home and were complimentary about the staff. One resident said the staff were, ‘wonderful people’. Staffing levels in the home are good with one nurse and five care staff on duty in a morning and one nurse and three care staff on duty in the afternoon. Staff confirmed that the staffing levels allowed time to be spent with residents delivering care, talking and encouraging residents to make choices. The staff were positive about working in the home and said they felt they all worked well as a team. The residents appeared to benefit from the relaxed and knowledgeable approach of the staff team. Staff are assisted to develop and improve their skills and abilities with varied training, which includes NVQ and on the job development. The new owners have developed a detailed Statement of Purpose and Service User Guide which contain information about the service provided at Lynmere. Lynmere Nursing Home DS0000064700.V278244.R01.S.doc Version 5.1 Page 6 The environment was not assessed at this visit, however the home was clean and tidy and no unpleasant odours were noted. Two domestic workers were busy in the home. The manager and registered person both stated that a redecoration and refurbishment plan was being developed for the home. What has improved since the last inspection? 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. Lynmere Nursing Home DS0000064700.V278244.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Lynmere Nursing Home DS0000064700.V278244.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3, 4 and 5 Sufficient information is provided to make an informed choice about the home’s suitability to meet individual needs. Resident’s needs are assessed before admission and confirmation of suitability is provided. EVIDENCE: Information about the home was readily available at the main entrance to the home; this included a Statement of Purpose, a copy of the home’s complaints procedure and the last inspection report for the home. The philosophy and quality assurance statement were also displayed. The statement of purpose was a new document, which had been developed by the new owners of the home. This contained detailed information about the services the home offers in accordance with the Care Home Regulations 2001. A service user guide had been developed and copies of this had been provided to the current residents in the home. It was reported that all prospective residents were given a copy of this when they visited before admission to the Lynmere Nursing Home DS0000064700.V278244.R01.S.doc Version 5.1 Page 9 home. The information in the service user guide provided practical information about the services the home offers. A sample of care plans were seen. The manager stated that the pre-admission assessments were kept separately from the resident’s main care plan. It is recommended that all pre-admission assessments be kept with the resident’s main care plan to provide a background and baseline picture of the resident at the point of admission to the home. Copies of the home’s pre-admission information were available and these contained information on the resident’s care needs. The manager confirmed that a community care assessment was not always obtained before admission to the home. One care file had a Care Manager assessment (Single Assessment Process) provided by Stockport Social Services and this contained minimal information. Intermediate Care (standard six) is not provided at the home. Lynmere Nursing Home DS0000064700.V278244.R01.S.doc Version 5.1 Page 10 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 Residents were treated with respect and dignity. Care planning was not consistently detailed to meet personal and health care needs of residents. Medication practices were safe. EVIDENCE: The home was peaceful and staff undertook their duties quietly and efficiently. The majority of the resident’s living in the home were frail and very dependent. Some residents’ who were very dependent and required full care were maintained comfortable in bed. Nightwear clothing and bedding looked fresh and clean and bedrooms were pleasant and tidy. Other residents were sat in the lounge and two residents said they were comfortable. Residents were assisted to maintain their personal appearance. The home’s information guides refer to the promotion of privacy and dignity in the home. Staffing levels at this visit enabled staff to provide a care service to each resident in an unhurried manner. One resident said, “ you couldn’t find better care” and one staff member said, ‘that care wasn’t rushed’ and ‘you had time to talk to the resident and ask them for their choices’. Lynmere Nursing Home DS0000064700.V278244.R01.S.doc Version 5.1 Page 11 The manager acknowledged that the home’s care plan documentation needed to improve and she stated that she intended to address this in the near future. The responsible person for the home also acknowledged that this was an area in the home that needed to be developed. Care plans were available for each resident but these contained generic assessments and care plans that did not detail the specific care needs of the individual resident. The focus of the records was task orientated – all staff signed when they had undertaken a particular task for each resident but information about the resident, as a person was not recorded in any detail. Evaluations of the care plans were also inadequate because they did not detail the effectiveness of the plan of care. Medication records and practices were briefly examined and these were safe. Lynmere Nursing Home DS0000064700.V278244.R01.S.doc Version 5.1 Page 12 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 Resident’s social needs are not consistently met but life style choices are available and visitors welcome at any time. The quality and choice of food provided to residents is good. EVIDENCE: Since the last inspection staff have attempted to involve residents in various activities such as dominoes, manicures, cards or reading to residents. A general record of these activities were maintained, however residents care plans did not detail the social activities each resident participated in or enjoyed. Discussion with the manager did identify that she was aware of the need to develop this. Staff were polite and supportive to residents and residents responded positively to staff. Routines in the home enabled residents to make some choices such as rest and retirement times. Staff also felt that the staffing levels in the home enabled them to offer choices to residents without having to rush. The home’s chef visited residents in a morning and asked them what their preference of lunchtime meal was. Most resident ate their meals in their bedroom or on small tables the lounge. The chef also monitored the dietary intake of the residents by monitoring what was returned to the kitchen and the Lynmere Nursing Home DS0000064700.V278244.R01.S.doc Version 5.1 Page 13 chef informed the manager of any concerns regarding a resident’s dietary intake. Lunch was homemade meat and potato pie, with cauliflower, broccoli, carrots and Swede with gravy. This was served on trays in a presentable manner and staff provided discreet assistance with the meals. Lynmere Nursing Home DS0000064700.V278244.R01.S.doc Version 5.1 Page 14 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 Residents are protected from abuse and can be confident that complaints will be treated seriously. EVIDENCE: Relatives and staff were clear that they could complain either to the manager or the proprietors of the home if the need arose. The manager reported that the home had not received any complaints. A copy of the complaints procedure was displayed clearly on a notice board near the home’s main entry. Staff understood the issues around abuse and were clear in describing the action they would take if they suspected abuse. Training in abuse had been provided to staff but the ‘Alerter’ training offered by Stockport local authority had not been accessed. Lynmere Nursing Home DS0000064700.V278244.R01.S.doc Version 5.1 Page 15 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): These standards were not assessed at this visit. EVIDENCE: Lynmere Nursing Home DS0000064700.V278244.R01.S.doc Version 5.1 Page 16 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 Staff are correctly vetted, employed in sufficient numbers and are trained to meet resident’s needs. EVIDENCE: Staffing levels were maintained in the home at a level appropriate to meet resident’s needs. There were usually six staff on duty in the morning, with a slight reduction in the afternoon. The staffing level did reduce on occasion to one nurse and two care staff after 6 pm. Staff spoken with listed the various training they had undertaken and said they felt supported to do a good job. The sale of the home had not disrupted the staff team which had remained stable. Staff spoken with said they felt there was a strong team spirit in the home. NVQ training is also being provided, and 11 out of the 15 care staff employed at the home had achieved a NVQ qualification and two other staff were half way through the NVQ training. Employment records were maintained appropriately, documentation such as application form, references, health check and disclosures were all obtained before the commencement of employment. Lynmere Nursing Home DS0000064700.V278244.R01.S.doc Version 5.1 Page 17 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, 36 and 38 The management of the home promotes the health, safety and wellbeing of the residents. Resident and relatives do, informally, have a say in how the home is run. Resident’s personal money is safe. EVIDENCE: The manager of the home has been in post approximately four months and during this time she has ensured that the sale of the home has not impacted on the quality of the service provided in the home. Staff, one relative and one resident said the manager was approachable and was willing to listen to any concerns. The manager does need to undertake training for a NVQ 4 in management. The manager has not had a significant number of ‘management hours’ since she has been in post mainly due to long term sickness of nursing staff and this has impacted on her time to undertake management responsibilities. Lynmere Nursing Home DS0000064700.V278244.R01.S.doc Version 5.1 Page 18 The manager acknowledged that quality assurance systems had not been implemented in the home but stated that this was under review. A quality assurance statement and policy was on display in the home. The responsible person for the home confirmed that quality assurance was being looked at and that he had recorded some visits in accordance with Regulation 26 of the Care Home’s Regulations 2001. The manager did state that she was available for residents, staff and relatives to discuss any concerns and one relative confirmed this. Both residents and staff spoken with were complimentary about the home and said the atmosphere was calm and relaxed. Staff had attended a staff meeting and staff formal appraisals had commenced and the manager anticipates formal one-to-one supervision to follow on from this. Resident’s personal monies were held securely and records were available which detailed all transactions. Receipts were held for all expenditure undertaken for each resident. Health and safety records were available. The manager has undertaken the weekly routine health and safety checks but the home is attempting to recruit a fulltime maintenance person to undertake these tasks. Fire records were maintained appropriately. Staff had had fire training and training in moving and handling was planned for later this month. Lynmere Nursing Home DS0000064700.V278244.R01.S.doc Version 5.1 Page 19 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 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 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 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 x 2 x 3 3 x 3 Lynmere Nursing Home DS0000064700.V278244.R01.S.doc Version 5.1 Page 20 Are there any outstanding requirements from the last inspection? N/A 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 12,15 Requirement The registered person must ensure that a care plan is recorded which reflects all the assessed needs of the resident. The registered person must ensure that evaluations of care plans are recorded in detail. The registered person must ensure that resident’s care plans detail the social aspects of the service provided to each resident. The registered person must ensure that the manager obtains a NVQ 4 in management as soon as possible. The registered person must ensure that quality assurance systems are implemented in the home. Timescale for action 31/05/06 2 3 OP8 OP12 12,14,15 12,14,15 31/05/06 31/05/06 4 OP31 10 31/10/06 5 OP33 26,24 31/07/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. Lynmere Nursing Home DS0000064700.V278244.R01.S.doc Version 5.1 Page 21 No. 1 2 3 4 5 6 7 Refer to Standard OP3 OP3 OP18 OP31 OP33 OP36 OP38 Good Practice Recommendations The registered person should ensure that pre-admission assessments are held with the resident’s main care plan. The registered person should ensure that community care assessments are consistently obtained for all new admissions into the home. The registered person should ensure that staff are enabled to attend the Stockport’s ‘Alerter’ training. The registered person should ensure that the manager has dedicated and protected management hours each week. The registered person should ensure a copy of the audit undertaken in the home in accordance with regulation 26 is provided to the local CSCI office. The registered person should ensure that regular one to one supervision continues on from the staff appraisals. The registered person should ensure that a dedicated maintenance person is employed for the home. Lynmere Nursing Home DS0000064700.V278244.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Ashton-under-Lyne Area Office 2nd Floor, Heritage Wharf Portland Place Ashton-u-Lyne Lancs OL7 0QD 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. 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