Random inspection report
Care homes for older people
Name: Address: Lynton Hall Care Centre 2 Lynton Road New Malden Surrey KT3 5EE two star good service The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Alison Ford Date: 1 3 0 8 2 0 0 9 Information about the care home
Name of care home: Address: Lynton Hall Care Centre 2 Lynton Road New Malden Surrey KT3 5EE 02089491765 02083361288 cartebar@bupa.com www.bupacarehomes.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : BUPA Care Homes (ANS) Ltd care home 57 Number of places (if applicable): Under 65 Over 65 2 1 57 57 dementia learning disability old age, not falling within any other category terminally ill Conditions of registration: 0 1 0 57 A variation has been granted to allow one specified service user in the Learning Disability, over 65 (LD(E)) category and one specified service user in the Learning disability (LD) category to be accommodated. As agreed on 12/6/06 a variation has been granted to allow 2 specified service users in the Dementia, over 65 (DE(E)) service user category to be accommodated. as agreed on 12/6/06 a variation has been granted to allow one specified service user (female) aged 54 years, requiring general nursing care, to be accommodated. Date of last inspection Care Homes for Older People Page 2 of 10 Brief description of the care home Lynton Hall is a nursing home owned by BUPA. It is situated in residential area, close to the town, in New Malden, Surrey and is close to public transport routes and the local shopping centre. A garden and off-street parking are to the rear of the home. The home is registered to provide nursing care for up to 57 older people. Accommodation is arranged over two floors, each of which has its own lounge, and bathroom and toilet facilities are on each floor. There are five double and forty-seven single bedrooms. All have washbasins and eleven have en-suite facilities. Adaptations within the home ensure that it is accessible to those who have physical disabilities and nurse call bells are in all areas. The home is staffed twenty-four hours a day by both trained nurses and care staff. In addition, a chef, activities coordinator, handyman and domestic staff are employed. At the time of the last inspection the fees were £930 - £970 per week. Different rates would apply to people who are self-funding, and those whose fees are paid by the local authority. Extra charges may be payable for services such as chiropody or hairdressing and these would be discussed prior to admission. Copies of the Statement of Purpose for the home and Service User Guide may be obtained from the home while the latest inspection report may be downloaded from the Care Quality Commission website at CQC.org.uk Care Homes for Older People Page 3 of 10 What we found:
This report follows an unannounced random inspection undertaken by two inspectors. The home has recently had a series of safeguarding alerts which are being addressed according to local authority procedures and which has lead to them ceasing to admit any new people to the home. We last inspected the service in April 2008, so we decided to visit and talk to some of the residents in order to try and find out what it is like for them to live there. We spent four hours in the home during which time we spoke with a number of residents, some relatives, members of staff on duty and also two senior representatives of BUPA who were in the home. A new manager has recently been appointed and we were able to meet with her and she told us about the future plans that are in place for the home. Some of the issues that have previously been raised by residents have highlighted the length of time that they have to wait when they ring their call bells. This has caused particular problems for them when they are waiting to use the toilet. We asked residents about this and several of them agreed, saying that they sometimes waited over half an hour. We tested this on four occasions during our visit and found that response times were between ten and thirty five minutes which we consider to be unacceptable. Residents consider that this issue is due to staff shortages and it also stops them participating in activities. These might be held in the lounge or in the garden and at times they have found that they have been left there afterwards as there are not enough staff to bring them back to their rooms. We asked staff about the staffing levels in the home and they said that June and July had been bad with a high reliance on agency staff who were unfamiliar with residents needs. We also noted that when care staff were busy in residents bedrooms it was difficult for them to hear call bells when they were bleeping. We asked residents if they felt that their dignity and privacy were being upheld by staff in the home. They told us that personal care is generally delivered in their own rooms and consultations with health care professionals are in private. However ,some of them told us that staff are not always careful to shut the door when they are using a commode. Another resident complained that if she was taken to use the toilet in a communal bathroom staff wandered in and out running the bath for other people. Staff told us that they had received training in the promotion of privacy and dignity however we did not consider that this was being demonstrated. We asked residents about the food that was served in the home and we had a mixed response. One said the food is pretty good another you always get a choice at mealtimes. residents said that they were able to eat in their rooms if they prefer and that staff will bring their meals to them if they ask. We observed a pureed meal brought to the table and this was attractively presented. Other residents complained that the food was always the same choice is very poor. We spoke with the chef who seemed to have a good understanding of the need to meet
Care Homes for Older People Page 4 of 10 residents preferences however, he admitted that there was still scope to improve the way that residents were able to contribute to meal planning. Extra snacks are available outside of meal times although residents we spoke with told us that they had never ordered these. We did notice that the kitchen seemed rather disorganised when we visited. A delivery had just arrived and this was being unpacked art the same time that lunch was being cooked. We looked at a sample of care plans during our visit. There is a standard BUPA care plan in place for each resident. These contained up to date information about residents health care needs including the prevention and management of pressure sores. BUPA employs a tissue viability nurse and the home uses photographic evidence to monitor wound healing. We did note that there was no evidence that residents have been able to contribute to the care planning process even when we could see that they would have been able to. There was also limited information available about their past lives and preferences which would help care staff understand more about them. The majority of the safeguarding referrals had arisen following care managers reviews and we wanted to make sure that residents knew the process to be followed should they want to raise any concerns themselves. We saw that there was a copy of the complaints procedure in the hall and residents said that they would tell a member of staff if they had any problems and they were sure that they would be sorted out. They were particularly confident of the abilities of the new manager. Staff were aware of the procedures to be followed should they suspect any abuse was occurring in the home although they were not always sure to contact should they need to tell someone more senior in the organisation. We did find that the occurrence of staff meetings and supervision in the past has been a bit patchy. Staff said that they had attended a meeting to meet the new manager but they felt that they would benefit from more one to one and group meetings in order to share ideas and good practise. We found some areas of the home uncomfortably hot and people told us that there is a lack of ventilation in the bathrooms. We were assured that this is going to be addressed What the care home does well: What they could do better:
Residents in the home consider that the service is short of staff and the evidence that we
Care Homes for Older People Page 5 of 10 found supports this conclusion. People are waiting a long time when they ring their call bells for help. When they need to use the toilet this has lead to some of them soiling themselves which we consider is unacceptable. Residents also tell us that the lack of staff stops them from joining in any activities in case they cannot get back to their rooms afterwards. BUPA must review the staffing levels in the home. Although there is training for staff about promoting residents privacy and dignity this is clearly not happening. People tell us that staff do not always shut the doors and go in and out when they are using the toilet. There must be an improvement in staff training in this area. Not all of the residents are happy with the food that is served in the home. The home must explore ways to involve them in menu planning and monitor their satisfaction with the meals that are served. We could not find any evidence that residents or their relatives are involved in the care planning process. Many of the residents in this home would be capable of discussing their care plan and others have relatives who might be interested. They must be given this opportunity to influence the way that care is provided to ensure that it meets their needs and preferences. There should also be more information available about residents past lives and preferences. This helps care staff understand more about the people that they are caring for and able to engage with them. Supervision and appraisal must be introduced for all staff in order to monitor their performance and identify future training needs. There must also be regular staff meetings to ensure that all staff are made aware of what is happening in the home. In order to improve the care of residents in the home a training plan must be introduced which focuses on considering the issues which affect the health and welfare of the people who live in the home. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Older People Page 6 of 10 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements
These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 7 of 10 Requirements and recommendations from this inspection:
Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours.
No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set.
No. Standard Regulation Requirement Timescale for action 1 7 15 Residents or, if it is not practicable, their representatives must be given the opportunity to contribute to the care planning process. To ensure that people are being supported in line with their preferences. 30/10/2009 2 15 16 More opportunities to 30/10/2009 influence meal planning must be be given to residents. So that they are able to get meal choices that suit their tastes and preferences. 3 27 18 Staffing levels must be reviewed and if necessary increased. To ensure that there are always enough staff on duty to meet the needs of the residents. 30/10/2009 4 30 18 All staff must participate in a 30/10/2009 training plan which focuses on the issues which affect
Page 8 of 10 Care Homes for Older People Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set.
No. Standard Regulation Requirement Timescale for action the health and welfare of the people who live in the home. So that they are able to understand about their needs and how to support them. 5 36 18 Supervision and appraisal must be introduced for all staff. In order to monitor performance and identify future training needs. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service.
No Refer to Standard Good Practice Recommendations 30/10/2009 1 6 It is recommended that more work should be done around collecting information about residents past lives and achievements. So that staff are able to understand about the people that they are caring for. Care Homes for Older People Page 9 of 10 Reader Information
Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 10 of 10 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
