Inspection on 09/05/05 for Lynwood

This inspection was carried out on 9th May 2005.

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

Lynwood 30/04/09

Lynwood 18/06/08

Lynwood 20/06/07

Lynwood 19/10/06

Lynwood 26/05/06

Lynwood 28/02/06

Lynwood 14/10/04

Lynwood 19/04/04

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 Lynwood 57 Mersey Road Heaton Mersey Stockport SK4 3DJ Lead Inspector Sylvia Brown Announced 9 May 2005 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 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. Lynwood F54 F04 lynwood A s8603 v219493 090505 stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Lynwood Address 57 Mersey Road, Heaton Mersey, Stockport, SK4 3DJ Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 0161-432-7590 0161-432-7590 Mr M Mohsin & Mrs A Munif Mrs A Munif Care Home 23 Category(ies) of Dementia - over 65 years of age (10) registration, with number Mental disorder, excluding learning disability or of places dementia - over 65 years of age (3) Old age, not falling within any other category (20) Lynwood F54 F04 lynwood A s8603 v219493 090505 stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: - Date of last inspection 22 September 2004 Brief Description of the Service: Lynwood is a large Victorian detached house which has been converted into a care home and is set back in its own extensive grounds. The accommodation consists of 21 single rooms and one shared room, which are spread over three floors. Three of the single rooms and the one shared room have en-suite facilities. There is one large dining room, which has a small seating area overlooking the garden, two further lounges and a conservatory. The home is owned by Mr and Mrs Munif and is managed on a day-to-day basis by one of the registered providers, Mrs Munif. Lynwood is registered to care for 23 older people. The registration also allows for up to ten service users who are suffering from a dementia type illness and three service users who may have a mental health problem. The home is located in the Heaton Mersey area of Stockport and is close to local shops and other amenities, Stockport town centre, motorway network and public transport are easily accessible. Lynwood F54 F04 lynwood A s8603 v219493 090505 stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection of Lynwood was announced, and took place over two days starting at 8am on the first day and 10:15am on the second, with a total of nine hours on the premises. During the inspection the inspector spoke with two residents at length spending time sitting with them in communal parts of the home and sharing meal times. Time was also spent with a number of residents who did not have the capacity to make informed decisions and choices. One relative spoke with the inspector directly about the care of her mother, the details of which are included within the report. The emphasis of this inspection was to evaluate the home’s progress to meet requirements made at the last inspection and enable the inspector to introduce herself to residents, staff and the registered owners and to familiarise herself with the home. Prior to the inspection comment cards were received from three residents, two of which were completed by a relative on their behalf, six relatives’ comment cards were also received, the comments of which are included within the report. The home was unable to complete the requested pre-inspection questionnaire prior to and during the inspection. Separate arrangements have been made for the registered owners to supply any outstanding details to the CSCI after the inspection. What the service does well: Feedback from relatives and through direct observations made at the inspection, it appears that residents’ health care needs were met appropriately. Positive comments were made from residents regarding the food served and the amount of choice offered. The registered owner/manager was open, identifying areas of development required for herself. Lynwood F54 F04 lynwood A s8603 v219493 090505 stage 4.doc Version 1.30 Page 6 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. Lynwood F54 F04 lynwood A s8603 v219493 090505 stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Lynwood F54 F04 lynwood A s8603 v219493 090505 stage 4.doc Version 1.30 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 standard(s) 1, 3 & 5 Standard 6 is not applicable to Lynwood Residents have their care needs assessed and have the opportunity to visit the home and assess the service prior to making decisions about their future. EVIDENCE: Since the last inspection the home’s Statement of Purpose has been amended to include more information for residents. A copy has been provided to the CSCI. Inspection of two residents’ files identified that they had care needs assessments in place. There was no information to confirm that residents were able to visit the home prior to moving in. The registered owners stated that they would prefer visits to take place, however some residents prefer not to. One relative stated that they had been able to view the home prior to making any decisions. Lynwood F54 F04 lynwood A s8603 v219493 090505 stage 4.doc Version 1.30 Page 9 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 standard(s) 7, 8, 9 & 10 Resident’s safety and well-being were compromised by poor record keeping and disorganised medication administration. EVIDENCE: Care plans inspected were basic and had not been developed to meet the regulatory standards, as required at the last inspection. Direct comments from one relative and information received from comment cards confirmed that residents receive sufficient support to maintain their health. Residents’ safety was compromised due to poor recording of administered medication and through interrupted medication administration. Medication administration records contained a number of signature omissions and the person administering medication also assisted residents to eat whilst giving out medication. The pre-inspection questionnaire did not identify the most recent training for staff with responsibility for administering medication. Lynwood F54 F04 lynwood A s8603 v219493 090505 stage 4.doc Version 1.30 Page 10 One comment card mentioned in detail the care practices observed when the relative visits. It stated that the main toileting area on the ground floor is not big enough as residents are often observed receiving care, and that due to the door remaining open, strong odours are present within the hallway. Nail care routines were also identified by two relatives as requiring improving. Lynwood F54 F04 lynwood A s8603 v219493 090505 stage 4.doc Version 1.30 Page 11 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 standard(s) 12, 13, 14 & 15 Residents do not receive social stimulation that meets their individual needs and preferences. Some residents are able to continue to maintain some control over their own lives. EVIDENCE: One resident stated she did not think there were enough activities provided in the home. The home does not maintain details of activities undertaken within the residents’ care files and comments made by the registered manager regarding what was provided could not be confirmed. A resident confirmed that she may rise and retire as she wishes and was able to spend as much time as she desired in her room, visiting communal parts of the home when she wished. All comment cards from relatives stated they were made to feel welcome when visiting. One relative spoken to stated that staff were friendly and polite. Without exception, residents commented favourably on the food served and the choice on offer. One relative’s comment card stated, “she is obviously well fed”. However, the inspector concludes that residents are not supported to maintain their independence and that some routines were set, rather than flexible. Lynwood F54 F04 lynwood A s8603 v219493 090505 stage 4.doc Version 1.30 Page 12 Observations of two meal times identified that one resident had their cup of tea and cereals prepared a considerable amount of time before they came for breakfast, culminating in the tea being cool if not cold. Most residents had their drinks poured for them regardless of their ability to pour drinks for themselves. Residents were observed asking for and receiving second helpings of food. One resident stated that the food was “nice”. Lynwood F54 F04 lynwood A s8603 v219493 090505 stage 4.doc Version 1.30 Page 13 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 standard(s) 16 & 18 The home’s complaints procedure is not know to all relatives. Complaints are not recorded in sufficient detail. Residents’ protection from abuse is compromised as staff are not trained in adult protection procedures. EVIDENCE: Although relatives’ comment cards stated they had no reason to complain, three relatives stated that they had not received information regarding the home’s complaints procedure. The registered owner/manager stated that there had been no changes regarding the recording of complaints and the requirement made at the last inspection had not been complied with. The pre-inspection questionnaire stated that adult protection procedures were in place, the inspection of which identified that only six staff had signed to say they had read the information. There were no records to confirm that staff had received adult protection training. Lynwood F54 F04 lynwood A s8603 v219493 090505 stage 4.doc Version 1.30 Page 14 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 standard(s) 19 & 26 Residents live in a clean and comfortable home. EVIDENCE: One comment card received from a relative described Lynwood as “more of a home than an institution”. The various lounges are individually decorated with a variety of seating to meet the needs of residents. Carpet replacement has commenced with the rear lounge and conservatory. On the day of the inspection the home was free from odours. The lounge/dining room to the rear of the home also includes an office area where records relating to the care of residents are on view. This is not advisable as it does not maintain confidentiality for residents and does not enhance the homeliness for residents. Lynwood F54 F04 lynwood A s8603 v219493 090505 stage 4.doc Version 1.30 Page 15 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28, 29 & 30 Staff are not provided in sufficient numbers to meet the needs and demands of the home. Staff moving and handling practices compromised residents’ safety. Staff recruitment procedures were adequate. EVIDENCE: Staff stated that residents’ dependency was high for them to manage, causing them some difficulty in completion of their tasks in a timely manner. Nighttime staff work alone which is not best practice nor does it ensure the protection of residents. The registered owner/ manager stated that she had tried to develop staffing levels and routines, however staff are resistant to change. Observations were that whilst the registered owner/manager administered medication at breakfast, she also assisted feeding residents. Such practice compromises residents’ safety. Mr Munif was also observed supporting breakfast routines, including serving and assisting residents to eat. Mr Munif is not included on the rota. Staffing levels, both morning and night, should be increased for the safety, support and comfort of residents. Lynwood F54 F04 lynwood A s8603 v219493 090505 stage 4.doc Version 1.30 Page 16 Observations were that care staff used wheelchairs without footrests and that visiting hairdressers also used wheelchairs to transport residents without using footrests. There was no evidence to confirm that the hairdressers were trained in moving and handling techniques, nor were they familiar with the residents’ individual moving and handling assessments. The pre-inspection questionnaire identifies that moving and handling training is planned for the future for the care staff. Inspection of staff files identified that recruitment and selection procedures had improved, sufficiently to meet the requirement previously made. The home’s lack of order in its administration systems did not enable the inspector to confirm that all levels of staff had received sufficient training appropriate to the work they perform which ensures the safe support of residents. Notwithstanding the above comments, the pre-inspection questionnaire states that nine of the 13 care staff have completed NVQ training at level 2. Lynwood F54 F04 lynwood A s8603 v219493 090505 stage 4.doc Version 1.30 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 33, 35, 36, 37 & 38 The home is not managed by a person trained to do so. Staff do not receive formal supervision and, in part, dictate the routines of the home rather than the residents. EVIDENCE: The registered manager was knowledgeable regarding the needs of residents and of the conditions associated with older age. The registered manager has yet to undertake NVQ training at level 4and achieve the registered manager’s award. Lynwood F54 F04 lynwood A s8603 v219493 090505 stage 4.doc Version 1.30 Page 18 The manager stated that the home does not take any responsibility for residents’ financial arrangements. Residents receive support from social services, advocates and family members regarding the management of their finances. The pre-inspection questionnaire stated that one resident continues to manage their own finances. Inspection of staff files identified that not all staff have received formal supervision. The home does not have an organised administration system. Information is held in three areas within the home. Such practice has the potential for residents’ needs not being identified or met and places them at risk. Information was collectively recorded, rather than individually on the residents’ files. There was no system to evaluate recorded information. Lynwood F54 F04 lynwood A s8603 v219493 090505 stage 4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x 3 x HEALTH AND PERSONAL CARE Standard No Score 7 1 8 2 9 1 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 2 14 3 15 3 COMPLAINTS AND PROTECTION 3 x 2 x x x x 3 STAFFING Standard No Score 27 2 28 1 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 1 x 1 2 x 2 x 3 1 2 3 Lynwood F54 F04 lynwood A s8603 v219493 090505 stage 4.doc Version 1.30 Page 20 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. 1. Standard OP7 Regulation 17 (a) (a) Schedule 3 Requirement The registered person must ensure that all care plans are appropriately detailed and provide sufficient information to enable staff to care for service users. The registered person must ensure that service users have a risk assessment as and when necessary. (Previous timescale of 31/11/04 not met). The registered person must ensure that medication administration records are completed to the required standard and that administration of medicines complies with the guidance set by the Royal Pharmaceutical Society. The registered person must ensure that residents privacy is respected at all times. The registered person must provide sufficient social activities to meet the individual needs of residents. The registered person must ensure that all residents and relatives are made aware of the homes complaint procedure. The registered person must Timescale for action 1/8/05 2. OP8 13(4) 1/8/05 3. OP9 13 (2) 1/6/05 4. 5. OP10 OP12 12 (a)(a) 16 (2)(m) 1/6/05 1/7/05 6. OP16 22 (5) 1/7/05 7. Lynwood OP16 22 1/6/05 Page 21 F54 F04 lynwood A s8603 v219493 090505 stage 4.doc Version 1.30 8. OP18 9. OP21 10. OP27 11. OP28 12. OP28 13. OP31 14. OP37 ensure that all complaints are recorded and that details include the nature of the complaint and the action taken to find a positive resolution. (Previous timescale of 31/11/04 not met). 13(6) The registered person must ensure that all staff, including herself, receive up to date adult protection training and that all staff are familiar with adult protection procedures within the home and are aware of their responsibility to report all allegations and/or suspicions of abuse. 23(1)(a) The registered person must ensure all toilets are of a suitable size and adapted to meet the needs and requirements of residents. 19(1)(a) The registered person must ensure that there are sufficient numbers of staff day and night to meet the needs and ensure the safety of residents. 13(4)(a) The registered person must ensure that staff are competent at safe moving and handling and that they ensure the correct use of footrests on wheelchairs when transporting and assisting residents. 18(1)(c) The registered person must (i) ensure that all staff with responsibility for providing care and support to residents receive up to date moving and handling training 9 (2)(b)(i) The registered manager must complete training at NVQ at level 4 and achieve the registered managers award. 37 & The registered person must Schedule ensure information relating to 3(j) accidents are maintained in accordance with the Data Protection Act 1988. F54 F04 lynwood A s8603 v219493 090505 stage 4.doc 1/7/05 1/7/05 1/7/05 1/6/05 1/7/05 31/3/06 1/6/05 Lynwood Version 1.30 Page 22 15. OP38 The registered manager must provide confirmation that of the homes compliance with requirements and recommendation made at the last fire inspection and compliance with requirements and recommendations arising from the last environmental health inspection. 1/6/05 16. 17. 18. 19. 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 OP5 Good Practice Recommendations The registered person should record all pre-admission visits undertaken by the residents and/or their representative, such records should detail information provided and any evaluations made during the visit The registered person should ensure that if nail care support is identified, it is included within the residents care file and recorded each time completed. The registered person should, wherever possible, enable residents to pour their own drinks. The registered person should ensure that information relating to residents is maintained confidentially and away from public access. The registered manager should ensure that all care staff receive formal supervision no less than six times per year and ancillary staff periodically. (This was a recommendation in the inspection report of April 2004). The registered manager should improve administration systems to enable the correct storing of information relating to residents. 2. 3. 4. 5. OP7 OP15 OP19 OP36 6. 7. 8. 9. Lynwood OP37 F54 F04 lynwood A s8603 v219493 090505 stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection 2nd Floor Heritage Wharf Portland Place Ashton under Lyne, 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. Extracts may not be used or reproduced without the express permission of CSCI Lynwood F54 F04 lynwood A s8603 v219493 090505 stage 4.doc Version 1.30 Page 24 - 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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