Inspection on 25/04/06 for Lynwood House

This inspection was carried out on 25th April 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Lynwood House 23/02/10

Lynwood House 24/11/08

Lynwood House 10/05/07

Lynwood House 17/10/05

Lynwood House 23/05/05

Lynwood House 03/02/05

Lynwood House 27/07/04

Lynwood House 06/02/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Lynwood House Lynwood Close Midsomer Norton Bath & N E Somerset BA3 2UA Lead Inspector David Smith Unannounced Inspection 25th April 2006 09:15a Lynwood House DS0000052026.V290277.R01.S.doc Version 5.1 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 Lynwood House DS0000052026.V290277.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 Adults 18-65. 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 House DS0000052026.V290277.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Lynwood House Address Lynwood Close Midsomer Norton Bath & N E Somerset BA3 2UA 01761 412026 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) Voyage Ltd Mrs Angela Czerny Care Home 14 Category(ies) of Learning disability (14) registration, with number of places Lynwood House DS0000052026.V290277.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. May accommodate up to 10 people in Lynwood House. May accommodate people who in addition to their learning disability have associated needs including autistic spectrum disorder. May accommodate, in designated rooms within Lynwood House, up to 4 people who in addition to their learning disability are wheelchair dependant. May accommodate up to 4 people in Lynwood House Annexe May accommodate, in the ground floor bedroom within Lynwood House Annexe, 1 person who, in addition to their learning disability, is a wheelchair user 17th October 2005 Date of last inspection Brief Description of the Service: Voyage Limited, who are part of the Paragon Healthcare Group, operate Lynwood House. Lynwood House is a spacious detached property situated in a quiet residential cul de sac in Midsomer Norton. A neighbouring property also forms part of the registration and is known as Lynwood Annexe. The service is near to local shops and facilities in the town of Midsomer Norton. Bath city centre is nine miles away. The house and the annexe are set within their own grounds backing onto school playing fields. Lynwood Houses statement of purpose describes its philosophy of care as based upon Gentle Teaching and good parenting techniques. The homes ethos is transitional care in the sense of young adults moving from specialised educational settings or from parental homes to a setting where their needs can be met on as long-term a basis as their healthcare conditions allow. Lynwood House DS0000052026.V290277.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced, Key inspection carried out during one day. The inspector gathered evidence for this inspection report through discussions with the manager, deputy manager, care staff, one resident and one parent. Interactions between staff and six other residents were also observed. Care plans and associated records were examined, as were staff training records, health and safety records and risk assessments. The inspector was also provided with a tour of the home. The people who live in the home wish to be described as “residents” and this term has therefore been used in the body of this report. What the service does well: The service continues to maximise each residents quality of life and this is recognised by those who advocate for each resident, be they parents, social care professionals or health professionals. A wide range of professional expertise is actively used in order to support and maintain residents’ health and well being. The expertise of families is also acknowledged and there is openness in this partnership. Pre-admission assessment procedures are thorough and are well applied. Comprehensive transitional planning is centred on each resident’s individual needs. Staff continue to support residents to participate in their local community and to develop their potential through the use of a range of community facilities and through experiencing events and places of interest. The sensory room is a particular strength. Lynwood House offers clean, pleasant and homely accommodation with good quality furniture, fixtures and fittings. Despite the amount of equipment necessary to meet health needs in many of the bedrooms and bathrooms, these rooms remain personalised to an impressive degree. Lynwood House DS0000052026.V290277.R01.S.doc Version 5.1 Page 6 There is a strong core of committed staff who are focussed on their responsibilities. Staff are well supported by a manager who is dedicated and able. Staff were responsive to the needs of the residents. Residents were seen to be relaxed and happy in the company of staff. What has improved since the last inspection? What they could do better: The home should update its Statement of Purpose. This will ensure all readers of this document are provided with accurate information. An alternative means to the passenger lift of transferring between the ground and first floors is needed. The fire alarm system must be checked on a regular basis. This will help to ensure the welafre and safety of residents and staff. Internal redecoration of communal areas in the main house should be kept on a rolling programme in anticipation of the inevitably high levels of wear and tear. Lynwood House DS0000052026.V290277.R01.S.doc Version 5.1 Page 7 Residents could be involved in ideas for making the back garden of the main house more visually interesting and developing its use. 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 House DS0000052026.V290277.R01.S.doc Version 5.1 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Lynwood House DS0000052026.V290277.R01.S.doc Version 5.1 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3 and 4. There continues to be a thorough and tailored process of assessment and visiting which enables the home and each prospective resident and their families to make an informed decision about the placement. EVIDENCE: The Statement of Purpose for the home was updated in January 2006. Together with the Service User Guide, it provides clear information about the service for families and placing authorities. This document needs to be updated to reflect recent changes within the staff team. The home has admitted two new residents since the last inspection. The care records for both residents were therefore examined. These records showed that comprehensive assessments were carried out by the home and were used in conjunction the Funding Authority’s Care Plan/Assessment of Needs. Information from families and previous placements had also been sourced. Lynwood House DS0000052026.V290277.R01.S.doc Version 5.1 Page 10 There were also records of assessment from other Health Care Professionals, such as Psychology reports, Sensory Integration Assessments, and Occupational Therapy Assessments. All of the available information had been used to determine whether a good quality service could be provided. Each resident had been formally offered a placement in the home. Each transitional plan was centred on the resident concerned. For example, one resident was supported by care staff form Lynwood House whilst she was living with her mother. Staff not only supported the resident in her mother’s home, but also supported trips out in the community. This was deemed the most appropriate way to establish her service and build relationships with the staff team. This process was supported with three separate visits to Lynwood House prior to the resident moving in to the home. The initial care plans were reviewed each month and an “Initial Placement Review” meeting had been held for each resident after living in the home for three months. Lynwood House DS0000052026.V290277.R01.S.doc Version 5.1 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9. The care plans examined provided good information in how to support each resident. There was a clear review process evident. Residents are supported to make decisions about their lives as much as their health conditions allow. Residents are supported to take risks as part of an independent lifestyle. EVIDENCE: The personal files of four of the residents were examined. Each file contained an individual care plan, which contained information on the residents’ health, medication, self help skills, daily living skills, activities and communication needs. These care plans were detailed and informative and set out action that needed to be taken by staff in order to meet the individual’s needs. The home uses a pro-forma to track care plan reviews. Minutes of each review meeting were also evident. Residents, parents, Social Workers and other Lynwood House DS0000052026.V290277.R01.S.doc Version 5.1 Page 12 Health Care Professionals such as Occupational Therapists and Physiotherapists, attend review meetings where appropriate. Each care plan had been reviewed recently and had also been signed by the resident’s parents, Social Worker and the manager of the home. Daily records for each resident have been improved. These are now written in an objective way and are now supported by evidence. The monthly summaries by residents’ key workers showed that the residents’ needs were being monitored. These now appear better linked to the care plan review. Due to the nature of the disabilities of some of the people who live in the home it can be difficult for them to clearly communicate choices/wishes. Staff explained that they use a number of methods to ensure people are supported to make choices and decisions. For example staff use observation of eye movements, body language, behaviours or gestures of individuals as indicators of choice/wishes as well as residents being able to express themselves verbally. There are person centred Risk Assessments in place, which are clear and concise. These support residents to take risks as part of an independent lifestyle. These form part of each persons care plan and are regularly reviewed and updated. The risk assessments in relation to manual handling tasks are currently being reviewed and simplified by the home. It is hoped these will include photos/pictures of each task. These will be examined as part of the next inspection process. Lynwood House DS0000052026.V290277.R01.S.doc Version 5.1 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14 and 15. Residents continue to be supported by staff to pursue activities which they enjoy, are tailored to their needs and which enable them to have an interesting and fulfilling lifestyle. Staff continue to support residents to participate in their local community and to develop their potential. Staff continue to enable and support family contact. The views of family members have been acknowledged and accommodated where practicable. EVIDENCE: The home’s activities schedule and observation during the inspection evidenced that residents continue to be supported to enjoy a range of activities, which include both social and educational opportunities. In January 2006 a new 30 hour post was created for an Activities Co-ordinator. The inspector spoke with this member of staff who confirmed that each Lynwood House DS0000052026.V290277.R01.S.doc Version 5.1 Page 14 resident now has an individual weekly programme, which all staff worked to support. Her post had helped develop and improve programmes for residents. A number of residents attend local colleges to pursue a wide range of interests. Residents continue to use a hydrotherapy pool. Individual/groups of residents are also regularly supported to enjoy such things as trampolining, horse riding, visiting the local library, shops or cafes, or enjoying day trips with staff members to places of interest. A small group of residents went ten pin bowling on the day of inspection. The inspector spoke to one resident who had just returned from college. He enjoys his course at Norton Radstock College and has many friends there. He also enjoys going horse riding and spoke of the sports day being organised for the summer, in the home’s garden. He has two holidays planned for this year, one is with the Gateway Club and another is with his friends at college. The home had a selection of videos for the residents to watch in the comfort of their own bedroom or in the main lounge area. Staff members were observed supporting residents to select a video of their choice to watch. On the day of inspection a new plasma screen television was being secured to the lounge wall. The home has its own sensory room facilities in the annexe, which is very well equipped and used by all of the residents. With resident’s permission the Inspector was able to sit in on part of a physiotherapy session. An Assistant Physiotherapist and the home’s education co-ordinator led this session. A variety of equipment was used, including a parachute, balloons and inflatables. The three residents appeared to enjoy this session and were seen to respond and interact positively. Most of the residents have regular contact with their families. Some residents regularly go to stay with their parents for weekends and some residents’ parents visit the home on specific days each week. Parents have a wealth of knowledge about their son or daughter to bring to the provision of their care and support. This information is sought and welcomed by the home. One parent spoken with explained she was able to discuss her views in relation to the care of her relative openly with the home manager. She felt her views were listened to and acted upon if possible. She had provided the home with lots of information relating to the care needs of her relative. She felt that Lynwood House, in general, provided good levels of care and support. Any issues or concerns she may have are raised with the home’s manager immediately. Lynwood House DS0000052026.V290277.R01.S.doc Version 5.1 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 and 19. Residents are supported in their preferred manner and their physical, emotional and healthcare needs are well met. Experienced staff have a good knowledge of each resident and how to provide appropriate levels of support. Any concerns are noted and acted upon. EVIDENCE: The care documentation in place for residents provided clear guidance for staff on how they should support each person with their personal care. The inspector saw that each person had in place care plan information covering the holistic and varied needs of each resident. Lynwood House DS0000052026.V290277.R01.S.doc Version 5.1 Page 16 The health needs of residents are well met with evidence of good multi agency working taking place on a regular basis. All of those living at the home are registered with a general practitioner; evidence was in care records to confirm that residents are supported with their primary healthcare needs such as optician and dentist. Other specialist services are accessed when an identified need arises. These are provided by Bridges Community Learning Disability Team. Care records show the home is regularly supported by the Consultant Psychiatrist, Physiotherapists, Speech and Language Therapists, Occupational Therapists and other relevant health care professionals. Contact with each professional is recorded and forms part of each persons care plan. It was noted by the inspector that the home evidently has an extremely close working relationship with Bridges CLDT. This provides a valuable resource to assist the home in planning and providing a specialist service for residents with complex needs. Staff spoken with confirmed that care plans contained extremely detailed information on the care and support needs of each resident. They are also provided with relevant training. Each member of staff commented they felt they had good knowledge of each resident’s health care needs and what would alert them to any changes in a resident’s health. It was evident at this inspection that the management and staff spoken with are sensitive to the healthcare and emotional needs of those living at the home and through observation and discussion demonstrated respect to the wishes of individuals living at the home. Lynwood House DS0000052026.V290277.R01.S.doc Version 5.1 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Residents are supported to communicate their views and they can be confident that they will be listened to and their views acted on if necessary. Clear policies and procedures are in place in order to protect residents from the likelihood of abuse, neglect and self-harm. EVIDENCE: The inspector examined the home’s complaints log. There have been no complaints recorded since the last inspection. There have been no complaints received by CSCI direct regarding Lynwood House. Staff spoken with were clear about the advocacy role they have. Due to the vulnerability of residents, many of them would rely on staff raising concerns on their behalf. Staff spoken with demonstrated a good knowledge of the action they would take if they suspected or witnessed abuse. They also confirmed that they had received training in the Protection of Vulnerable Adults. They use their daily interactions and observations when supporting residents to help alert them to any physical signs or changes in behaviour, which may cause them concern. One resident spoken with who is able to communicate verbally was open about their views of the home and said that the manager and staff listened to their Lynwood House DS0000052026.V290277.R01.S.doc Version 5.1 Page 18 views. Residents observed who are unable to communicate verbally or manually seemed relaxed and happy in the company of staff. Lynwood House DS0000052026.V290277.R01.S.doc Version 5.1 Page 19 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27, 29 and 30. Lynwood House offers clean, pleasant and homely accommodation with good quality furniture, fixtures and fittings. Internal redecoration of communal areas in the main house should remain on a rolling programme in anticipation of the inevitably high levels of wear and tear. Bedrooms and bathrooms have been personalised by residents with the help of parents and /or staff to an impressive degree. An alternative means to the passenger lift of transferring between the ground and first floors of the main house remains unresolved. The back garden of the main house still requires a clear plan of development/improvement. EVIDENCE: The inspector was provided with a tour of the home. There have been no changes in the services and facilities provided at the home since the previous Lynwood House DS0000052026.V290277.R01.S.doc Version 5.1 Page 20 inspection. The location and layout of the home is suitable for its intended purpose. Between them, the main house and annexe offer fourteen single bedrooms, all with en-suite facilities. Within the main house there are four bedrooms on the ground floor and six bedrooms on the first floor. There is a passenger lift between the two floors. There are two communal lounge areas, two adjoining dining areas, an activity room with kitchenette and a domestic style kitchen. Within the annexe there is one ground floor bedroom and three further bedrooms on the first floor. There is no passenger lift between floors and service users who accommodate bedrooms on the first floor of the annexe need to be able to manage stairs. There is a dining room, a communal lounge, and a domestic style kitchen in the annexe. Both properties provide a ground floor communal toilet and both properties have laundry facilities. In addition there is a sensory room available in the annexe, which all residents are able to use. Each bedroom remains furnished and decorated to a high standard and personalised through photographs and other personal possessions. This level of personalisation, with the evident involvement of the person themselves where possible, showed that their individuality is respected and promoted. Almost all of the bathrooms had had a similar degree of personalisation. There are ceiling track hoists in many rooms and mobile hoists are also available. The home also has other specialist equipment to ensure the dignity and comfort is maintained for each person who lives in the home. Some communal areas in the main house, notably corridors and skirting boards, still show signs of wear and tear: this is understandable given the amount of use of wheelchairs and other equipment. The manager told the inspector that redecoration costs of these areas should be included within this years maitenece budget and this work would hopefully be carried out shortly. The issue of residents on the first floor having an alternative to the shaft lift remains unresolved. The manager told the inspector that discussions were ongoing in relation to this issue. The back gardens for both houses are private areas; the plan to develop the back garden of the main house is not yet finalised. This area will be developed/improved although areas of clear space are required to enable wheel chair users to enjoy the garden area. Lynwood House DS0000052026.V290277.R01.S.doc Version 5.1 Page 21 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 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, 32, 33, 35 and 36. There is a strong core of committed staff who remain very focussed on their responsibilities. Staff are well supported by the manager. The relationships between staff and residents are well established. This provides a supportive environment for each individual who lives in the home. Staff are provided with appropriate training and support to ensure they can meet each resident’s care and support needs. EVIDENCE: There is a core of well-established staff with varying abilities who are skilled and experienced to meet the needs of those living in the home. Staff members spoken with were able to demonstrate a clear understanding of their role and responsibilities within the team and their own personal role and accountability. Discussions with staff members and observation of their work practice demonstrated that they were approachable, good communicators and were comfortable with the residents living at the home who were at ease with them. Lynwood House DS0000052026.V290277.R01.S.doc Version 5.1 Page 22 Staff members told the inspector that the staff team was extremely open, honest and supportive. Each commented on how nice it is to work in the home. They felt well supported by the manager and were able to discuss issues in an open and honest way. There are regular staff meetings. The day staff and night staff teams meet separately. All meetings are recorded and appropriate subjects are discussed in order to guide and direct staff practice. Staff are provided with regular, formal supervision. Staff spoken with told the inspector they are supervised approximately every four to six weeks. They find supervision helpful and supportive. On the day of inspection the Deputy Manager supervised several members of the night staff team. The training records of six staff were examined. These showed that staff were being provided with appropriate training to enable them to support residents. The training provided includes TOPPS Induction, Protection of Vulnerable Adults, Manual Handling, Food Hygiene, Health and Safety, Total Communication, Epilepsy, Autism, First Aid, Fire Safety, Positive Positioning and Peg Feeding. Staff spoken with told the inspector that additional training is encouraged by the home. Some staff have attended Intensive Interaction, Infection Control and LDAF training. One staff member has recently been trained to deliver Manual Handling training to the staff team. There has been progress in supporting staff to attain a National Vocational Qualification. Two senior staff members are currently working towards their A1/A2 NVQ Assessors Award. They are therefore acting as assessors for care staff. The home currently has approximately 55 of the staff team either qualified or working towards an NVQ. Lynwood House DS0000052026.V290277.R01.S.doc Version 5.1 Page 23 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 42 and 43. The home is well managed ensuring that resident’s interests and rights are promoted and protected. The manager promotes a person centred approach and this is clearly communicated throughout the service. There are systems in place designed to promote and protect the health & safety of both individuals and staff. Some areas require minor improvement to ensure welfare and safety. EVIDENCE: The manger Mrs Czerny has worked at Lynwood House for two and a half years and has a good understanding of the diverse range of needs of those living at the home. Lynwood House DS0000052026.V290277.R01.S.doc Version 5.1 Page 24 The management approach is open and positive, with a clear sense of direction and leadership. Staff spoken with said their views are listened to, and that they are well supported by the manager. The philosophy of the home is based on ‘Gentle Teaching’ and ethos is of transitional care from other residential/educational settings or family homes to a setting where individuals needs can be met on as long term basis as their health condition allows. A person centred approach is adopted in the provision of care and support of each resident. All staff spoken with felt that each resident was seen as an individual and that their individual wants/needs/wishes were respected. In general, the recording systems in place to support the maintenance of health and safety in the home are being used consistently. The fire logbook for the home was examined at this inspection. The checks on the emergency lighting have improved since the last inspection. These are now conducted weekly. Regular fire drills are taking place; the last recorded dates were 20/12/05 and 24/4/06. Fire extinguishers are serviced annually. The fire alarm system should be checked on a weekly basis. However, during the last twelve weeks, there is no record of the fire alarm system being checked on two separate weeks. The Risk Assessment in relation to fire procedures was updated on 23/3/06. The home maintains records relating to PAT testing, lift servicing, hoist servicing, sling safety checks, electrical wiring, water temperatures, gas safety and clinical waste disposal. All of these records were in order and checks were up to date. Lynwood House DS0000052026.V290277.R01.S.doc Version 5.1 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 2 3 3 3 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 4 26 3 27 3 28 X 29 2 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 X 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 3 12 3 13 4 14 4 15 3 16 X 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 4 X X 3 3 X X X 2 3 Lynwood House DS0000052026.V290277.R01.S.doc Version 5.1 Page 26 Are there any outstanding requirements from the last inspection? YES 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. 2. 3. Standard YA1 YA42 YA29 Regulation 4 Sch 1 23(4) 23(2n) Requirement Statement of purpose must be amended to comply with National Minimum Standards. Ensure fire alarm checks are carried out at stipulated frequencies Provide an alternative means to the passenger lift of transferring between the ground and first floors. Timescale for action 24/05/06 25/04/06 25/07/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard YA24 YA24 Good Practice Recommendations Maintain a rolling programme of internal re-decoration of communal areas in the main house. Develop/improve the back garden of the main house. Lynwood House DS0000052026.V290277.R01.S.doc Version 5.1 Page 27 Commission for Social Care Inspection Bristol North LO 300 Aztec West Almondsbury South Glos BS32 4RG 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 House DS0000052026.V290277.R01.S.doc Version 5.1 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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