Inspection on 25/09/06 for Lynwood House

This inspection was carried out on 25th September 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

Lynwood House 18/09/08

Lynwood House 05/12/05

Lynwood House 20/07/05

Lynwood House 29/10/04

Lynwood House 14/04/04

Similar services:

Turret Villa Retirement Home

Moor House

Mendip House

Beaconsfield Court Care Home

Little Sisters Of The Poor

Manor House

Middleton Hall Ltd

Middlesbrough Intermediate Care Centre

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

CARE HOMES FOR OLDER PEOPLE Lynwood House Lynwood House Durham Road Lanchester Co Durham DH7 0LP Lead Inspector Mr Stephen Ellis Unannounced Inspection 25th September 2006 2:00 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 Lynwood House DS0000031189.V311084.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Lynwood House DS0000031189.V311084.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Lynwood House Address Lynwood House Durham Road Lanchester Co Durham DH7 0LP 01207 520292 P/F 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) Durham County Council Mrs Ann Steadman Care Home 36 Category(ies) of Dementia - over 65 years of age (10), Learning registration, with number disability over 65 years of age (7), Old age, not of places falling within any other category (26) Lynwood House DS0000031189.V311084.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Learning Disability - LD(E) That 7 places be maintained for those service users in the category of LD(E) until those service users no longer require this accommodation. 5th December 2005 Date of last inspection Brief Description of the Service: Lynwood House is a long established care home for older people. Durham County Council’s Adult and Community Services Department is the registered provider of the service. There are 36 single bedrooms, although only 33 are intended for use. These do not have en-suite facilities, but all are situated on the ground floor. Toilet and bathing facilities, plus lounges and dining areas, are well distributed and accessible. There is a semi-independent unit of 10 beds dedicated to assessment. Three beds in the larger unit are reserved for respite care, with the remainder given over to permanent care. The home is centrally located, between the Anglican Church and King’s Head pub in Lanchester. There is good access. It occupies a large, relatively level site with spacious garden. The weekly charge is £432.32, although the amount service users pay depends on their personal circumstances. They may also be required to pay a contribution towards the costs associated with some activities. Hairdressing is available, with costs varying between £2 and £8.50. The home is provisionally due to close in 2006 and a decision on its future is expected between October and December 2006. Lynwood House DS0000031189.V311084.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over 3.5 hours. It included a tour of the building, examination of a number of records and discussions with 9 residents, one relative and 3 staff. The overall quality rating for this care home is: ‘good’. This judgment has been made from evidence gathered both during and before the visit to this service. What the service does well: What has improved since the last inspection? What they could do better: There are no significant issues to address at present. An announcement concerning the home’s future is expected in late Autumn. Lynwood House DS0000031189.V311084.R01.S.doc Version 5.2 Page 6 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 DS0000031189.V311084.R01.S.doc Version 5.2 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 Lynwood House DS0000031189.V311084.R01.S.doc Version 5.2 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 and 3 Quality in this outcome area is good. This judgment has been made from evidence gathered both during and before the visit to this service. Prospective residents and their representatives have the information needed to choose a home that will meet their needs. They have their needs assessed and a contract which clearly tells them about the service they will receive. EVIDENCE: Residents confirmed that full assessments of their needs were carried out prior to being admitted to the home. They said they had enough information from which to make a choice about being admitted. Comprehensive service user guides and clear statements of terms and conditions of residence are supplied routinely. Care plans revealed comprehensive, detailed assessments of need being carried out both prior to admission and afterwards, as confirmed by members of staff. These assessments showed that the home only admitted people whose assessed needs it could meet. Over the past 2 years, the home has developed a 10-bedded assessment unit. This unit only admits people for short-term assessment from hospital or the community. The people it admits Lynwood House DS0000031189.V311084.R01.S.doc Version 5.2 Page 9 undergo assessment prior to admission to ensure that the unit is appropriate for their needs. This unit is proving to be very successful in carrying out short term, intensive assessments: 99 admissions between 1st August 2005 and 1st June 2006, with an average length of stay of about 4 – 5 weeks. Elsewhere within the home, there are a small number of beds provided for respite care. The majority of beds are for long-term care. Intermediate care (intensive, multi-agency rehabilitation service) is not provided. Lynwood House DS0000031189.V311084.R01.S.doc Version 5.2 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 Quality in this outcome area is good. This judgment has been made from evidence gathered both during and before the visit to this service. The health and personal care, which a resident receives, is based on their individual needs. The principles of respect, dignity and privacy are put into practice. EVIDENCE: Residents said that they believed their health and social care needs were well known by staff and were being fully met. They said that the community nurse or doctor would see them whenever required. Their personal and social care needs were known, understood and respected by the staff team. They said that they felt they were treated with respect and sensitivity. As one resident said: “You couldn’t ask for a nicer, cleaner place…the staff are very good to us”. Another resident said: “One of the best places you could go to…good company, good food and good staff…we all get on very well…no problem if I need to see the doctor who will visit me at the home”. Several described the staff as being “very helpful”. Lynwood House DS0000031189.V311084.R01.S.doc Version 5.2 Page 11 Care plans were detailed and comprehensive about service users’ health and social care needs, providing clear guidance to staff. They were subject to regular review, in keeping with National Minimum Standards. Staff training (e.g. NVQ level 2) has included the important issues of privacy and dignity and a high percentage of care staff (61 ) have achieved NVQ in care. A typical comment from a resident was: “It’s excellent here and we mix well together”. There are good arrangements for the safe administration of medicines. Most care staff members, including residential supervisors and manager, have completed the Safe Handling of Medicines course. There is good support from a local Pharmacist who supplies most of the medication in Monitored Dosage form (in blister packs with the medication clearly identified for the individual resident). There are good storage systems and care staff check all medication when it is received into the home. The home requires medication to be administered only from the container(s) into which the pharmacist dispensed it originally. Medication is kept securely in lockable cabinets and trolleys. Residents may attend to their own medication, but in practice most prefer to delegate this responsibility to staff. Unwanted medicines are returned promptly to the Pharmacist and the home is careful not to stockpile large quantities. Care staff carry out medicine audits routinely. Lynwood House DS0000031189.V311084.R01.S.doc Version 5.2 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 - 15 Quality in this outcome area is good. This judgment has been made from evidence gathered both during and before the visit to this service. Residents are able to choose their lifestyle, social activity and keep in contact with family and friends. Social, cultural and recreational activities meet residents’ expectations. Residents receive a healthy, varied diet according to their assessed requirement and choice. EVIDENCE: Residents said that they enjoyed living at Lynwood House. They described the staff as being caring and helpful. They could exercise choice in their daily lives. For example, they could decide what clothes they wore and how they spent their days, including what times they got up and went to bed. They said that there was a varied programme of social and recreational activities, including visiting entertainers, crafts, reminiscence and outings. Since the last inspection, residents have had a barbecue at the home plus several outings, including visits to the Metro Centre, Dale Centre and South Shields. A typical programme includes a fish and chip supper on the last Friday of every month, a visiting entertainer twice a month, visits from ‘Create’ twice a month (local crafts, reminiscence and recall service in which residents can participate), plus Lynwood House DS0000031189.V311084.R01.S.doc Version 5.2 Page 13 residents’ meetings every 2 months at which matters of interest and suggestions are discussed. Residents could pursue individual interests if they wished, such as reading, television, gardening or knitting. People’s religious needs were being addressed. There were services from different denominations held each month within the home. An Anglican Church is just across the road. Residents said that visitors were always made welcome and could call at any reasonable time. Some residents went out with relatives or friends for part of the day. Many residents said they liked the atmosphere in the home, describing it as being peaceful, friendly, supportive and caring. They liked the small groups in the various lounges. They were free to sit in any lounge, in their own bedroom, or in the reception area or dining room. All were satisfied with the arrangements for daily life in the home. All the residents spoken to said the catering was very good. There was a good choice and the Cook understood their preferences. They particularly liked the home baking. A cooked breakfast was available for those who wanted one. Residents mainly dined together in one or other of the two dining rooms. They could, however, eat their meals elsewhere and at different times if required. Décor and furnishing in dining areas was attractive, creating a relaxed and welcoming environment. For example, good use is made of tablecloths, napkins and floral arrangements, plus there are practical, comfortable chairs for residents’ use. Records are kept of meals served, available for inspection. There was much emphasis on home baking and cooking, such as cakes and broths, which were very popular with residents. A choice of two menus, plus alternatives, was always provided. Birthdays were always celebrated with a cake and, sometimes, a special tea if it was a ‘special’ birthday. Residents also have access to a bar within the home serving drinks of their choice, including alcohol. Lynwood House DS0000031189.V311084.R01.S.doc Version 5.2 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 Quality in this outcome area is good. This judgment has been made from evidence gathered both during and before the visit to this service. Residents have access to a robust, effective complaints procedure and are protected from abuse. EVIDENCE: Pre-employment checks are carried out on staff, including enhanced checks with the Criminal Record Bureau and Protection of Vulnerable Adult checks. Also, two references are obtained in respect of each new employee, with special attention given to the last employment. This is to try to ensure that unsuitable people are not employed to care for vulnerable adults. New staff members go through induction and foundation training to ensure they have the right knowledge and skills to do their jobs competently. All care staff members have completed Protection of Vulnerable Adults training. Residents reported a caring, supportive atmosphere in the home, which is well established. There is good leadership and teamwork evident and these features reinforce the caring culture and provider policies concerning adult protection. Residents described staff as being supportive, kind and helpful. They expressed every confidence in the staff team and said they would not hesitate to approach staff with any concern or complaint. They knew that such matters would be taken seriously and acted on appropriately by the staff and management of the home. Members of the care staff team confirmed that they had completed adult protection training and would not hesitate to refer any suspicions of abuse or neglect to the appropriate authorities. Lynwood House DS0000031189.V311084.R01.S.doc Version 5.2 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): 19 and 26 Quality in this outcome area is good. This judgment has been made from evidence gathered both during and before the visit to this service. The physical design and layout of the home enables residents to live in a safe, wellmaintained and comfortable environment, which encourages independence. EVIDENCE: There were no unpleasant odours and the home was found to be clean in all the areas inspected. Care staff members have completed training in Health and Safety, Infection Control and Food Hygiene. Paper towels and liquid soap were provided in toilets and bathrooms in wall-mounted containers, to promote hygienic practices (although residents have personal flannels and towels in their rooms). Residents said that they were pleased with the premises, finding them comfortable and homely as well as practical. They also described the home as being clean. The home is well maintained with repairs and servicing being carried out promptly and according to schedule. A typical comment from a resident was “You couldn’t wish for a nicer, cleaner place”. Lynwood House DS0000031189.V311084.R01.S.doc Version 5.2 Page 16 Lynwood House DS0000031189.V311084.R01.S.doc Version 5.2 Page 17 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 - 30 Quality in this outcome area is good. This judgment has been made from evidence gathered both during and before the visit to this service. Staff in the home are trained, skilled and in sufficient numbers to fulfil the aims of the home and meet the changing needs of residents. EVIDENCE: On the day of inspection, there were 20 residents being accommodated, including 5 on the assessment unit (10 beds). (An admission to the assessment unit took place during the inspection, and has been included in the numbers referred to above.) Typically there are 5 care staff and one residential supervisor on duty in the early part of the day, and one residential supervisor plus 4 care staff during the latter part of the day (day shifts run from 7 am to 10 pm). At night, there are 2 members of care staff on duty. There are 2 full time cooks and 3 full time domestics, plus an administrator. The full time registered manager works weekdays. Her hours are not included in the care hours available. During the day, 2 members of care staff are on duty on the assessment unit. A full staff training and development programme is in operation, including moving and handling, first aid, safe handling of medicines, protection of vulnerable adults, fire awareness, health and safety, infection control and food Lynwood House DS0000031189.V311084.R01.S.doc Version 5.2 Page 18 hygiene. Staff confirmed that they had undergone extensive induction and foundation training. Fourteen out of the 23 members of care staff (61 ) (including residential supervisors) had achieved NVQ level 2 or 3, which is commendable. Pre-employment checks are carried out on staff, including enhanced checks with the Criminal Record Bureau and Protection of Vulnerable Adult checks. Also, two references are obtained in respect of each new employee, with special attention given to the last employment. This is to try to ensure that unsuitable people are not employed to care for vulnerable adults. New staff members go through induction and foundation training to ensure they have the right knowledge and skills to do their jobs competently. All care staff members have completed Protection of Vulnerable Adults training. Residents reported a caring, supportive atmosphere in the home, which is well established. There is good leadership and teamwork evident and these features reinforce the caring culture and provider policies concerning adult protection. Lynwood House DS0000031189.V311084.R01.S.doc Version 5.2 Page 19 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 and 38 Quality in this outcome area is good. This judgment has been made from evidence gathered both during and before the visit to this service. The management and administration of the home is based on openness and respect, has effective quality assurance systems developed by a qualified, competent manager. EVIDENCE: The registered manager is experienced and competent in her role. Residents and staff spoke well of her leadership skills and commitment to good outcomes for residents. She was described as being approachable and caring. She has completed her Registered Manager’s Award at NVQ level 4. Lynwood House DS0000031189.V311084.R01.S.doc Version 5.2 Page 20 Good accounting procedures are followed, with receipts and signatures being obtained for all financial transactions involving residents’ personal monies, in which the home is involved, wherever practicable. Relatives look after the personal monies of many residents. In those situations where the home helps look after residents’ monies, such as pocket monies, clear individual Building Society accounts and records are maintained. Comments received from staff and management confirmed that there are good health and safety policies and practices that promote the health, safety and welfare of residents and staff. All staff members do refresher training in Health and Safety, such as moving and handling, fire safety and food hygiene. This helps reinforce the registered provider’s written policies on Health and Safety. Health and Safety issues are also discussed at bi-monthly staff meetings. Residents and staff expressed satisfaction with the way the home was run and the good standards that were evident in many instances. They said they believed the home was safe and run in the best interests of residents. For example, there is an annual survey of residents’ satisfaction carried out and the findings are reported within the home. There is a quarterly newsletter for residents, plus residents’ meetings, in which issues of interest and concern are discussed. Lynwood House DS0000031189.V311084.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 x x x x x x 3 STAFFING Standard No Score 27 4 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 x x 3 Lynwood House DS0000031189.V311084.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Lynwood House DS0000031189.V311084.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Darlington Area Office No. 1 Hopetown Studios Brinkburn Road Darlington DL3 6DS 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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