Inspection on 05/12/05 for Lynwood House

This inspection was carried out on 5th December 2005.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Lynwood House 18/09/08

Lynwood House 25/09/06

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 5th December 2005 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.V258517.R01.S.doc Version 5.0 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.V258517.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Lynwood House Address Lynwood House Durham Road Lanchester Co Durham DH7 0LP 01207 520292 01207 520292 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.V258517.R01.S.doc Version 5.0 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. 20th July 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 Social Care and Health Department is the registered provider of the service. There are 36 single bedrooms, although only 33 are intended for use. These are all situated on the ground floor. 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 home is provisionally due to close in 2006. Lynwood House DS0000031189.V258517.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over 3.25 hours. It included a tour of the building, examination of a number of records and discussions with 11 residents and 6 staff. What the service does well: 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 House DS0000031189.V258517.R01.S.doc Version 5.0 Page 6 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.V258517.R01.S.doc Version 5.0 Page 7 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): 3. Residents are only admitted to the home after a detailed assessment of their needs has been carried out and having been assured that the home can meet their needs. EVIDENCE: Residents described detailed assessments of need being carried out prior to being admitted to the home. Staff comments confirmed this to be the case. Care plans examined at the last inspection in July 2005 revealed comprehensive, detailed assessments of need being carried out both prior to admission and afterwards. These assessments showed that the home only admitted people whose assessed needs it could meet. Over the past 18 months, 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 undergo assessment prior to admission to ensure that the unit is appropriate for their needs. Elsewhere within the home, there are a small number of beds provided for respite care. The majority of beds are for longterm care. Lynwood House DS0000031189.V258517.R01.S.doc Version 5.0 Page 8 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Residents’ health, personal and social care needs are fully met. Residents are treated with respect and their privacy and dignity are promoted. There are good arrangements for dealing with people’s medication requirements. 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: “I think the staff put a lot of thought into different things here. They’re there all the time. They put themselves out to make it homely”. Another resident said: “The staff are fine, approachable and nice to talk to”. Several described the staff as being “very helpful”. Care plans were examined at the last inspection in July 2005 and were detailed and comprehensive about service users’ health and social care needs, providing clear guidance to staff. They were subject to regular review, in Lynwood House DS0000031189.V258517.R01.S.doc Version 5.0 Page 9 keeping with National Minimum Standards. At the time of inspection, a visiting optician was making her annual visit to check residents’ eyesight and provide new spectacles if required. Staff training (e.g. NVQ level 2) has included the important issues of privacy and dignity and a high percentage of care staff have achieved NVQ in care. A typical comment from one resident was: “The staff are lovely people and they look after you. I cannot grumble at anything; I’m comfortable and well fed. I’m very, very satisfied with everything”. 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. Some permanent night care staff might benefit from doing Safe Handling of Medicines training, although there is usually at least one member of staff on night duty who has had the training. Lynwood House DS0000031189.V258517.R01.S.doc Version 5.0 Page 10 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Residents experience a satisfying lifestyle that matches their expectations and preferences. They are encouraged to maintain contact with family, friends and the wider community as they wish. They are helped to exercise choice and control over their lives. Catering arrangements are very good, providing wholesome, appetising menus with good choice of meals and beverages. 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. One member of staff takes a lead in organising social events. A full programme had been arranged for December, including meals out, a visiting entertainer, Christmas raffle and a visit from the local Brass Band. Residents could pursue individual interests if they wished, such as reading, television 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. Lynwood House DS0000031189.V258517.R01.S.doc Version 5.0 Page 11 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 the dining room. They could, however, eat their meals elsewhere and at different times if required. Records are kept of meals served, available for inspection. The Cook confirmed the varied, appetising menu. 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.V258517.R01.S.doc Version 5.0 Page 12 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): 18. Residents 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. Lynwood House DS0000031189.V258517.R01.S.doc Version 5.0 Page 13 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. Service users live in a safe, well-maintained environment. The home is clean, pleasant and hygienic. 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. Lynwood House DS0000031189.V258517.R01.S.doc Version 5.0 Page 14 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Staffing numbers and mix of skills are appropriate for the needs of residents. Staff members are trained and competent to do their jobs, with well over 50 having NVQ level 2 or above. The home’s recruitment policy and practices support and protect residents. EVIDENCE: On the day of inspection, there were 21 residents being accommodated, including 6 on the assessment unit (10 beds). 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, health and safety, infection control and food hygiene. Staff confirmed that they had undergone extensive induction and foundation training. Fourteen out of the 22 members of care staff (including residential supervisors) had achieved NVQ level 2 or 3, which is commendable. Two more care staff members are expected to qualify at NVQ level 2 in care in December Lynwood House DS0000031189.V258517.R01.S.doc Version 5.0 Page 15 2005 and January 2006. Two part time staff members are expected to register for NVQ in care, soon. 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.V258517.R01.S.doc Version 5.0 Page 16 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. The manager of the home is fit to be in charge, of good character and able to discharge her responsibilities fully. The home is run in the best interests of residents. Residents’ financial interests are safeguarded in those situations where the home is involved. The health, safety and welfare of residents and staff are promoted and protected. 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. 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 Lynwood House DS0000031189.V258517.R01.S.doc Version 5.0 Page 17 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. There is, however, a need for the registered provider’s representative to report on the findings of her monthly, unannounced visits to the home, in keeping with regulation 26 of the Care Homes Regulations 2001. Copies of the report must be sent to the Commission for Social Care Inspection and the home’s manager, as well as key members of the registered provider organisation. Lynwood House DS0000031189.V258517.R01.S.doc Version 5.0 Page 18 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 x 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.V258517.R01.S.doc Version 5.0 Page 19 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 Standard OP33 Regulation 26 Requirement Copies of reports of Regulation 26 visits, carried out each month by the Responsible Individual’s representative, must be sent to the Commission for Social Care Inspection, the home’s manager and key personnel in the registered provider organisation. The previous timescale of 01/09/05 for this action has not been achieved. Timescale for action 01/01/06 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 Refer to Standard OP30 Good Practice Recommendations It is desirable for permanent night staff to do the Safe Handling of Medicines training. Lynwood House DS0000031189.V258517.R01.S.doc Version 5.0 Page 20 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. Extracts may not be used or reproduced without the express permission of CSCI Lynwood House DS0000031189.V258517.R01.S.doc Version 5.0 Page 21 - 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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