Inspection on 23/05/07 for Lynwood Residential Care Home

This inspection was carried out on 23rd May 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 Residential Care Home 22/05/06

Lynwood Residential Care Home 26/10/05

Lynwood Residential Care Home 31/05/05

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Lynwood Residential Care Home 22/26 Grosvenor Road Paignton Devon TQ4 5DY Lead Inspector Stella Lindsay Key Inspection (unannounced) 23rd May 2007 10:00 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 Residential Care Home DS0000063555.V333455.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 Residential Care Home DS0000063555.V333455.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Lynwood Residential Care Home Address 22/26 Grosvenor Road Paignton Devon TQ4 5DY 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) 01803 551581 01803 527491 Lynwood Residential Home Limited Joanne Brown Care Home 22 Category(ies) of Dementia - over 65 years of age (22), Old age, registration, with number not falling within any other category (22), of places Physical disability over 65 years of age (22) Lynwood Residential Care Home DS0000063555.V333455.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 22/05/06 Brief Description of the Service: Lynwood Residential Home is registered to provide accommodation and care for a maximum of twenty-two men and women who fall into the registration categories of Old Age, Dementia over 65 years of age and Physical Disability over 65 years of age. Lynwood is in a residential area of Paignton and is within walking distance of the town centre and the railway and bus stations. There is a parking area at the front, and an enclosed garden at the rear. There are steps to the front door. Easier access is via sloping paths to the right of the house, with one step to enter the lounge. The homes fees range from £375 to £450 a week and additional charges are made for professional hairdressing, chiropody and a private telephone line, if required. The service providers have produced a written Statement of Purpose and Service Users’ Guide, both of which will be provided to prospective service users on request. Reports of previous inspections are available on the CSCI Website. The latest report is on display in the entrance hall at Lynwood. Lynwood Residential Care Home DS0000063555.V333455.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over two days in May 2007. It involved observation or discussion with fourteen of the residents, the Registered Manager and five staff on duty. Surveys were received from a random sample of staff, and one relative. The Responsible Individual for the organisation, Mrs Sue Heybourne of PS Care Home Management, supplied additional information prior to the inspection. Care records, staff files, health and safety records and the medication system were examined. A partial inspection of the premises was carried out and the interaction between the registered manager, staff and residents was observed. This visit was unannounced, and on the second day the visit started at 7.30am. What the service does well: What has improved since the last inspection? It was felt that the atmosphere has become even more relaxed over the past year. Choice has been increased for residents, in that they are now offered meals in their rooms. Eight residents choose to have breakfast in their room, while four take all their meals in their room. Lynwood Residential Care Home DS0000063555.V333455.R01.S.doc Version 5.2 Page 6 Refurbishment of the home has continued, with laminate flooring having been laid in the dining room and hallway and a new carpet in the lounge. Bedrooms have been redecorated while they are vacant. What they could do better: Additional care staff are needed, so that a carer is on hand at all times to assure residents’ safety. Staff shortages make residents vulnerable to aggression from other residents, and some residents need supervision to avoid risk to themselves. There should also be sufficient staff to allow more time for individual attention, in order to develop their understanding of residents’ needs, and provide individual social activities and outings. The information available for new residents should be updated and accurate, to help them make a well-informed choice. A full assessment of needs should be made before accommodation is offered, including respite residents. The Manager should be able to make the time to meet with a prospective resident, unless distance makes this impractical. Residents’ records should be in good order, and entirely separate from each other, so that they may look at them if they so wish. Care plans should include a summary of the residents’ needs so that staff can easily see their preferred daily routine. Staff records required for the protection of residents, including references and CRB checks, must be on the premises so that they are available for inspection. The Manager has not yet achieved the nationally recognised qualification known as National Vocational Qualification level 4 in Care and the Registered Managers’ Award, but is booked to start this training in order to provide a competent and qualified service. Further training should be provided in the care of people with dementia. There must be a qualified first aider on duty at all times, to assure the safety of residents. Access from the house to the grounds should be improved, to help people get about easily. Ways of helping people get about the building should be considered, including signs or pictures on doors, as well as grab rails. The quality assurance system needs to be developed, using the feedback that has been gathered, and carrying out internal audits, in order to ensure a consistent and responsive service. Please contact the provider for advice of actions taken in response to this Lynwood Residential Care Home DS0000063555.V333455.R01.S.doc Version 5.2 Page 7 inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Lynwood Residential Care Home DS0000063555.V333455.R01.S.doc Version 5.2 Page 8 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 Residential Care Home DS0000063555.V333455.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3, Quality in this outcome area is adequate. Information for new residents is readily available, but needs up-dating, and though there are proper processes for assessing the needs of new entrants, full information is not always available before a service is offered. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A Statement of Purpose and a Service Users’ Guide have been produced, and are given to prospective residents and their family or representative. They need to be up-dated to maintain accuracy. The files of two recently admitted residents were examined. Information had been received from a family member and from nursing staff. Lynwood has a ‘client enquiry form’, which records basic details and contact with the prospective client and their family. It did not have a document that would ensure that all aspects of care were considered. Lynwood Residential Care Home DS0000063555.V333455.R01.S.doc Version 5.2 Page 10 The Manager had not had time to meet one client before offering accommodation recently, but said that her normal practice is to meet with them as part of the assessment process. Full information had not been gathered in respect of short stay residents. Lynwood Residential Care Home DS0000063555.V333455.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is adequate. Good personal care is provided, but record keeping is inconsistent and social assessment is lacking. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All residents had new care plans which had been drawn up by the Manager, and assessed their needs for personal care and help with mobility. These had been agreed with the resident or their relative. The Manager had written a monthly summary of the person’s well-being and social engagement. There was no summary of care needs to guide staff on the residents’ daily routine, including preferred times of getting up in the morning, routines of personal care and dietary needs. Assessments of social need were inadequate, for example ‘watching television’. There were no personal profiles or life history, which would help staff understand the whole person and give guidance as to individual skills and interests. Lynwood Residential Care Home DS0000063555.V333455.R01.S.doc Version 5.2 Page 12 Risk assessments had been carried out with respect to mobility. There was no risk assessment in place for the use of bed rails. Records were irregular, with some personal care being recorded in daily sheets, some in the Senior Staff Communication Book, and some in the bath book. This made it difficult to get a clear track of a person’s care. More than one resident’s details were recorded on some pages, which would make it impossible to share this information with the resident (or their family) if they wanted to see them. Daily reports and care plans provided evidence that the residents’ health care needs are monitored and that timely referrals are made to the professional healthcare services as and when necessary. An inspection of the medication administration practices, records and storage was carried out. The resident’s medication is administered by staff who have received appropriate training. It would be good practice to provide a list of their names and a sample of the initial that they use in order that any queries can be easily traced back to the correct member of staff. The records seen were found to be clear and up to date and the storage arrangements were satisfactory. It would be good practice to include a photo of each resident in front of their page in the Medication Administration Record, as an additional aid to giving medication to the correct person. During the inspection the registered manager and staff were observed to be treating the residents with affection and respect. The residents who spoke to the inspector made very positive comments about the way that the Manager and staff treat them. One said how pleased they were with the way they were washed ‘all over’, with perfume and powder; another said ‘they’ve got a lot of patience’, and another that ‘they help you into the bath, then give you a bit of privacy’. However, staff were not always alert to habits that need to be challenged in spite of having received training the protection of vulnerable adults. For example, a commode was in regular use for moving residents from the lounge to the dining table, which is inappropriate. A carer came to the lounge before breakfast, and went round the room brushing everyone’s hair with the same brush. Lynwood Residential Care Home DS0000063555.V333455.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is adequate. The home enables residents to enjoy social activities together, but individual social interests and outings are not resourced. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Some residents at Lynwood are helped by night staff to get up and dressed early in the mornings. One resident rises at 6am. When asked if this suited, they said – ‘it’s the best part of the day!’ The inspector met with others in the lounge at 7.30am, to find out to whether they were able to get up at the time of their choice. Four of the six said that they wake early and do not like to be inactive, and another that they like to be woken at 6am and washed or bathed. They were enjoying each other’s company in the lounge. A member of staff explained how people who have reduced cognitive skills are helped to get up in the mornings. They said that staff check them at least hourly during the night. They do not wake them, but if they are awake they help them wash and dress because they would otherwise try and do it themselves, thereby putting themselves at risk. Breakfast was taken on trays to all other residents. Lynwood Residential Care Home DS0000063555.V333455.R01.S.doc Version 5.2 Page 14 All residents said they were happy with their meals. No-one knew what they would be given that day, but had every confidence that they would enjoy it. The Manager said that she had discussed new menus with residents, and had been talking to suppliers to obtain different ingredients. She said she was preparing to introduce these new menus which will include a choice of main course every day. Staff will take residents’ choices during the morning. Residents agreed that it would be a good idea to have the menu for the day displayed on the entrance to the lounge. Staff have developed good skills in promoting social activities in the home. Bingo and a card game were held during this inspection, and ten of the current 16 residents joined in. A record is kept showing that such games are held frequently, and entertainers visit. A professional visiting entertainment company known as ‘Tranquil Moments’ have a regular spot, and a harpist played recently, which was well attended. Staff have lead creative activities of various sorts. Residents were made to feel involved even if they were not actually playing. There was a most friendly atmosphere. There is no television normally in the lounge. A resident sat by the CD player, and played music that pleased the other residents. Impromptu sing-songs occurred, and one resident told the inspector that, ‘it’s like this all the time – it’s like heaven’. A television with video recorder is available for ‘film afternoon’, which is held weekly. Mary Poppins and Daniel O’Donnell have been well received. There is a television in the small lounge on the first floor, where some residents like to watch favourite programmes together. All residents are provided with televisions in their room. The residents said that they had been in the garden the previous day, and they had drinks and meals out there sometimes. They were looking forward to outings that had been planned, to the seaside and local beauty spots. There are currently insufficient staff to provide outings, or to follow up individuals’ skills and interests. One resident was waiting to be taken to the bank and to meet a friend, and was aware that this was not possible until more staff were available. Some residents had family or friends who are able to take them out. One relative returned a comment card to the CSCI, which was entirely positive about the way the home keeps in contact with them. A Minister of the Church visits monthly to take Communion. Lynwood Residential Care Home DS0000063555.V333455.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Quality in this outcome area is poor. Complaints are taken seriously and investigated promptly, although some problems should have been avoidable. Staff shortages make residents vulnerable to aggression from other residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The complaints procedure is included in the Service Users’ Guide, which is available in the entrance hall and given to new residents. The Manager had required all staff to read the complaints policy during April 2007, and sign to say they had read and understood. Three complaints had been received by the CSCI during March and April 2007 and passed to the Service Provider to investigate. The first was concerning an external door to a private room. The key had been lost and the door could not be secured. It is not known for how long the security of the home had been compromised. The maintenance man had been asked to fit a new lock, but he was not available at the time a new resident was admitted to this room. Following this complaint being received the relative of the new occupant of the room was reimbursed for the expense of fitting a new lock. The second was concerning resources and care practices in the home, and was not upheld. Lynwood Residential Care Home DS0000063555.V333455.R01.S.doc Version 5.2 Page 16 The third was concerning medication which had not been re-ordered in time, and supplies had run out. The Manager said that in future she will include new residents in the regular monthly order immediately on admission, to avoid this problem happening again. Training in the Protection of Vulnerable Adults was provided in March 2007. Staff remained unaware of some poor practices within the home (see the final paragraph in the section on Health and Personal Care). Advice was given to the Manager with regard to the arrangements for reporting allegations of abuse to the Social Services Adult Protection team. Residents were well protected by positive staff attitudes, but when no staff were present they were seen to be at risk from the potential aggression of another resident, and were preparing to protect each other. Some residents need supervision to avoid risk to themself. For example, during the inspection one resident pulled over a heavy water dispenser that was in the hallway, which could have caused injury to themselves or others. Management had failed to respond adequately to the requirement made in July 2006 to increase staffing levels. Lynwood Residential Care Home DS0000063555.V333455.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,22,25,26 Quality in this outcome area is good. The residents benefit from living in a clean, safe and well presented home, but there is no level access to the exterior, or signage to help people with cognitive impairment. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home was originally three large terraced houses. Residents’ accommodation is on two floors, with a passenger lift and stair lift. The lower ground floor is used for office space and staff accommodation. Refurbishment has continued through the year including a new carpet in the lounge, and laminate flooring in the entrance hall and dining area. CCTV cameras are used for security purposes at the front and back of the home. They are also filming a corridor to show staff when residents leave their room and need attention. This is not acceptable as it intrudes on the privacy of residents. Neither is it effective in protecting them, as staff would only see that the person had left their room if they happened to be in the basement office where they can see the screen. Lynwood Residential Care Home DS0000063555.V333455.R01.S.doc Version 5.2 Page 18 There is a small dining area, with a dividing wall to provide privacy for those who have difficulty eating. It is well lit with wall lamps, and leads directly into the lounge which has a large window and patio door opening over a step onto the garden. The chairs are well built to enable people to get in and out of them, and are attractive and washable. There are another small lounge and dining room on the first floor. There was no evidence that the house had been assessed by an Occupational Therapist. Access to the garden is via a step down over a threshold, and there is no grab rail. This is the most accessible exit from the building. There were no grab rails in the communal in the toilets, or signs to help people recognise toilets and bathrooms. The ground floor bathroom has been fitted with a Jacuzzi bath that is suitable for use by people with physical disabilities, and residents said that they enjoyed using it. A small number of bedrooms are only accessible via stairs but these rooms are only used by people who can manage the stairs. Some bedrooms have an en suite toilet, and those without are supplied with a commode for night use. All bedrooms are supplied with a television. A feature of this house is its large windows, so bedrooms are well lit. One resident was provided with a dimmer switch as a safer alternative to a bedside light. Radiators that residents come into contact with had been fitted with covers, to ensure their safety. Central heating can be adjusted in each bedroom. Checks had been made to assure safety from Legionella. The house was clean and sweet smelling throughout. Two communal toilets were carpeted, and although these were clean, a non-slip washable floor would be more hygienic. Lynwood Residential Care Home DS0000063555.V333455.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is poor. Staff are well motivated to care properly for the residents, but they are not employed in sufficient numbers to meet all their needs or to assure their safety at all times. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is a written rota which shows that there are sometimes three care staff on duty if the Manager is included. There are often two, especially at weekends and in the afternoon. There are not enough care staff on duty to ensure the safety of residents at all times. The inspector saw residents unattended in the lounge, feeling threatened by the behaviour of another resident, due to their condition. This person was also capable of harming themself, having pulled over a drink dispenser during the course of this inspection. In the lounge before breakfast, six residents had attention only by chance, as the carer due on duty at 8am had arrived early. They would otherwise have been unattended at this time. Residents’ needs would be better met if one of the day care staff comes on duty at 7am. A staff member who returned a survey also said that there is too much work to get done by 8am. Lynwood Residential Care Home DS0000063555.V333455.R01.S.doc Version 5.2 Page 20 One care worker provides waking cover from 10pm to 8am and one care worker is on sleeping in duty and on-call. One staff member who regularly works at night said that the sleeper is usually called once or twice per week. The cook is employed from 9 – 5 during the week, and 8 – 2pm on Sundays. The cleaner works on weekday mornings. A new induction training programme has been adopted, to be followed by the newly recruited staff member. A nationally recognised qualification known as NVQ training is supported, with more than 50 having achieved level 2 or equivalent. The file of the newly recruited staff member was examined. An application form had been completed, including a full employment history. References were not seen, and the CRB clearance was still awaited. This carer was not working alone (ie night shifts), but was not additional to the rota. This potentially leaves residents at risk of harm or abuse, as constant supervision may not be practical in these circumstances. Four other staff files were examined. All included proof of identity, but not all included written references, which are required for the protection of residents from potential harm, and are required to be kept in the home. Training was being provided, with one topic each month. This had included Health and Safety and the Protection of Vulnerable Adults. Not all staff had any specialist training in the care of people with dementia, though some staff had completed a training session. Further training in this area should be provided, in the interests of providing person centred care, individually designed activities and awareness of how to make the environment more enabling. Lynwood Residential Care Home DS0000063555.V333455.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,36,37,38 Quality in this outcome area is poor. The Registered Manager makes every effort to run the home in the best interests of the residents, but does not have all the necessary resources. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The new Manager, Mrs Joanne Brown, was registered with the CSCI in January 2007. She has demonstrated her aptitude and fitness for this work, but has not yet the experience or qualifications required to fulfil all these responsibilities without good management support. Lynwood Residential Care Home Ltd. must improve levels of care staff to enable the Manager to deliver the National Minimum Standards at Lynwood. She needs more time when she is not included on the care rota, and support to achieve her qualifications. She is enrolled for her qualifying training, and will start training for the Registered Managers’ Award in September 2007, following which she will work for the nationally recognised qualification known as National Vocational Qualification Lynwood Residential Care Home DS0000063555.V333455.R01.S.doc Version 5.2 Page 22 level 4 in Care. She and her Supervisor would benefit from training in supervisory skills, and further training in specialist dementia care. Mrs Sue Heybourne is the Responsible Individual for Lynwood Residential Care Home Ltd., the providers of the service. She is in frequent contact by telephone with the Manager, and visits at least once a month. The Manager and staff have responded to suggestions from residents and visitors. Questionnaires have been used to gather feedback, but the results have not yet been published or used to contribute to a development plan for the home. There is a quality assurance policy which states that three monthly audits will take place, of housekeeping, catering, standards of care and administration, but there was no evidence that this had taken place. Staff meetings are held periodically. At the last one in January 2007, an interpreter was engaged to ensure that a deaf member of staff could be fully involved. The Manager does not deal with money on behalf of any resident. Some valuables are held for safekeeping; the records of these were seen. Some residents were able to keep their cash safely in their room, while others were supported by their relatives. The Supervisor has started a programme of individual supervision sessions with care staff. A format has been provided, showing areas of discussion that should be covered. Not all records that should be kept in the home were available for inspection. Four staff files were examined, and not all contained references and CRB clearances. Lynwood’s performance on fire safety was very good. The Supervisor had trained as Fire Warden, and took responsibility for weekly checks. The fire precaution system had been serviced professionally on 3rd May, dorgards were fitted in July 2006 so that doors would no longer be wedged open. The door closers had been adjusted so that all fire doors close properly, and signs had been fitted around the house, and the laundry. A professional fire risk assessment of the home had been commissioned in June 2006, and staff training provided. The Fire Warden was advised that night staff must have three monthly updates of their fire safety awareness. There was not a qualified first aider on duty at all times. Accidents had been recorded, but the records were not consistent. Most were entered on the accident forms, but some were in personal care records only. There is a chart for making a monthly summary, to see whether any patterns Lynwood Residential Care Home DS0000063555.V333455.R01.S.doc Version 5.2 Page 23 were emerging, or any preventative action that might be taken, but these had not been completed. Lynwood Residential Care Home DS0000063555.V333455.R01.S.doc Version 5.2 Page 24 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 2 X 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 1 3 3 X 2 X X 3 3 STAFFING Standard No Score 27 1 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X 3 3 2 2 Lynwood Residential Care Home DS0000063555.V333455.R01.S.doc Version 5.2 Page 25 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 OP7 Regulation 15, 16 Requirement The registered persons must ensure that the resident’s individual social needs are included in the care planning process. Previous timescale – 24/07/06. The registered persons must ensure that arrangements are made to enable the residents who wish to do so to engage in social activities, including visiting friends and attending Church services, outside their home environment. Previous timescales for compliance 26/11/05 and 24/07/06 - not met. The registered persons must ensure that enough care staff are employed to meet the needs of the residents, in order to keep them safe as well as provide for individual activities. Previous timescale – 24/07/06 Records kept about each resident must be kept DS0000063555.V333455.R01.S.doc Timescale for action 24/07/07 2. OP12 16(m) 24/07/07 3. OP27 OP18 18(a) 24/07/07 4. OP37 OP14 17(1) 24/07/07 Lynwood Residential Care Home Version 5.2 Page 26 5. OP37 OP29 17(2) individually, in accordance with the Data Protection Act, so that they may see their own records on request. They must be in good order so that they can be easily understood. Records required for the protection of the service users must be obtained and kept on the premises. This includes references and CRB clearances on behalf of all staff. Suitable arrangements must be made for training staff in first aid in order that a qualified first aider is on duty at all times, including through the night, to assure residents’ safety. Accidents must be recorded consistently. 31/08/07 6. OP38 13(4) 31/08/07 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 OP1 OP3 Good Practice Recommendations The information available for prospective residents should be up to date and accurate, to help them make a wellinformed choice. The Manager should ensure in all cases that a full assessment of prospective resident’s care needs has been carried out before accommodation is offered, in order that service is always offered appropriately. Care planning should include a summary of the resident’s needs so that staff know their preferred daily routine. Care planning should include a life history, so that staff may have a more complete understanding of each individual, their skills and interests. Lynwood Residential Care Home DS0000063555.V333455.R01.S.doc Version 5.2 Page 27 3. OP7 4. 5. OP19 OP22 CCTV cameras should be restricted to entrance areas for security purposes only. The premises should be assessed by a suitably qualified person. Safe movement within the house and access to the grounds should be improved, as should signage to help people with cognitive impairment. Further staff training should be provided with respect to care of people with dementia. The Manager should complete the NVQ4 and Registered Managers Award on which she is enrolled, and obtain specialist knowledge in dementia care and supervision skills. Feedback from questionnaires should be published or used to contribute to a development plan for the home. Audits of housekeeping, catering, standards of care and administration should be carried out. The Responsible Individual should recommence sending reports to the CSCI of her monthly visits, in accordance with regulation 26. 6. 7. OP30 OP31 8. OP33 Lynwood Residential Care Home DS0000063555.V333455.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Residential Care Home DS0000063555.V333455.R01.S.doc Version 5.2 Page 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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