Inspection on 31/05/05 for Lynwood Residential Care Home

This inspection was carried out on 31st May 2005.

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 23/05/07

Lynwood Residential Care Home 22/05/06

Lynwood Residential Care Home 26/10/05

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 Limited 22/26 Grosvenor Road Paignton Devon TQ4 5DY Lead Inspector Judy Hill Unannounced 31st May 2005 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Lynwood Residential Care home Limited D54-D07 S63555 Lynwood V220468 310505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Lynwood Residential Care home Limited Address 22/26 Grosvenor Road, Paignton, Devon, TQ4 5DY Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01202 427780 01202 423913 Lynwood Residential Home Limited Mrs Hilda Teale Care Home 22 Category(ies) of Dementia (22), Old age, not falling within any registration, with number other category (22), Physical disability (22) of places Lynwood Residential Care home Limited D54-D07 S63555 Lynwood V220468 310505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. Registered Manager must complete an NVQ at Level 4 by December 2005 2. The Home may accommodate a maximum of 22 service users in the registration categories of old age, dementia - over 65 years of age and physical disability - over 65 years of age Date of last inspection 11th November 2005 Brief Description of the Service: Lynwood Residential Care Home is registered to provide accommodation and care for a maximum of twenty-two people who are over sixty-five years of age and who may have dementia and/or physical disabilities. Since the last inspection the home has been re-registered as a limited company. A management consultant, Mrs Susan Heybourne, has been registered as the Responsible Individual and a new manager, Mrs Hilda Teale, has been registered. Lynwood Care Home is situated in a residential area of Paignton and is within walking distance of the town centre, the bus station and the railway station. The sea front is approximately half a mile away. Most of the bedrooms are single rooms and several have en-suite facilities. There are two lounges and two dining rooms. Care is provided on a twenty-four hour basis and meals are home cooked. Lynwood Residential Care home Limited D54-D07 S63555 Lynwood V220468 310505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and was carried out from 11.35am to 5.05pm on Tuesday 31st May 2005. The information contained in this report was gained in conversation with the registered manager and from private interviews with four residents, a relative of one of the residents and one member of staff. The interaction between a further ten residents and the staff on duty was observed. Additional information was gained from a partial inspection of the premises and an inspection of records, including needs assessments, care plans, the staff rota, the medication administration record sheets, the record of complaints, the record of accidents, and records of staff training. What the service does well: What has improved since the last inspection? What they could do better: The residents needs and risk assessments need to be fully competed and this information needs to be used to formulate detailed care plans which the staff can follow to ensure that each of the residents individual needs are met. The care staffing levels are often very low and need to be raised and maintained at a level that is sufficient to meet the assessed needs of the Lynwood Residential Care home Limited D54-D07 S63555 Lynwood V220468 310505 Stage 4.doc Version 1.30 Page 6 residents and to enable the manager to concentrate on her management duties. Parts of the home need to be redecoration and refurbishment to improve the level of cleanliness that can be maintained and to provide a nicer home environment for the residents. Carpets that cannot be adequately cleaned need to be replaced. Additional staff training should be provided to ensure that the staff administering medication initial the medication administration sheets when the medication is taken by the residents or use the code to identify why any item of medication was not administered. The manager must ensure that the kitchen staff are informed and keep records of any residents with special dietary needs, such as diabetes. 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 Residential Care home Limited D54-D07 S63555 Lynwood V220468 310505 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Lynwood Residential Care home Limited D54-D07 S63555 Lynwood V220468 310505 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 3 & 4 The Statement of Purpose and Service User’s Guides are well written but prospective service users and their representatives cannot be certain that the home can meet their needs. EVIDENCE: The Statement of Purpose and Service Users’ Guides were updated when the Lynwood was re-registered. Copies are held on the Commissions files and these documents are satisfactory. The needs assessments of the two most recently admitted residents were inspected. A new format has been introduced which should help the manager to gather all of the information needed to enable her to formulate detailed care plans. However, neither of the assessments seen had been fully completed. An assessment carried out by Social Services prior to the admission of one of the residents identified that she needed two members of staff to transfer her, as there are not always two care assistants on duty, the home could not meet the prospective resident’s assessed needs at the time of her admission. Lynwood Residential Care home Limited D54-D07 S63555 Lynwood V220468 310505 Stage 4.doc Version 1.30 Page 9 The manager said that six or seven of the service users had some degree of dementia and provided evidence in the form of training certificates to demonstrate that both she and a senior care assistant had attended training courses on the care of people with dementia. Additional staff training should be provided to ensure that there is always at least one trained member of staff on duty. Lynwood Residential Care home Limited D54-D07 S63555 Lynwood V220468 310505 Stage 4.doc Version 1.30 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 standard(s) 7, 8 & 9 The resident’s health needs are carefully monitored but care planning is poor and does not set out in detail how the resident’s social and physical needs are to be met. The resident’s daytime medication is administered safely and conscientiously but more care needs to be taken with the administration and recording of their evening medication. EVIDENCE: An inspection of the residents care plans demonstrated that new systems of care planning are being introduced but the care plans inspected had not been fully completed and did not provide sufficient details of the action which needs to be taken by the care staff to ensure that all aspects of the residents health, personal and social care needs can be met. Records were seen which demonstrate that the resident’s health needs are being monitored and that timely referrals are being made to the primary and secondary health care services. Lynwood Residential Care home Limited D54-D07 S63555 Lynwood V220468 310505 Stage 4.doc Version 1.30 Page 11 The storage of the resident’s medicine was seen to be satisfactory. An inspection was carried out of the medication administration record sheets. This demonstrated that although the staff are initialling the record sheets when they give out the medication in the morning and at lunch time, the records are not always initialled when the evening medication is administered. Lynwood Residential Care home Limited D54-D07 S63555 Lynwood V220468 310505 Stage 4.doc Version 1.30 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 standard(s) 12 & 15 The residents are not given the opportunity to live their lives according to their individual needs and preferences. Insufficient attention is being given to ensure that the resident’s dietary needs are met safely. EVIDENCE: An inspection of the resident’s needs assessments identified that their social and occupational interests and their religious needs are being recorded. Although it was demonstrated in conversation with the manager that she does consider the individual needs and preferences of the residents, conversations with some of the residents identified that their opportunities to exercise choice in some areas of their daily living are limited by the low care staffing levels that are maintained. A record of the resident’s dietary needs and preferences is recorded on their needs assessments. These records identified that at least three of the residents are diabetic and that their condition can be controlled by their diet. This information was not recorded on the records that are kept in the kitchen of residents with special dietary needs. Lynwood Residential Care home Limited D54-D07 S63555 Lynwood V220468 310505 Stage 4.doc Version 1.30 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 & 18 The residents and their representatives can be sure that any complaints they make will be listened too, taken seriously and acted upon. The residents are protected from abuse. EVIDENCE: A copy of the complaints procedure is included in the Statement of Purpose and the Service Users’ Guide. The record of complaints demonstrated that complaints are taken seriously and dealt with appropriately. There are policies and procedures in place to protect the service users from abuse. The home has a copy of the Alerter’s Guide and of the ‘No Secrets’ video, which the records of staff training identified is being used to provide in house training. Lynwood Residential Care home Limited D54-D07 S63555 Lynwood V220468 310505 Stage 4.doc Version 1.30 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22, 25 & 26 The specialist equipment needed to ensure that the residents can maintain their independence is available but because the staffing levels are often very low, the resident’s independence is not maximised. The premises are safe, but parts of the home do not look or smell clean, fresh and hygienic and do not provide a pleasant home environment for the residents. EVIDENCE: A partial inspection of the premises was carried out. The premises have been inspected by an occupational therapist and a copy of her report has been seen. A passenger lift provides access to the bed-sitting rooms on the first and second floor and to the first floor lounge and dining room but because of the layout of the home the residents will still need to be able to manage stairs to access most of these rooms. Lynwood Residential Care home Limited D54-D07 S63555 Lynwood V220468 310505 Stage 4.doc Version 1.30 Page 15 The cordless call bell system enables the controls to be wall mounted or kept anywhere in the residents rooms. One of the residents said that she did not know how to use the call bell system so this was demonstrated to her. The staff responded appropriately. Following the demonstration the resident still said that she did not know how to use the call bell. Another resident said that there were often long delays in the staffs response to the call bell, which the resident attributed to staff shortages stating that there was often only one care assistant on duty. The rooms that were seen had good natural light and evidence that the table and bed-side lighting is safe was provided by a record showing that all of the portable appliances had been professionally tested in May 2005. Radiators are covered and water temperatures are controlled to prevent scalding. Records showed that the fire safety equipment is checked regularly and that the staff receive fire safety training. Although a full inspection of the premises was not carried out it was observed that some of the rooms would benefit from redecoration. It was also observed that a number of repairs including a cracked window, broken tiles and a damaged ceiling needed to be carried out and that two of the bed-sitting rooms that were seen smelt strongly of stale urine. Lynwood Residential Care home Limited D54-D07 S63555 Lynwood V220468 310505 Stage 4.doc Version 1.30 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 The care staffing levels are not high enough to meet the resident’s needs. EVIDENCE: Copies of two weeks rotas were seen. The staff rotas show that a total of seven care assistants are employed to provide day care (8am to 8pm). One of these is on long term sick and one has resigned and is working out her notice. Two of the day care staff also do regular cleaning duties and the hours that they spend as care assistants and those that they spend on cleaning duties are not made clear on the rotas. The staff rotas indicate that there are usually two day care assistants on duty, but that there are occasions when the staffing levels were raised to three or reduced to one. Some of the residents have physical disabilities that make them very dependent on the staff for physical support. One resident said that there were often delays in responding to requests for staff assistance because of staff shortages. The resident’s needs assessments identified that at least one of the residents need two member of staff to transfer her, but there are not always two care assistants available. Some of the residents rarely leave their bed-sitting rooms and therefore require regular checks. Several residents have dementia and need supervision and stimulation. There are not enough staff on duty to enable the residents to be taken out, either as a group or individually by the staff. There is one care assistant on waking duty from 8pm to 8am with a second care assistant sleeping in and on-call. The care staff also prepare the resident’s breakfasts, finish preparing their evening meal and do the laundry. Lynwood Residential Care home Limited D54-D07 S63555 Lynwood V220468 310505 Stage 4.doc Version 1.30 Page 17 Cooks are employed for five hours a day to prepare lunch and the evening meal. The Cooks are supported by kitchen assistants, who work between four and four and a half hours a day. In conversation the manager confirmed that she was still doing care work and that she was providing a hairdressing service when she needs to be focussing on her management role. Lynwood Residential Care home Limited D54-D07 S63555 Lynwood V220468 310505 Stage 4.doc Version 1.30 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 35 & 38 The residents’ financial interests are safeguarded but more consideration needs to be given to ensuring that the health, safety and welfare of the residents and staff is protected. EVIDENCE: The Statement of Terms and Condition states that the management cannot accept responsibility for handling resident’s personal finances and the manager confirmed that the registered providers, management and staff do not do so. This is recognised as good practice. The staff training records show that most of their training needs with regard to health and safety related topics have been met, although some updating is needed. Lynwood Residential Care home Limited D54-D07 S63555 Lynwood V220468 310505 Stage 4.doc Version 1.30 Page 19 Records show that the gas, electrical and fire safety appliances are serviced regularly. Radiators have been fitted with covers and hot water temperatures are monitored. The manager said that the homes Health & Safety policies were being updated by the management agency. No records were available to demonstrate that risk assessments had been carried out to ensure that the staff are using safe working practices. Accidents are recorded in the Accident Report Book, which was seen. Lynwood Residential Care home Limited D54-D07 S63555 Lynwood V220468 310505 Stage 4.doc Version 1.30 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 1 1 x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 x 14 x 15 1 COMPLAINTS AND PROTECTION x x x 2 x x 3 2 STAFFING Standard No Score 27 1 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x x x 4 x x 2 Lynwood Residential Care home Limited D54-D07 S63555 Lynwood V220468 310505 Stage 4.doc Version 1.30 Page 21 Yes Are there any outstanding requirements from the last inspection? 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 3 Regulation 12 & 14 Requirement All new residents must have their needs assessed before being offered a place at the home. Where the needs assessment has been carried out by Social Services, the manager must not arrange an admission unless the service can provide the level of care required. New residents should not be admitted unless the home can provide written confirmation that the service can meet their assessed needs. The registered providers must ensure that the service users care plans are presented in a suitable format and are used by the staff as working documents. Timescale for action 31/6/05 2. 4 12 & 14 31/6/05 3. 7 15 31/7/05 4. 9 13 & 18 5. 12 16 & 18 Previous timescale 25.12.04 not met. The manager must ensure that 31/6/05 all of the staff administering medcines sign the MAR sheets as the medicines are administered. The registered persons must 31/6/05 ensure that there are sufficient care staff on duty to enable the residents to exercise more choice in their daily routines. Version 1.30 Page 22 Lynwood Residential Care home Limited D54-D07 S63555 Lynwood V220468 310505 Stage 4.doc 6. 15 12 & 13 7. 22 14 & 18 8. 26 16 & 23 9. 27 18 Previous timescale 25.12.05 not met. The manager must ensure that the catering staff are aware of and keep records of the residents medical dietary needs. The needs of residents with physical disabilities must be reassessed and it must be demonstrated that the care staffing levels are sufficient to meet their needs. Carpets that smell of urine must be cleaned or replaced. Damaged tiles, windows and ceilings must be repaired or replaced. The care staffing levels must be raised to a level where it can be demonstrated that they are high enough to meet the assessed needs of the service users. If necessary, agency staff should be used to make up any shortfall until suitable staff are recruited. Previous timescale 1.12.04 not met. The manager must arrange for risk assessments to be carried out and recorded for all safe working practices. 31/6/05 31/6/05 31/6/05 31/6/05 10. 38 13 31/8/05 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 Good Practice Recommendations Lynwood Residential Care home Limited D54-D07 S63555 Lynwood V220468 310505 Stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 Residential Care home Limited D54-D07 S63555 Lynwood V220468 310505 Stage 4.doc Version 1.30 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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