CARE HOMES FOR OLDER PEOPLE
Malmesbury Lawn Woolston Road Leigh Park Havant Hampshire PO9 4JY Lead Inspector
Mr Roy Bega Unannounced Inspection 25th October 2005 10:15 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 Malmesbury Lawn DS0000038646.V260781.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. Malmesbury Lawn DS0000038646.V260781.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Malmesbury Lawn Address Woolston Road Leigh Park Havant Hampshire PO9 4JY 023 92 244900 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) Bill-Dyet@hants.gov.uk Hampshire County Council William Tollins Dyet Care Home 37 Category(ies) of Dementia - over 65 years of age (37), Old age, registration, with number not falling within any other category (37) of places Malmesbury Lawn DS0000038646.V260781.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 1st June 2005 Brief Description of the Service: Marlmesbury Lawn is managed by Hampshire County Council Social Services. It is a purpose built residential care home for 37 older persons including those who have dementia. The home is situated within a residential area of Leigh Park, a short distance from the town of Havant. Residents are accommodated on two floors in single bedrooms. A passesnger lift provides easy access to both floors. Currently 25 residents are being accommodated due to ongoing discussions with regards to dining room/lounge spatial requirements. Residents have the benefit of two enclosed landscaped gardens. There is a separate 6 beded Intermediate Care Unit located on the ground floor designated to deliver short term intensive rehabilitation for residents discharged from hospital to return home. Malmesbury Lawn DS0000038646.V260781.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. Hampshire County Council manages Malmesbury lawn. This report reflects the situation with regards to standards inspected at the time of the visit. Standards not inspected on this occasion will be assessed during future visits. This inspection took place over one day, a total of four hours between 10-15 a.m. and 2-15 p.m. opportunity was taken to look around the home, view records and talk with, residents and staff. There are ongoing discussions within senior management of Hampshire County Council regarding the home not operating to full capacity due to communal spatial requirements. What the service does well: The home is well managed. The staff team are highly motivated and have good relationships with residents. Staff were observed to respect residents and explain aspects of care before carrying it out. At the time of the visit the premises were clean, hygienic and free from offensive odours throughout. Systems are in place to control the spread of infection. Residents spoken with informed the inspector that although it’s not home staff encourage them to bring personal items into the home. Staff are also very helpful, make them feel welcome and supportive in getting them “settled in”. Residents also informed the inspector that staff are very courteous when it comes to cleaning their rooms and the laundry service is very good. Staff spoken with portrayed a sense of sensitivity when approached with regards to the matter of death and bereavement. Malmesbury Lawn DS0000038646.V260781.R01.S.doc Version 5.0 Page 6 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. Malmesbury Lawn DS0000038646.V260781.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Malmesbury Lawn DS0000038646.V260781.R01.S.doc Version 5.0 Page 8 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6. Service users assessed and referred solely for intermediate care are helped to maximise their independence. EVIDENCE: This standard was inspected in part. The proposed use of the 6 beded unit located on the ground floor was a requirement raised resulting from the previous inspection. Subsequent to the previous inspection this unit has become operational in partnership with Health to provide intermediate care for service users who have mental health needs. Mr Dyett informed the inspector that service users are admitted from home or hospital for a six-week assessment. Staff provides short-term intensive rehabilitation to enable service users to return home or enter suitable residential accommodation. Malmesbury Lawn DS0000038646.V260781.R01.S.doc Version 5.0 Page 9 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): 11. Residents are assured that at the time of their death, staff will treat them and their family with care and sensitivity. EVIDENCE: The home has an appropriate policy and procedure to assure residents at the time of their death, that they and their family will be treated with care, sensitivity and respect. Residents’ cultural/requirements/ wishes upon death are recorded in care plans. Training in managing death and bereavement has been provided for staff. Staff spoken with portrayed a sense of sensitivity when approached with regards to this matter. Malmesbury Lawn DS0000038646.V260781.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): EVIDENCE: None of the standards in this section were assessed on this occasion. Malmesbury Lawn DS0000038646.V260781.R01.S.doc Version 5.0 Page 11 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. Management ensures residents are safeguarded from any form of abuse. EVIDENCE: The home has an appropriate policy and procedure document with regards to the protection of residents from all areas of abuse. Adult protection forms an integral part of staff training. Discussions with staff on duty indicated that they have a good understanding with regards to the protection of vulnerable adults. Residents spoken with informed the inspector that they feel safe and well cared for and had an understanding of what to do if they had any concerns. Positive working relationships between residents and staff on duty were evident. Malmesbury Lawn DS0000038646.V260781.R01.S.doc Version 5.0 Page 12 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): 20, 23, 25 and 26. The location and layout of the home is suitable for its stated purpose. It is accessible, safe, clean and well maintained. It meets residents’ individual and collective needs in a comfortable and homely way. EVIDENCE: Mr Dyet informed the inspector that discusions with Hampshire County Council senior management regarding the provision of an all season conservatory to meet communal spatial requirements for 37 residents is continuing. Therefore, only 25 residents are being accommodtaed until the mater has been resolved. A sample of ten bedrooms was inspected. Rooms are furnished and equipped to assure comfort and privacy. It was noted that residents’ have personalised rooms with their own possessions. Malmesbury Lawn DS0000038646.V260781.R01.S.doc Version 5.0 Page 13 Bedrooms are individually and naturally ventilated with windows conforming to recognised standards. They are centrally heated with residents having the ability to control the temperature. Radiators and pipe work are guarded to prevent possible burns from hot surface temperatures. At the time of the visit the premises were clean, hygienic and free from offensive odours throughout. Systems are in place to control the spread of infection. Laundry facilities are sited so that soiled articles, clothing and infected linen are not carried through areas where food is stored or prepared. Residents spoken with informed the inspector that although it’s not home staff encourage them to bring personal items into the home. Staff are also very helpful, make them feel welcome and supportive in getting them “settled in”. Residents also informed the inspector that staff are very courteous when it comes to cleaning their rooms and the laundry service is very good. Malmesbury Lawn DS0000038646.V260781.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): EVIDENCE: None of the standards in this section were assessed on this occasion. Malmesbury Lawn DS0000038646.V260781.R01.S.doc Version 5.0 Page 15 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, 32, 33, 34, 35, 37 and 38. Residents live in a home, which is well run and managed with an ethos of being open and honest. Effective quality assurance systems based on seeking the views of residents and relatives are in place. Residents benefit from an effectively and efficiently run home. EVIDENCE: Staff spoken with readily informed the inspector that the working environment is open with management being readily available. This was evident during the inspection. Positive working relationships were evident between residents and staff on duty. A random sample of the transaction of residents’ personal monies were seen and assessed to be maintained as required.
Malmesbury Lawn DS0000038646.V260781.R01.S.doc Version 5.0 Page 16 The home has an annual development plan and internal audit system in place. Views of residents and their relatives/representatives were available. The home also maintains positive contact with visiting professionals as part of the audit system. Hampshire County Council have recently developed a new quality control audit system that is soon to be put in place. Hampshire County Council manages accounting and financial procedures centrally. The manager and unit’s administrator maintain records of all financial transactions within the home. Records seen were well managed, up to date and kept secure. The home’s health and safety file was available. Staff are provided with a copy and advised of it’s content as part of the induction process. No unsafe practices were observed during the inspection. Certificates were available for required checks of systems and equipment. Risk assessments where necessary have been completed. Staff have received training in first aid and moving and handling. It was noted that there is not natural ventilation in the kitchen. The inspector was informed that this matter has been raised with the appropriate department within Hampshire County Council. This issue was also raised resulting from the previous inspection of 1 June 2005. A mobile cooling system has been put in place but staff informed the inspector that it is not sufficient. Hampshire County Council’s attention is drawn to Havant Borough Council’s hygiene report dated 6 January 2005 where this issue is also raised. Malmesbury Lawn DS0000038646.V260781.R01.S.doc Version 5.0 Page 17 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 X X X 3 HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 X 10 X 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 X 2 X X 3 3 3 3 STAFFING Standard No Score 27 X 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 3 3 3 3 2 Malmesbury Lawn DS0000038646.V260781.R01.S.doc Version 5.0 Page 18 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 OP20 Regulation 23 (e) Requirement To clarify the proposals in meeting the communal dinning space. This issue was also raised resulting from the previous inspection of 1 June 2005. To clarify the proposals to improve the ventilation in the kitchen. This issue was also raised resulting from the previous inspection of 1 June 2005. Timescale for action 05/12/05 2 OP38 23 (5) 05/12/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Malmesbury Lawn DS0000038646.V260781.R01.S.doc Version 5.0 Page 19 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Malmesbury Lawn DS0000038646.V260781.R01.S.doc Version 5.0 Page 20 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
