Inspection on 07/07/05 for Marion Lauder House

This inspection was carried out on 7th July 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Marion Lauder House 21/02/07

Marion Lauder House 15/01/06

Marion Lauder House 11/11/04

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

CARE HOMES FOR OLDER PEOPLE Marion Lauder House 20 Lincombe Road Wythenshawe Manchester M22 6PY Lead Inspector Les Hardy Unannounced 7 July 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. Marion Lauder House F55 F05 s61036 Marion Lauder V237719 D070705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Marion Lauder House Address 20 Lincombe Road Wythenshawe Manchester M22 6PY 0161 437 3246 0161 498 8241 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) CareConcepts Limited Responsible Individual - Martin John Clark Michelle Margaret Wiliams Care home with nursing (N) 46 Category(ies) of Dementia, over 65 years of age (36) (DE(E)) registration, with number Old age, not falling within any other category of places (9) (OP) Mental disorder, excluding learning disability or dementia (1) (MD) Marion Lauder House F55 F05 s61036 Marion Lauder V237719 D070705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1 A maximum of 46 service users can be accommodated at any one time. Of this number a maximum of 36 service users will require nursing care as a result of dementia and a maximum of 9 service users will require personal care only, by reason of old age. 2 One named service user is below 65 years of age and requires accommodation due to having mental disorder ( excluding learning disability or dementia ) When this service user leaves the category will revert back to Dementia, over 65 years of age (DE(E)). Staffing levels for service users who require personal care only must comply with the minimum requirements of the Residential Forum guidance ` Care Staffing in Care Homes for Older People`. Staffing levels for service users who require nursing care must comply with the minimum requirements of the staffing notice issued under Section 13 (3) of the Care Standards Act 2000 on 9th July 2004. The service must employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. 11 November 2004 3 4 5 Date of last inspection Brief Description of the Service: Marion Lauder is a 46 bedded home. It has 9 beds for residents requiring personal care only and 37 beds for service users requiring personal care with nursing. The staff have expertise in caring for service users with dementia. The home was originally built as a residential care home by The City of Manchester but was purchased 12 years ago for its current use. It is about half amile from the centre of Wythenshawe and is near a major motorway network. Major bus routes to Manchester,Stockport and Altrincham are within 400 yards of the Home.. The Home is on 2 floors. Bedrooms, toilets, and bathrooms are available on both floors. All lounges and dining rooms are on the ground floor. There is a passenger lift between the two floors. Marion Lauder House F55 F05 s61036 Marion Lauder V237719 D070705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection, which was unannounced, was carried out on a Thursday afternoon, started at 3.30 pm and lasted for 5 hours. During the inspection, 10 residents, 12 visitors and 9 staff were spoken with. Residents at this home suffer with dementia and were not able to hold long focused conversations. From those held it was evident that they were happy at the home, and were doing things that they want to do. They all were seen to have good appetites and eat well. The home was giving a very good standard of care with residents being treated as individuals. Staff were very knowledgeable and committed and enjoyed good relationships with visitors, who rated the service highly, as one said, “the care is fantastic.” Relatives did say that because of the nature of their illness the residents could not generally speak for themselves, but when they went home did not have any worries about the ability of any of the staff at the home to actually deliver the care, which they felt that their relative needed. There was one requirement from the previous report, which had been met. As a result of this inspection no new requirements have been made. although recommendations have been made. During this inspection only a selection of key National Minimum Standards were assessed therefore to gain the full picture of how the home meets the needs of residents, this report should be read with the previous and any future reports. What the service does well: Residents in the home are treated as individuals by competent enthusiastic staff in good numbers who know residents well and respond to their needs. Good relationships are apparent with relatives and other visitors whose concerns are listened to and action taken to meet them. Care is well assessed, planned and delivered. Medicines are managed well. Marion Lauder House F55 F05 s61036 Marion Lauder V237719 D070705 Stage 4.doc Version 1.40 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. Marion Lauder House F55 F05 s61036 Marion Lauder V237719 D070705 Stage 4.doc Version 1.40 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 Marion Lauder House F55 F05 s61036 Marion Lauder V237719 D070705 Stage 4.doc Version 1.40 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) 3,5 Good assessments were undertaken prior to admission which ensured that the home only took new residents they could provide appropriate care to. The home was found to be delivering what it promised to residents and relatives. EVIDENCE: All residents were assessed before admission to the home both by the referrers and by the homes manager. These assessments were then used to formulate care plans (see Health and Personal Care, the next section). Relatives of 3 recently admitted residents said that they had visited the home to look round and discuss the home and the admission prior to making the decision for there relative to be admitted. They said they had found this helpful. NHS nurses trained to do so using national criteria regularly assessed residents receiving nursing care. Marion Lauder House F55 F05 s61036 Marion Lauder V237719 D070705 Stage 4.doc Version 1.40 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 standard(s) 7,8 and 9 The home met the identified care needs of the residents. Medications were safely handled to ensure the protection of residents. EVIDENCE: Residents had care plans, which showed all their needs, and how these were to be met. The care plans had been devised using the assessments mentioned under choice of home. Those for new admissions were available to staff prior to admission so they were aware of the residents needs before they arrived. Relatives confirmed that care plans had been discussed with them. Appropriate risk assessments on each resident were undertaken, and like the care plans were reviewed monthly. Where these showed that specialist care or equipment was required this was made available. Staff were aware of the needs of each resident and showed that they were able to give the care required. Relatives commented on how care needs had been identified and met, and they all spoke of the positive effect care in the home had had on their relatives. The home was found to handle medication appropriately and clear records were kept. Marion Lauder House F55 F05 s61036 Marion Lauder V237719 D070705 Stage 4.doc Version 1.40 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 standard(s) 12,13,14 and 15 Residents were treated as individuals. Good quality food, which met the needs of residents, was served. EVIDENCE: Residents were able to get up and go to bed when they wanted. At 8.30 pm nearly all the residents were up in the lounges. The home has limited formally organised activities, due, the manager said to the lack of ability of residents to maintain concentration. Some group activities such as bingo were organised, but individual activities were undertaken to meet residents known needs. Staff spent time with residents individually, but as one relative commented, this could ever be as much as they wanted, even though staff did give individual care as much as possible. A good number of visitors were seen in the home during the inspection. They confirmed they could visit when they wished, and were very positive about how the staff involved them and kept them up to date with what was happening with the resident they were visiting. The evening meal was served during the inspection. The home serves a lighter meal at lunchtime with a larger meal in the evening. The meal was either a Pork Chop or Sausages served with mash potatoes, mixed vegetables and broccoli. Servings matched the known appetites of residents. The food was of Marion Lauder House F55 F05 s61036 Marion Lauder V237719 D070705 Stage 4.doc Version 1.40 Page 11 good quality and had been freshly cooked, served directly from the kitchen to each resident. Other choices were available and given on request. Fresh fruit was freely available. Residents who needed soft diets were served these. Residents said they liked the food. They were encouraged to eat by themselves and most did. Staff were seen to keep a watchful eye encouraging as appropriate. Meals are served in two rooms currently. The larger dining room had been recently redecorated, and had new flooring. Unlike those in the other room tables were bare, with no clothes, no set cutlery and no condiments. It is recommended that the setting of these tables be reviewed to create a more normal environment which could also create a normal expectation of what was about to happen when they were taken to sit at the table. Marion Lauder House F55 F05 s61036 Marion Lauder V237719 D070705 Stage 4.doc Version 1.40 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 standard(s) 18 The homes Policies and Procedures protected residents from abuse. EVIDENCE: The home had appropriate policy in place regarding adult abuse. Since the last inspection a member of staff had been referred to, and was provisionally on the Protection of Vulnerable Adults Register. As that person was also a Registered Nurse they had also been referred to the Nursing and Midwifery Council. Marion Lauder House F55 F05 s61036 Marion Lauder V237719 D070705 Stage 4.doc Version 1.40 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 standard(s) 19, 25 and 26 The home is clean, did not smell and provides an appropriate environment for the residents. Appropriate facilities are in place to safeguard and protect the residents. The provided safe outdoor environment for residents. EVIDENCE: Since the last inspection, some of the grounds have been professionally landscaped to provide a secure garden area freely accessible from one of the lounges. This means that on warm days the doors can be left open and residents can go into the garden whenever they wish. Since the last inspection in November 2004, all the radiators in areas to which residents have access have had a cover fitted to stop residents being able to accidentally burn themselves. The home was found to be kept clean and odour free. In fact relatives commented on the fact that the home did not smell and was very clean. The home disposes of infected waste appropriately. Marion Lauder House F55 F05 s61036 Marion Lauder V237719 D070705 Stage 4.doc Version 1.40 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 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 and 28, The home is appropriately staffed to provide care at the expected level and is moving to the required number of qualified care staff. EVIDENCE: The home employed at least the minimum number of staff required by the staffing notice currently in force. It was clear though that they normally have more staff on duty. One relative commented that there was always plenty of staff around. Since the last inspection 4 care staff have obtained the NVQ Level 2 award, and 6 more should complete this award by October 2005. Two staff members are also undertaking NVQ Level 3. The home will have at least the required minimum of 50 of care staff achieving the NVQ level 2. Marion Lauder House F55 F05 s61036 Marion Lauder V237719 D070705 Stage 4.doc Version 1.40 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 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) 31 and 33 The home is well managed and the views of residents and relatives both sought and responded to. EVIDENCE: The manager clearly had knowledge of all that was going on in the home. The Manager provided clear leadership and were well respected by resident’s, relatives and staff. She is undertaking her Registered Managers award, which should be completed by the end of 2005. The Manager gets good support from the Managing Director who spends a lot of time at the home and is well known to residents and visitors. The home undertakes regular audits of the service they provide by means of a questionnaire to visitors and residents. The findings of these are given to residents at regular meetings, which visitors also attend. When it was found from the audits that the laundry service was routinely evaluating badly, more Marion Lauder House F55 F05 s61036 Marion Lauder V237719 D070705 Stage 4.doc Version 1.40 Page 16 staff were employed to improve the service. Follow up questionnaires have found this to be the case. Visitors said that they could raise concerns with staff and found that these were responded to. Marion Lauder House F55 F05 s61036 Marion Lauder V237719 D070705 Stage 4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 4 x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 x x x x x 3 x STAFFING Standard No Score 27 3 28 3 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x 3 3 x 3 x x x x x Marion Lauder House F55 F05 s61036 Marion Lauder V237719 D070705 Stage 4.doc Version 1.40 Page 18 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 Regulation Requirement No requirements have been made as a result of this inspection. Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard 15 28 31 Good Practice Recommendations The Registered Manager should review the presentation of tables in the main dining room at meal times. The Provider should ensure that they continue to take steps to ensure that by December 2005 at least 50 of care staff will have NVQ level 2. The manager should ensure that she completes the Registered Managers award by December 2005. Marion Lauder House F55 F05 s61036 Marion Lauder V237719 D070705 Stage 4.doc Version 1.40 Page 19 Commission for Social Care Inspection 9th Floor, Oakland House Talbot Road Manchester M16 0PQ 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 Marion Lauder House F55 F05 s61036 Marion Lauder V237719 D070705 Stage 4.doc Version 1.40 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!