Inspection on 11/05/06 for Sweet Lawns

This inspection was carried out on 11th May 2006.

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

The inspector 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

Sweet Lawns 27/01/10

Sweet Lawns 04/11/08

Sweet Lawns 19/10/05

Sweet Lawns 12/05/05

Sweet Lawns 04/11/04

Sweet Lawns 15/06/04

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

CARE HOMES FOR OLDER PEOPLE Sweet Lawns 7 The Gardens, Vaughan Road Harrow Middlesex HA1 4HE Lead Inspector Judith Brindle Key Unannounced Inspection 11th May 2006 09:30 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 Sweet Lawns DS0000017563.V289583.R01.S.doc Version 5.1 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. Sweet Lawns DS0000017563.V289583.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Sweet Lawns Address 7 The Gardens, Vaughan Road Harrow Middlesex HA1 4HE 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) 020 8427 8293 Ms Joan Swan Ms Joan Swan Care Home 6 Category(ies) of Old age, not falling within any other category registration, with number (6) of places Sweet Lawns DS0000017563.V289583.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 19th October 2005 Brief Description of the Service: Sweet Lawns is a care home providing personal care and accommodation for up to 6 older people. Mrs Joan Swan owns the care home, and is the registered manager. The care home was first registered in March 1988. Sweet Lawns is located in West Harrow, in a quiet residential street near central Harrow, and within a short walk from local shops, and other amenities. A train service is located close to the care home. The home is in keeping with other houses in the area. Four of the bedrooms are single, and one room is a shared room. Two bedrooms have en-suite facilities. The home has an enclosed well-maintained garden that is accessible to residents. Documentation/information about the care home is accessible to residents and visitors. Fees, including additional charges are recorded in the resident’s terms and conditions/contracts. The range of fees recorded in pre inspection information is £400-£450. Sweet Lawns DS0000017563.V289583.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place throughout five and a half hours during a day in May 2006. The inspector was pleased to meet, and speak with all of the residents, and the staff. There were two vacancies at the time of this inspection. The purpose of the inspection was to spend time with the residents to gain their views of the service, assess key standards, and to follow up and assess as to whether a requirement and the recommendations from the previous inspection had been met. The inspection included a tour of the premises, and inspection of resident’s care plans, staff personnel records, medication storage and administration systems, meals and mealtimes, and inspection of a variety of other records. The inspector spent a significant part of the inspection talking with all the residents, and observing interaction between residents and staff. Two feedback/comment cards from relatives/visitors and three from healthcare professionals were received by the Commission for Social Care Inspection. The registered manager was present during the inspection. Staff kindly provided all the information, and documentation requested by the inspector during the inspection. Key National Minimum Standards were assessed during the inspection and the requirement from the previous inspection was judged as having been met. What the service does well: What has improved since the last inspection? Sweet Lawns DS0000017563.V289583.R01.S.doc Version 5.1 Page 6 The quality of the service provided has remained consistently good. There were no requirements from this inspection. There has been some development in the provision and the choice of activities for residents. Inspection requirements from the previous inspection have been met. Staff training has continued to be developed. 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. Sweet Lawns DS0000017563.V289583.R01.S.doc Version 5.1 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 Sweet Lawns DS0000017563.V289583.R01.S.doc Version 5.1 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): Standard 2, and 3 (6 is not applicable) Quality in this outcome area is good. The judgement has been made using available evidence including a visit to this service. Residents receive a statement of terms and conditions/contract when they move into the care home. Arrangements are in place to ensure that residents have their needs assessed prior to moving into the care home. EVIDENCE: Records confirmed that the residents receive a statement of terms and conditions/contract when they move into the care home. In this documentation the fees, and any additional charges are recorded. All the residents have lived in the care home for over a year. The care home has an admission procedure. The registered manager confirmed that she assesses, with involvement from the resident, (and family/significant others) each prospective resident prior to his or her admission. Some residents also receive assessment from the Local Authority funding authority. There was evidence of assessment of each residents needs in the care plans inspected. Sweet Lawns DS0000017563.V289583.R01.S.doc Version 5.1 Page 9 This information forms the basis of the individual care plans. The manager confirmed that residents have the opportunity to visit the care home prior to their admission. A visitor visited the care home during the inspection to assess suitability of the care home for a relative of hers. Sweet Lawns DS0000017563.V289583.R01.S.doc Version 5.1 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 the following standard(s): Standard 7,8,9 and 10 Quality in this outcome area is good. The judgement has been made using available evidence including a visit to this service. Arrangements are in place to ensure that resident’s health social and personal care needs are set out in an individual care plan. Medication is stored and administered to residents safely. Arrangements are in place to ensure that the residents are respected and their right to privacy upheld. EVIDENCE: All the residents have a plan of care. The care plans were all inspected and included recorded evidence of assessment of residents’ needs, including personal care needs, health needs and cultural needs. Individual goals and staff guidance to support residents in meeting their assessed needs were recorded. The care plans recorded evidence of being regularly reviewed. There was evidence that these care plans are reviewed at least monthly and updated to record any changes in needs. There was evidence that a resident had been involved in her care plan. The manager spoke of a resident recently having had a review meeting in regard to Sweet Lawns DS0000017563.V289583.R01.S.doc Version 5.1 Page 11 their plan of care. Daily residents progress records are documented. The care plan included risk assessment in regard to prevention of falls, and pressure sores, also manual handling assessments. Residents spoke of the staff being caring, and of being very satisfied with the service provided. Records confirmed that resident’s health needs are met. Appointments with the GP, dentist, community nurse, chiropodist, were documented. Resident’s weight is monitored. There was evidence that resident’s nutritional needs had been assessed. Records confirmed that residents have access to hearing and sight tests. The manager reported that there were no resident’s who had pressure sores, and that pressure relieving equipment when needed is accessible to residents. The care home has a medication policy/procedure. Medication is stored securely, and was judged to have been administered safely during the inspection. The registered manager (a registered nurse) spoke of assessing/training staff to administer medication, and that staff also receive medication training from an external trainer. This assessment/training documentation was available for inspection. Medication administration records were fully recorded. Resident’s privacy was observed to be respected. Residents spoke of staff being understanding of their needs, and confirmed that they wear their own clothes. A staff member confirmed that she had been informed during induction of the issues in regard to respect and privacy of residents. Documentation informed the inspector that residents sign on receipt of their mail. Residents have access to a telephone. A resident spoke of receiving phone calls from family members. Sweet Lawns DS0000017563.V289583.R01.S.doc Version 5.1 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 the following standard(s): Standard 12,13,14 and 15 Quality in this outcome area is good. The judgement has been made using available evidence including a visit to this service. Arrangements are in place to enable residents to participate in activities of their choice, and to maintain contact with family/significant others, as they wish. Meals are varied and wholesome. EVIDENCE: There is an activity programme displayed in the care home. There has been some development in the provision and choice of activities for residents since the last inspection. Residents kindly spoke of activities that they enjoyed. These included reading, walking in the garden, and reading newspapers. A mobile library service regularly brings books to the home. Residents were observed to all join in a ball game during the inspection. They indicated that they enjoyed this activity. A resident spoke of going to church regularly. Records confirmed that residents choose whether to participate in a particular activity or not. A resident spoke of enjoying participating in household duties such as drying dishes, she reported that she “liked to be busy”. Several residents spoke of having visits from their relatives. The visitor’s book confirmed that there were frequent visitors to the care home. The registered Sweet Lawns DS0000017563.V289583.R01.S.doc Version 5.1 Page 13 person confirmed that visiting times were flexible to suit the needs of residents and their visitors. A resident spoke of trips out with family members. Records confirmed that resident’s bedtimes were flexible, and that some residents chose to stay up late. Resident’s bedrooms confirmed that residents have the opportunity to bring some of their personal possessions into the care home. Residents were offered choices during the inspection. Records are stored securely. The menu was available for inspection and recorded meals were judged to be varied, nutritious and wholesome. The registered manager reported that she had reviewed the menu the day before the inspection to ensure that some more seasonal meals were provided. Residents spoke of enjoying the meals, and confirmed that they liked the breakfast and lunch that they had during the inspection. Residents were offered drinks and snacks frequently during the inspection. A variety of fresh, frozen and dried foods were stored. Sweet Lawns DS0000017563.V289583.R01.S.doc Version 5.1 Page 14 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): Standard 16 and 18 Quality in this outcome area is good. The judgement has been made using available evidence including a visit to this service. Arrangements are in place to ensure that complaints are dealt with promptly and effectively, and that residents are protected from abuse. EVIDENCE: A complaints procedure was displayed in the care home. There have been no recorded complaints or ‘concerns’ for over two years. It is recommended that the registered person further develop ways of ensuring that residents are supported and encouraged to communicate ‘concerns’ about the service and that these are recorded and responded to appropriately. The home has the Local Authority Protection of Vulnerable Adults procedure. The ‘in house’ adult protection procedure was dated 2001, and in need of review. A reviewed policy/procedure was supplied to the Commission for Social Care Inspection following the unannounced inspection. Staff who kindly spoke with the inspector had knowledge and understanding of Protection of Vulnerable Adults reporting and recording procedures. The inspector was informed by the registered person that this information is given to staff during their induction programme. The care home has a whistle blowing procedure/policy. Sweet Lawns DS0000017563.V289583.R01.S.doc Version 5.1 Page 15 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): Standard 19 and 26 Quality in this outcome area is good. The judgement has been made using available evidence including a visit to this service. The location and layout of the care home is suited for its stated purpose, and is well maintained, and very clean. EVIDENCE: The care home is located within a few minutes walk or drive from central Harrow. The inspection included a tour of the premises. The home, including the enclosed garden is well maintained. A maintenance plan was available for inspection. Residents spoke of enjoying the garden in the warm weather. Garden furniture was evident. Residents spoke of being happy with their bedrooms. These were observed to be personalised, light and airy. The laundry facilities are located away from food storage and food preparation areas. Hand washing facilities are accessible. The care home has an infection control policy/procedure. Staff were observed to have an awareness of appropriate infection control procedures. Sweet Lawns DS0000017563.V289583.R01.S.doc Version 5.1 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 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): Standard 27,28,29 and 30 Quality in this outcome area is good. The judgement has been made using available evidence including a visit to this service. Arrangements are in place to ensure that staffing numbers and skill mix meet the needs of the residents, and that residents are protected by the care homes’ recruitment and selection procedures. Staff receive appropriate training to ensure that they have the skills and competency to meet the needs of residents. EVIDENCE: The registered person has continued to maintain appropriate staffing levels in the care home since the previous inspection. The staff rota was available for inspection, and copies of four weeks staff rota were supplied to the Commission prior to this inspection. There are two staff on duty during the day and one staff on duty at night. Four staff personnel files were inspected. These include required information and documentation, including enhanced Criminal Record Bureau checks. The inspector was informed by the registered person that a staff member was in the process of completing an NVQ level 2 care qualification, and that another staff member was doing an NVQ level 3 care course. A staff training plan and a staff personal development plan were available for inspection. A staff member confirmed that they had received induction training, and that she was in the process of completing an NVQ level 2 course, which she Sweet Lawns DS0000017563.V289583.R01.S.doc Version 5.1 Page 17 reported had helped her in the development of a variety of skills appropriate to the role of care worker. Staff training has continued to be developed. Records confirmed that staff received a variety of appropriate training, which includes basic First Aid, health and safety, food and hygiene, and manual handling training. The registered person reported that all staff had received dementia care training. Staff training was discussed with the registered person, who spoke of plans to access training resources from certified training organisations. Sweet Lawns DS0000017563.V289583.R01.S.doc Version 5.1 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 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): Standard 31, 33,35 and 38 Quality in this outcome area is good. The judgement has been made using available evidence including a visit to this service. The resident’s benefit from an experienced and competent management approach to the care home. Arrangements are in place to ensure that the service provided by the care home is monitored and improved as necessary to meet the aims and objectives of the home. Resident’s financial interests are safeguarded, and the health, safety and welfare of residents and staff are promoted and protected. EVIDENCE: The registered manager is also the owner of the care home. She has run and managed the care home for many years. She is a trained nurse, and is in the process of completing an NVQ level 4 in management. It was evident from inspection of records, talking to residents and staff that there are clear lines of accountability within the home. Sweet Lawns DS0000017563.V289583.R01.S.doc Version 5.1 Page 19 Inspection of records confirmed that care plans, and staff training are reviewed regularly. An up to date business/development plan was available for inspection. The inspector was informed that feedback questionnaires about the service provided by the care home are supplied to relatives/significant others, and residents. The previous inspection report was displayed in the care home. Several policies did not show evidence that they had been reviewed within two and three years. Policies should be reviewed annually. The care home has a finance and acceptance of gifts policy. During the previous inspection the registered manager confirmed that residents have their finances managed by relatives/significant others. Records confirmed that individual inventories of possessions are maintained for residents. Pre inspection information and documentation informed the inspector that checks and servicing of systems within the care home are carried out as required. These include electrical and gas system checks. Required fire checks and drills are carried out. An environmental health officer carried out an inspection in March 2006. The care home has a recorded fire risk assessment. Health and safety policies and procedures were available for inspection. The required health and safety poster was displayed. Key safety risk assessments including kitchen safety, food handling risk, and risk of using the stairs were recorded. The employer’s liability insurance certificate was displayed and up to date. Sweet Lawns DS0000017563.V289583.R01.S.doc Version 5.1 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X 3 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Sweet Lawns DS0000017563.V289583.R01.S.doc Version 5.1 Page 21 Are there any outstanding requirements from the last inspection? NO 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. Standard Regulation Requirement 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 Refer to Standard OP16 Good Practice Recommendations It is recommended that the registered person further develop ways of ensuring that residents are supported and encouraged to communicate ‘concerns’ about the service and that these are recorded and responded to appropriately. Policies should be reviewed annually. 2 OP33 Sweet Lawns DS0000017563.V289583.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Harrow Area office Fourth Floor Aspect Gate 166 College Road Harrow HA1 1BH 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 Sweet Lawns DS0000017563.V289583.R01.S.doc Version 5.1 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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