Inspection on 12/05/05 for Sweet Lawns

This inspection was carried out on 12th 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 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 11/05/06

Sweet Lawns 19/10/05

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 HA1 4HE Lead Inspector Judith Brindle Unannounced 12 May 2005 8:50am 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. Sweet Lawns G62-G11 S17563 Sweet Lawns v212181 120505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Sweet Lawns Address 7 The Gardens Vaughan Road Harrow HA1 4HE 020 8427 8293 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) Mrs Joan Swan Mrs Joan Swan CRH PC 6 Category(ies) of OP 6 registration, with number of places Sweet Lawns G62-G11 S17563 Sweet Lawns v212181 120505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 4/11/04 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. Sweet Lawns G62-G11 S17563 Sweet Lawns v212181 120505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place over 5 hours during the day in May 2005. There were two vacancies at the time of the inspection. A tour of the premises took place. Care records, and staff personnel records were among several records inspected. All the residents and the staff kindly spoke with the inspector. The registered manager was on duty during the inspection. Requirements from the previous inspection have been met. Commission for Social Care Inspection comment cards/feedback forms were supplied to the registered manager to be given to residents and significant others in regard to obtaining their views of the service provided. Leaflets about the CSCI were supplied to residents during the inspection. The registered person had met all the requirements from the previous inspection. What the service does well: What has improved since the last inspection? What they could do better: The registered person should continue to carry out staff recruitment so as to employ a full establishment of staff. Documentation in regard to the service should be easily accessible. Sweet Lawns G62-G11 S17563 Sweet Lawns v212181 120505 Stage 4.doc Version 1.30 Page 6 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 G62-G11 S17563 Sweet Lawns v212181 120505 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 Sweet Lawns G62-G11 S17563 Sweet Lawns v212181 120505 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, 5 (Standard 6 is not applicable to this care home) There is accessible comprehensive information and documentation needed for prospective residents to make an informed choice as to whether they wish to consider the service as their prospective home. All residents have their needs assessed prior to moving into the care home, and during the trial period to ensure that the service can meet the needs of prospective residents. Residents, and their relatives/significant others have the opportunity to visit the care home prior to their admission so as to assess the suitability of the care home, and the quality of the service. EVIDENCE: The care home has a statement of purpose, which had recently been reviewed, and a previous inspection requirement met. This document, and the service user guide were accessible to residents. Copies of these documents were located in the communal sitting room. The previous inspection report was displayed on a notice board in a communal area of the home. Sweet Lawns G62-G11 S17563 Sweet Lawns v212181 120505 Stage 4.doc Version 1.30 Page 9 The home has an admission policy. The admission process is documented in the statement of purpose. Records confirmed that residents receive assessment of their needs prior to their admission to the care home, and during the ‘settling in’ period. Residents recently admitted to the care home had recorded comprehensive assessment of their needs. There was evidence that some residents had completed service user questionnaires. Information provided by residents in respect of their needs was recorded in the appropriate care plan documentation. Assessment documentation included information in regard to health, personal care, and welfare needs. Recorded assessment also includes risk assessment. Records confirmed that assessment of a residents’ needs had been completed by a Care Manager from the purchasing authority. Staff who kindly spoke to the inspector, and observation by the inspector confirmed that staff had knowledge and understanding of the residents’ needs. The residents who kindly spoke to the inspector reported that they were satisfied with the service provided in regards to their needs being met. The registered manager reported during a previous inspection reported that residents are encouraged to visit the care home prior to their admission. Two residents spoke of their relatives/significant others visiting the care home prior to their admission. Both said that it they did not mind not visiting the care home prior to their admission, and one resident was aware that there was a trial period before they made a decision to stay. It should be recorded as to the reason why a prospective resident might not visit the care home. There should to be evidence that prospective residents are given the choice as to whether they wish to visit the care home. Sweet Lawns G62-G11 S17563 Sweet Lawns v212181 120505 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 and 10 Arrangements are in place to ensure that service users’ health and personal care needs are met, and that their privacy and dignity is respected. There is recorded staff receive guidance to meet service users identified individual needs. Medication is stored and administered safely. EVIDENCE: All the residents have an individual plan of care that is generated from a recorded assessment of their needs. All the care plans were inspected. These four care plans included information, and documentation in regard to the identification of residents’ needs and recorded guidance to meet these personal care needs, and healthcare needs. Assessment included risk assessment of falls, manual handling and mobility needs. All the residents were mobile at the time of the inspection. Care plans inspected recorded evidence of having been regularly reviewed. Records, residents, and staff confirmed that residents had access to dental facilities, chiropody services, and optician services. All the residents are registered with a GP. Records confirmed that a resident had received a health check from a nurse, and that a resident had received an occupational therapist assessment. Residents’ weight is monitored. Sweet Lawns G62-G11 S17563 Sweet Lawns v212181 120505 Stage 4.doc Version 1.30 Page 11 Daily records are maintained of residents’ progress, and of their changing needs, including particular behaviour needs. These records were comprehensive in recording individual residents assessed needs, and the recorded terminology was positive. Records confirmed that a staff member had received training in regard to ‘effective communication and diversity in the care environment’. The care home has an accessible medication policy. Medication is stored in a locked facility, and was administered safely during the unannounced inspection. Records confirmed that there were no gaps in recording, and there were photographs of individual residents on the appropriate medication administration recording chart. The allergy section of these records was completed. A format of the in house staff training documentation was available for inspection. The registered manager, and a care staff member reported that staff had received recent external medication training. Information supplied to the Commission for Social Care Inspection following the unannounced inspection confirmed that a previous requirement in regard to the medication policy had been met. Staff were observed to have an understanding of residents’ privacy needs. Staff were respectful to residents during the inspection, and were observed to offer residents choice. Sweet Lawns G62-G11 S17563 Sweet Lawns v212181 120505 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, 13,14 and 15 There has been continued progress in the provision of varied leisure and social activities for residents since the last inspection. Residents are supported in maintaining contact with relatives/significant others. Meals provided are varied and wholesome. EVIDENCE: The care home has a recorded activity programme. Records confirmed that residents participated in varied activities. These included reading, television, dominoes, word puzzles, bingo and playing cards. Residents participated in an exercise session during the inspection. They were offered choice as to whether they wished to join in the activity. Residents spoke of enjoying these exercise sessions. One service user spoke of particularly enjoying reading, and that she had an accessible supply of books. Records, and a resident confirmed that residents have the opportunity to participate in some everyday living skills, such as helping clear the table. It is positive that residents are supported in maintaining, and developing their skills within the care home. Records, and a resident confirmed that she attended church regularly with her relative. Records, and residents informed the inspector that they had regular contact with their relatives/significant others. Visits to the care home, and the Sweet Lawns G62-G11 S17563 Sweet Lawns v212181 120505 Stage 4.doc Version 1.30 Page 13 visits of a resident to stay with a relative were recorded. A resident spoke of having access to the telephone. Phone contact with relatives/significant others was recorded. Records, staff, and residents confirmed that they had a choice as to when to go to bed. There was evidence that residents could choose to bring personal possessions into the care home. It was confirmed during an inspection in 2004 that the care home is registered under the Data Protection Act 1998, and that relatives of residents generally manage their financial affairs. The four week menu was inspected. Varied and wholesome meals were recorded. The residents informed the inspector that they enjoyed the meals provided. Fruit and vegetables were included in the menu. Two meals were provided during the inspection. Residents were offered choice during these meals, and several drinks were provided throughout the inspection. Staff were observed to be attentive and understanding of residents particular needs during mealtimes. Food eaten by residents was recorded. A variety of fresh, frozen, and dried foods were stored. Residents nutritional needs were recorded in their individual care plan. Sweet Lawns G62-G11 S17563 Sweet Lawns v212181 120505 Stage 4.doc Version 1.30 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 standard(s) 16, and 18 Arrangements are in place for handling complaints objectively. Residents have knowledge of the complaints procedure. Appropriate systems are in place for responding to any suspicion or allegation of abuse. EVIDENCE: The home has a detailed complaints procedure. This is displayed in the communal area of the care home. There have been no recorded complaints since the last inspection. Records confirmed that staff are informed of the complaints procedure, and the whistle blowing procedure during the staff induction programme. The care home has appropriate recorded protection of vulnerable adults procedures. There are also other recorded policies to ensure that residents are protected from abuse. These include a whistle blowing policy, and a gifts policy. The registered person informed the inspector that staff receive abuse awareness’ training. The registered person should ensure that regular refresher training in abuse awareness is accessed by her and care staff. Sweet Lawns G62-G11 S17563 Sweet Lawns v212181 120505 Stage 4.doc Version 1.30 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 standard(s) 19, 24 and 26 The home is well maintained, and has homely features. Residents are provided with safe, comfortable surroundings. Residents are satisfied with their bedrooms, and have the opportunity to take personal possessions with them on their admission to the care home. The home is very clean. EVIDENCE: The house is located in a residential area in West Harrow, close to central Harrow. The house is in keeping with other houses in the area. A tour of the premises took place. The environment is well maintained, facilities, equipment and documentation contributes to the safety of the environment. A second banister/handrail has been fitted in the stairway. This is positive for residents and staff in regard to stair safety. Residents freely accessed communal areas of the home during the unannounced inspection. The care home has homely features. Pictures are displayed, and fresh flowers were located in the sitting room. Sweet Lawns G62-G11 S17563 Sweet Lawns v212181 120505 Stage 4.doc Version 1.30 Page 16 The garden is enclosed and attractive, and is accessible from the sitting room by a ramp. There were pots of flowers in the garden. The registered person informed the inspector that the gardener was expected during the afternoon of the unannounced inspection. A resident spoke of looking forward to spending time in the garden when the weather improves. Residents who kindly spoke to the inspector said that they were happy with their bedrooms. The bedrooms inspected were individually personalised and there was evidence that a resident had brought some furniture from her previous home to put in her room at the care home. The home has an infection control policy. Records confirmed that staff had received infection control training. The care home is very clean, and free from offensive odours. The laundry facilities are located away from food storage, and food preparation areas. The washing machine has the facility to wash laundry at high temperatures. Protective clothing, including disposable gloves is accessible to staff. Sweet Lawns G62-G11 S17563 Sweet Lawns v212181 120505 Stage 4.doc Version 1.30 Page 17 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, 29, and 30 Arrangements are in place to ensure that staff enable the assessed health, personal care and welfare needs of residents to be met. The procedures for the recruitment of staff are robust and provide safeguards to offer protection to people living in the care home. Staff receive training that is required and appropriate in regards to them being competent to carry out their role of meeting residents assessed needs and in providing residents with a quality service. EVIDENCE: The registered manager, and a care member of staff were on duty during the unannounced inspection. Two weeks staff rota was inspected. There are two staff on duty during the day, and one staff member at night. The registered manager works several shifts during the week, and is present within the home most days. There are agency staff employed for some shifts. The manager reported that she is in the process of recruiting care staff. This was confirmed during the inspection when a staffing applicant met with the registered person at the care home. This staff applicant had the opportunity to meet residents prior to her interview. The registered person should continue to carry out staff recruitment so as to employ a full establishment of permanent staff. Staff personnel files were inspected. There was some documentation not accessible for inspection. The required information was supplied to the Sweet Lawns G62-G11 S17563 Sweet Lawns v212181 120505 Stage 4.doc Version 1.30 Page 18 Commission for Social Care Inspection following the unannounced inspection. Staff personnel documentation included satisfactory Enhanced Criminal Record Bureau checks, and two references. Residents spoke of the staff being ‘helpful’ and caring. A care staff member was observed to interact with residents in an understanding, and respectful manner during the inspection, and responded to residents’ requests promptly. A staff member who spoke to the inspector had knowledge, and understanding of the residents’ varied individual needs. Records, and staff informed the inspector that staff complete an induction programme. A staff induction record available for inspection confirmed that staff induction includes informing care staff of personal care procedures, and health and safety procedures. Training completed by staff included, basic First Aid, manual handling training, health and safety training, and basic food and hygiene training. Staff, and records informed the inspector that staff supervision took place. The care home has a staff training plan. One staff member had completed an NVQ level 2 care course, and that another was in the process of completing the course. The registered person had difficulty sometimes locating records required by the inspector. She reported that documentation was in the process of being sorted out. Documentation in regard to the service should be easily accessible. Sweet Lawns G62-G11 S17563 Sweet Lawns v212181 120505 Stage 4.doc Version 1.30 Page 19 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, 37, and 38 There is leadership, guidance and direction to care staff to ensure that residents receive consistent quality care. Required records are in place to ensure that a quality, and safe service is provided to residents. Arrangements are in place, which promote and safeguard the health, safety and welfare of the people using the service. EVIDENCE: The registered person has owned and managed the care home for many years. She works hard to maintain and improve standards, and to meet inspection requirements. Residents were positive about the care that they received, and were aware of who the registered manager was. ‘Thank you’ cards from relatives were displayed within the care home. The registered manager informed the inspector that she had commenced the Registered Managers’ Award. This is positive in regard to the service. Sweet Lawns G62-G11 S17563 Sweet Lawns v212181 120505 Stage 4.doc Version 1.30 Page 20 Liquid eraser was observed on some documentation. This must not be used on records in the care home. This was discussed with the registered manager. Required and appropriate records were in place, and the sample of records inspected, were generally up to date and fully recorded. Fridge/freezer temperatures are monitored. Hot water temperatures are monitored. The home has a fire risk assessment, which had been reviewed in 2004. The ‘weekly’ fire alarm checks need to be carried out weekly the last recorded ‘weekly’ check was in February 2005. Fire drills were recorded. The last one was 6/5/05. Fire equipment had been serviced in March 2005. There needs to be a record of the names of the residents who did not respond during the last fire drill and there needs to be staff guidance in how to respond when this situation occurs. There was recorded evidence of fire training having taken place. The call bell system is regularly tested. The home has a health and safety policy, and accident reporting policy. The emergency procedure was recorded. The required health and safety poster was displayed. There was recorded evidence of some health and safety risk assessments, including COSHH. The Employers liability insurance certificate was displayed, and was up to date. Sweet Lawns G62-G11 S17563 Sweet Lawns v212181 120505 Stage 4.doc Version 1.30 Page 21 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 3 x 3 N/A 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 3 x x x x 3 x 3 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 x x x x x 2 2 Sweet Lawns G62-G11 S17563 Sweet Lawns v212181 120505 Stage 4.doc Version 1.30 Page 22 NO 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. 2. Standard 37 38 Regulation 17 23(4) Requirement Liquid eraser must not be used on service records. The fire alarm system checks need to carried out more frequently. There needs to be a record of the names of the residents who did not respond during the last fire drill and there needs to be staff guidance in how to respond when this situation occurs. Timescale for action 01/07/05 01/08/05 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 3 Good Practice Recommendations It should be recorded as to the reason why a prospective resident might not visit the care home. There should be evidence that prospective residents are given the choice as to whether they wish to visit the care home. The registered person should ensure that regular refresher training in abuse awareness is accessed by her and staff. Documentation in regard to the service should be easily accessible. 2. 3. 4. 18 37 Sweet Lawns G62-G11 S17563 Sweet Lawns v212181 120505 Stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection 4th 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 G62-G11 S17563 Sweet Lawns v212181 120505 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. 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