Inspection on 19/10/05 for Sweet Lawns

This inspection was carried out on 19th October 2005.

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 11/05/06

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 Unannounced Inspection 19th October 2005 11:00 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.V259022.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. Sweet Lawns DS0000017563.V259022.R01.S.doc Version 5.0 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.V259022.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 4th November 2004 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 DS0000017563.V259022.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place throughout 3.5 hours during the day in October 2005. There was one vacancy at the time of the inspection. The inspector was pleased to meet, and speak with four residents (one resident was out with relatives), and the two staff on duty. The inspection included a tour of the premises, inspection of resident’s care plans, and a number of other records. The inspector spent the majority of the inspection time with the residents, and observing staff interaction with them. Staff were very welcoming, and kindly provided all the information, and documentation requested by the inspector during the inspection. The registered manager/proprietor was not present during the inspection. 14 National Minimum Standards for Older Persons were inspected. Requirements from the previous inspection had been met. The Commission for Social Care inspection report from that unannounced inspection was easily accessible within the home. What the service does well: What has improved since the last inspection? The quality of the service provided has remained consistent. A number of new staff with a variety of skills and experiences have been employed since the last inspection, so outstanding staff vacancies have been filled. People living in the care home commented positively about these staff. Sweet Lawns DS0000017563.V259022.R01.S.doc Version 5.0 Page 6 There has been some development in the provision of activities for residents. Staff who spoke with the inspector had an understanding of the importance of activities for residents. Requirements from the previous inspection have been met. 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.V259022.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 Sweet Lawns DS0000017563.V259022.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): Standard 3 Residents have their needs assessed prior to moving into the care home, and during the trial period to ensure that the service can meet prospective service users needs. EVIDENCE: The care home has an admission policy/procedure. All the care plans were inspected. Each care plan had information, and documentation in regard to the assessment of resident’s needs. Assessment documentation, and information is comprehensive. Physical, psychological, and social needs of residents are assessed. Assessment also includes risk assessment, which includes risk of falls, manual handling, and pressure sore risk assessment. A resident recently admitted to the care home had recorded comprehensive assessment of their needs. Care plans inspected recorded evidence of assessment, and review of assessment from the relevant purchasing authority. Assessment documentation is detailed, and allows for staff to be informed of action need to ensure that resident’s needs are met. Staff who kindly spoke with the inspector had a good knowledge and understanding of the resident’s needs, and spoke of the accessibility of information in the care plan documentation. Sweet Lawns DS0000017563.V259022.R01.S.doc Version 5.0 Page 9 Residents who kindly spoke to the inspector reported that they were satisfied with the service provided. Sweet Lawns DS0000017563.V259022.R01.S.doc Version 5.0 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 and 10 Arrangements are in place to ensure that resident’s health, and personal care needs are met. There needs to be some development in recorded staff guidance to meet some identified care needs. Medication is stored and administered safely. EVIDENCE: All the residents have a care plan. The care plans inspected generally recorded comprehensive assessment of individual needs, and the staff action to meet those assessed needs. Assessment included personal care needs, eating and drinking, mobility, sleep pattern, and communication needs. The care plans showed evidence of being regularly reviewed, which was generally on a monthly basis. One care plan needs to be updated to ensure that pressure sore risk and needs of a resident, and the instructions from a community nurse in regard to the pressure area care of the resident is clearly recorded in the care plan, and that this guidance is reviewed. This was discussed with the staff in charge. She had knowledge and understanding, of this staff guidance. Staff spoke of the care plan documentation as being accessible and informative. A resident had signed the statement of terms and conditions. Sweet Lawns DS0000017563.V259022.R01.S.doc Version 5.0 Page 11 There should be more recorded evidence of resident’s involvement (as far as possible) in their plan of care. Daily records of the progress of people living within the care home were very descriptive, and informative in recording each resident’s needs, mood, progress, and daily activities, and changing needs. This is good practice. Staff were aware of a resident’s particular communication needs and were observed to provide the facility for assisting the resident to communicate their needs. Staff spoke of the recent changing needs of a resident. This resident should be assessed by a doctor in regard to their recent mood, and behaviour changes in need. A staff member reported that the registered manager was trying to arrange this. Assessments are performed in regard to moving and handling, falls and skin integrity; corresponding plans of care are in place based on these assessments, which record evidence of being regularly reviewed. Records confirmed that resident’s health needs are met. Residents have access to chiropody, dental and optician care and treatment. Visits by the community nurse and the GP were documented. Referrals/appointments to hospital professionals were also recorded. Resident’s weight is monitored. A tour of the care home and talking with a resident confirmed that resident’s privacy and dignity is maintained when they are being assisted by staff with personal care needs. Medication is stored in a locked facility. Medication administration records were fully recorded and up to date. A staff member who spoke with the inspector had knowledge and understanding of appropriate medication procedures, and staff spoke of having received appropriate medication training. Sweet Lawns DS0000017563.V259022.R01.S.doc Version 5.0 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 and 15 Activities for people living in the care home take place, and there has been progress in this provision. Meals provided are varied and wholesome. EVIDENCE: An activity programme was displayed. Records confirmed that resident’s preferred activities were recorded in their care plan. A resident spoke of the activities that she enjoyed, and of having choice in the kind of activities that they participated in. Recorded activities included bingo, spending time in the garden, exercise sessions, dominoes reading, word puzzles, and watching television. An activity goal was recorded in a care plan inspected, which included staff guidance in regard to encouraging and motivate a resident to participate in activities. Residents watched television, read and spoke to each other during the inspection. Books were accessible in the sitting room. A resident reported that she regularly attended a place of worship with her son. The visitors record book confirmed that family/significant others visited their relatives/friends in the care home. A resident spoke of receiving visitors regularly. A resident was out with a family member at the time of the unannounced inspection. The homes social activity programme should continue to be developed, which could include the opportunity of more access to community facilities/amenities for residents (particularly for those who have Sweet Lawns DS0000017563.V259022.R01.S.doc Version 5.0 Page 13 infrequent visitor contact). Cards with positive comments about the service from relatives/significant other were displayed throughout the care home. The care home has a four week menu. Residents spoke of enjoying the food provided. A meal judged as wholesome, and nutritious was provided for lunch during the inspection. A staff member assisted one resident with her meal. Food eaten by residents was recorded, and there was a comprehensive record of all food eaten and drunk by a resident with assessed particular nutritional needs. Drinks were regularly offered to residents during the inspection. Records and a resident confirmed that hot drinks were offered at night. Sweet Lawns DS0000017563.V259022.R01.S.doc Version 5.0 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 18 Systems are in place in regard to the responding to any suspicion or allegation of abuse. EVIDENCE: The care home has appropriate policies, and procedures for responding to any suspicion or allegations of abuse. These were inspected during the previous inspection, and included a whistle blowing policy and acceptance of gifts policy. Staff who spoke with the inspector had knowledge, and understanding of reporting and recording procedures in regard to suspicion of abuse. Staff reported that they had had abuse awareness training. Recruitment and selection procedures of staff were inspected during the previous inspection, and were judged as meeting requirements. The registered manager during that inspection confirmed that she carried out robust recruitment procedures including obtaining enhanced Criminal Record Bureau checks. Sweet Lawns DS0000017563.V259022.R01.S.doc Version 5.0 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 Residents live in a safe, well maintained environment. The service users are provided with clean comfortable and safe surroundings. EVIDENCE: The care home is located within a few minutes’ drive or walk from central Harrow. Train and bus public transport facilities are located close to the care home. The inspection included a tour of the premises. The home is well maintained, and bedrooms showed evidence of personalisation. Residents spoke positively about their bedrooms. The care home is centrally heated, well lit, and felt warm during the inspection. Radiators are covered. The home was very clean and odour free. Laundry facilities are located away from food storage and preparation areas. Hand washing facilities are accessible throughout the care home. Protective clothing including disposable gloves was accessible for staff. Sweet Lawns DS0000017563.V259022.R01.S.doc Version 5.0 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 and 30 Arrangements are in place to ensure that appropriate numbers, and skill mix of staff meet resident’s needs. Staff are appropriately trained to have the knowledge and understanding to meet the needs of the people living within the care home. EVIDENCE: There were two staff on duty during the inspection. Records confirmed that there were two and sometimes three staff on duty during the day, and one staff on duty at night. Residents who kindly spoke with the inspector commented that staff were ‘kind’ and ‘helpful’. Staff spoke of receiving a comprehensive induction programme, which included gaining knowledge of health and safety, abuse awareness, policies and procedures, and of resident’s individual care and support needs. A staff member spoke of particular support from the manager in them gaining an understanding of the needs of people living within the care home. One staff on duty reported that they had completed an NVQ level 2 in care qualification, and food and hygiene training. Both staff confirmed that they received regular supervision from the registered manager/person. Sweet Lawns DS0000017563.V259022.R01.S.doc Version 5.0 Page 17 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 35 and 38 Resident’s financial interests are safeguarded. The health, safety and welfare of residents and staff are promoted and protected. EVIDENCE: 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. A resident who kindly spoke with the inspector confirmed this. The care plans inspected all contained a recorded inventory of resident’s possessions. The care home has some secure facilities for the storage of valuables. The care home is very well maintained. The home has records of health and safety information, staff spoke of having received health and safety training during their induction period, and during an NVQ care training course. A required health and safety poster was displayed. A staff member informed the inspector that the hoist equipment had been serviced recently. It is recommended that the registered person ensure that the person who services Sweet Lawns DS0000017563.V259022.R01.S.doc Version 5.0 Page 18 this equipment provides recorded evidence on the hoist equipment (such as using a sticky label with the recorded information). Control of substances Hazardous to Health Regulations (COSHH) safety data sheets and safety risk assessments were recorded. Household cleaning materials were stored securely. There is a call bell system within the care home, and when tested was found to be in working order. An incident reporting procedure was available for inspection. Fridge/freezer temperatures are monitored daily. Required fire safety checks take place. A fire risk assessment was reviewed 6/5/05, and the last recorded fire drill was 2/8/05, which included resident’s participation. Regular fire training for staff was recorded. Fire safety devices were in place on some doors in the communal areas of the care home. Fire action guidelines were displayed. The employer’s liability insurance certificate was displayed and expires 13/3/06. Sweet Lawns DS0000017563.V259022.R01.S.doc Version 5.0 Page 19 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 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X 3 X X 3 Sweet Lawns DS0000017563.V259022.R01.S.doc Version 5.0 Page 20 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. 1 Standard OP7 Regulation 12, 13 • Requirement A care plan needs to be updated and reviewed to ensure that instructions (including weekly weight monitoring) from a community nurse in regard to the pressure area care of a resident is actioned by staff. Timescale for action 01/12/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 Refer to Standard OP7 OP7 OP38 Good Practice Recommendations A doctor in regard to recent mood and behaviour need changes should assess a resident. There should be more recorded evidence of resident’s involvement (as far as possible) in their plan of care. It is recommended that the registered person ensure that the person who services this equipment provides recorded evidence on the hoist equipment (such as recording the service date on a sticky label). Sweet Lawns DS0000017563.V259022.R01.S.doc Version 5.0 Page 21 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.V259022.R01.S.doc Version 5.0 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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