Inspection on 04/11/08 for Sweet Lawns

This inspection was carried out on 4th November 2008.

CSCI found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Sweet Lawns 27/01/10

Sweet Lawns 11/05/06

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 31/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Sweet Lawns 7 The Gardens, Vaughan Road Harrow Middlesex HA1 4HE     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Tony Lawrence     Date: 0 4 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 24 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 24 Information about the care home Name of care home: Address: Sweet Lawns 7 The Gardens, Vaughan Road Harrow Middlesex HA1 4HE 02084278293 02084277127 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Ms Joan Swan care home 6 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: . The maximum number of service users who can be accommodated is: 6 The registered person may provide the following category of service only: Care Home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP Date of last inspection Brief description of the care home 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 home was first registered in March 1988. Sweet Lawns is located in West Harrow, in a quiet residential street, within a short walk from local shops and an underground station. There are four single bedrooms and one shared room. Two bedrooms have ensuite facilities. The home has an enclosed well-maintained garden that is accessible to residents. Details of the weekly fee can be obtained from the owner / manager. 0 Over 65 6 Care Homes for Older People Page 4 of 24 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This unannounced key inspection took place on Tuesday 4th November 2008 from 10:00 - 14:30. During this visit we reviewed services provided in the home against the key National Minimum Standards for Care Homes for Older People. We did this by talking to people living in the home, staff and the homes owner / manager. We also checked selected care records kept in the home, including residents care plans and risk assessments. We saw all parts of the home including residents bedrooms and communal areas. Three people living in the home sent us confidential surveys we sent to them as part of this inspection and we have included their comments in this report. Care Homes for Older People Page 5 of 24 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 6 of 24 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 7 of 24 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents and their relatives can be confident that they will be given the information they need to make a choice to move into the home. Residents can be sure that their care needs will be fully assessed and met when they move into the home. Evidence: My son agreed the contract with the Manager. Comment from a resident. During this visit we checked the care plan files for two people who lived in the home. We saw that both files included assessments of the persons health and social care needs. The homes own assessments were supported by assessments and reports written by health and social care professionals. We saw evidence that the residents and their relatives had been involved in the care needs assessments and their views were clearly recorded in the homes own assessments. People living in the home could be confident that their needs would be assessed before they moved into the home and Care Homes for Older People Page 8 of 24 Evidence: the home would be able to meet those needs. Both of the care plan files we checked included a clear contract / statement of the terms and conditions of residence. This clearly detailed the residents rights and responsibilities and we saw evidence that residents and their relatives had been involved in agreeing the contract. The manager told us that the home did not provide intermediate care and Standard 6 did not apply. Care Homes for Older People Page 9 of 24 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home and their relatives know that their care needs are recorded in a personal plan and are reviewed regularly. Residents know that their medication will be managed safely and they will receive the medication they need. Evidence: The staff are very good. They look after me very well. Comment from a resident. If I want privacy, I can always go to my room. Comment from a resident. During this visit we checked the care plan files for two people living in the home. Each of the files included a detailed care plan that had been written by staff. We saw clear evidence that residents and their relatives had been involved in developing the care plans. The plans included some clear goals that covered peoples personal, health and social care needs. We also saw that the plans included guidance for staff on how residents should be supported to achieve the agreed goals. Residents and their relatives could be confident that the care plans emphasised the importance of Care Homes for Older People Page 10 of 24 Evidence: maintaining each residents independence. Both residents and their relatives had signed the plan to show that they agreed with the goals. We saw that staff from the home had completed risk assessments for both of the residents whose care we reviewed during this visit. The risk assessments covered moving and handling, falls and pressure care. The assessments were reviewed regularly, in some cases monthly and residents and their relatives could be confident that actions would be agreed to minimise identified risks. During this visit we also checked the arrangements for managing residents prescribed medication. We saw that medication was securely stored in a lockable cabinet in the homes dining room. We checked the medication records for all five people living in the home and saw that these were well completed by care staff. Residents could be confident their medication would be managed safely and they would receive all of the medication they were prescribed. Residents who spoke with us during this visit were very positive about the care and support they received from staff working in the home. Three people told us that staff treated them with respect at all times. All three people also said that they could choose to spend time with other people or alone in their rooms, whenever they wanted. Two people told us that they could always see visitors privately in their rooms, if they chose. Care Homes for Older People Page 11 of 24 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents and their relatives know that people will be supported to carry on their hobbies and leisure interests. Staff will support people to stay in touch with relatives, friends and other people. The home provides varied and nutritious food for residents. Evidence: The food is quite good and there is always plenty of choice. Comment from a resident. The food is good and I can eat in my room or the dining room. Comment from a resident. I enjoy reading and jigsaw puzzles and I can do these whenever I want. Comment from a resident. During this visit we spoke to residents about their daily lives and activities and the food provided in the home. We also checked the care plan files for two people and the homes menus. We saw that peoples care plans included details of the activities they enjoyed and the support they needed. We also saw that the home had books, board Care Homes for Older People Page 12 of 24 Evidence: games and puzzles for people to use. Residents told us that they went out to local shops, with staff support or with their families. One person told us that he worked with a visiting artist each week to improve his own painting skills and we saw that his work was displayed in his bedroom. During this inspection, a visitor from the local church also came to the home to spend time with residents. She told us that she had been visiting weekly for more than five years and spent time with individuals and groups of residents. We saw that residents care plans included information about the persons cultural and religious care needs and how these would be met in the home. Staff also told us that they had supported some residents to attend local places of worship. The care plans we checked during this visit included good information about residents relatives, friends and other significant people. The plans also included information about how to contact these people in an emergency. We saw that residents and their relatives had signed the plans to agree these arrangements. We checked the homes menus and saw that the home provided a varied and nutritious diet for residents. Choices were available at each meal time and people told us that they enjoyed the food. When we visited, people had a choice at lunch time between savoury mince, pork chops or roast pork, with potatoes and cabbage. A chocolate and cream dessert was also available. We also saw that people were offered hot and cold drinks, snacks and biscuits during the day. People told us that they usually ate their meals in the homes dining room, but sometimes chose to eat in their bedrooms. We saw that the dining room was comfortable and provided a welcoming place for residents to eat together. Care Homes for Older People Page 13 of 24 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff know how to look after residents safely. Residents and their relatives can be confident that any complaints they might have will be investigated thoroughly and promptly. Evidence: Ive never had any complaints. I suppose Id talk to my son or the manager. Comment from a resident. I feel very safe here, its a very good home. Comment from a resident. I would tell the owner if I had any worries about residents. Comment from a member of staff. During this visit the homes owner / manager told us that she had a copy of the local authoritys Safeguarding Adults policy and procedures and that she had been to a recent event organised by Social Services to relaunch the revised and updated procedures. She also told us that there had been no safeguarding adults concerns or investigations since our last visit. Staff working in the home also told us that they knew where to report any concerns they had about the welfare of residents. Residents and the owner / manager told us that the homes complaints procedure was Care Homes for Older People Page 14 of 24 Evidence: included in a welcome pack for new residents. We also saw that the procedure was displayed on a notice board in the homes hallway. The owner / manager told us that there had been no formal complaints since our last visit. Care Homes for Older People Page 15 of 24 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides excellent standards of private and shared accommodation. Bedrooms are comfortable and very individual and shared areas are comfortable and well decorated. Evidence: Im very happy with my room. I have some of my own things and the home has provided some very nice furniture. Comment from a resident. I like to spend time in the lounge and there is a lovely view of the garden. Comment from a resident. Sweet Lawns is a registered care home for 6 older people. The home is located in a residential street in West Harrow, close to shops and an underground station. The home has four single and one shared bedroom. Two of the bedrooms have an en suite toilet and wash hand basin. There are enough bathrooms and toilets for residents to use. The lounge and dining room are comfortable, well furnished and well decorated. The home has a large, accessible garden that residents told us they enjoyed using in the summer. During this visit we saw all shared parts of the home and each persons bedroom. The Care Homes for Older People Page 16 of 24 Evidence: home provided excellent standards of private and shared accommodation. All parts of the home were clean, pleasant and hygienic. There were enough bath / shower rooms and toilets for residents to use. The owner / manager must make sure that the lock on the ground floor toilet is repaired. All bedrooms and shared areas were well decorated, bright, spacious and comfortably furnished. Bedrooms were very individual and residents told us they were supported and encouraged to bring their own furniture and belongings with them to personalise their rooms. The home had a large, attractive garden that residents told us they enjoyed using when the weather allowed. Care Homes for Older People Page 17 of 24 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has enough staff to meet the care needs of residents. Staff have good access to training and are well supported by the homes owner / manager. The owner / manager follows robust recruitment procedures to make sure that only staff suitable to work with vulnerable adults are employed in the home. Evidence: The staff are very, very good and are always pleasant. Comment from a resident. The staff are lovely and will do anything for you. Comment from a resident. The trainings good. I can always do training that helps me do my job well. Comment from a member of staff. During this visit we spent time talking to residents, staff working in the home and the owner / manager. We also checked the staff files for two members of staff. The owner / manager told us that a minimum of two staff were on duty in the home each morning and afternoon. At night, there was one person on duty in the home to support people, if needed. We checked the homes staff rota and this showed us that these levels of staff were provided consistently. During our visit, we saw that staff worked well together to make sure that each resident was supported promptly and appropriately. Care Homes for Older People Page 18 of 24 Evidence: Care plans showed us that the owner / manager considered staffing issues when providing care and support to residents. For example, a male resident and his relatives were asked if he would prefer a male carer to support him with his personal care. We saw that this discussion and the agreed decision were well recorded, as part of the persons care plan. We checked two staff files and saw that each included an application form, two written references, a Criminal Records Bureau check and proof of the persons identity. Both files also included copies of supervision records, annual appraisals and training certificates. We saw that both staff had completed food hygiene, infection control and first aid training. The owner / manager also told us that refresher training for manual handling was planned for all staff in the near future. Care Homes for Older People Page 19 of 24 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has a highly qualified and very experienced owner / manager. Residents and their representatives are involved in developing the services provided in the home. Standards of record keeping are good. Residents are cared for safely and there are no health and safety concerns. Evidence: The manager is very, very good. Shes a lovely, caring person. Comment from a resident. During this visit the homes owner / manager told us that she was a qualified midwife, general and psychiatric nurse. After practising as a nurse and midwife for some years, she took over the ownership of Sweet Lawns in 1988. She confirmed she has completed her NVQ Level 4 Registered managers Award and we have registered her as a fit person to own and manage a care home for older people. Care Homes for Older People Page 20 of 24 Evidence: We saw that people living in the home, their relatives and other people were regularly asked for their views on the way the home was run. The two care plan files we checked each included a completed annual survey form. The owner / manager told us that the surveys were used to develop an annual business plan for the home, that included and responded to the views of residents and their families. We saw from the staff files we looked at during this visit that all staff working in the home were well supervised. Staff met regularly with the manager and a written record was kept of the issues discussed at each meeting. All staff also had an annual appraisal of their performance that included a review of their training needs. Following a recommendation made after our last inspection, the owner / manager told us that she reviewed and updated the homes policies and procedures each year. Staff told us that they read the homes policies and procedures as part of their induction. During this visit we checked a selection of records kept in the home. These included residents care plans, risk assessments, daily care notes, medication records and menus. We saw that all of these records were up to date and well kept. The owner / manager told us that she had completed a fire safety risk assessment and we saw that records of fire drills and fire alarm tests were well kept. Fire doors throughout the home were fitted with self closing devices, activated by the homes fire alarm system. We found no health and safety concerns during this visit. Care Homes for Older People Page 21 of 24 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 22 of 24 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 21 23 The owner must make sure that the lock on the ground floor toilet door is replaced. This will makes sure that residents have privacy when using the toilet. 31/12/2008 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 23 of 24 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. 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