Inspection on 31/05/07 for The Laleham

This inspection was carried out on 31st May 2007.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

The Laleham 16/05/08

The Laleham 29/05/06

The Laleham 03/10/05

The Laleham 23/05/05

The Laleham 17/01/05

The Laleham 09/08/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE The Laleham 117/121 Central Parade Herne Bay Kent CT6 5JN Lead Inspector Mark Hemmings Key Unannounced Inspection 31st May 2007 09:20 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 The Laleham DS0000023571.V338524.R01.S.doc Version 5.2 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. The Laleham DS0000023571.V338524.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Laleham Address 117/121 Central Parade Herne Bay Kent CT6 5JN 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) 01227 363340 Kent County (Residential Homes) Limited Post Vacant Care Home 75 Category(ies) of Dementia - over 65 years of age (1), Learning registration, with number disability (1), Old age, not falling within any of places other category (73) The Laleham DS0000023571.V338524.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Residential care for people with a learning disability is restricted to one (1) person whose date of birth is 29.06.1946 Residential care for people with dementia is restricted to one (1) person whose date of birth is 04.05.1922 29th May 2006 Date of last inspection Brief Description of the Service: The Laleham (the Service) is registered to provide accommodation and personal care for up to 75 people. Of this number 74 can be older people (service users) who are 65 years of age and above. One of these service users can be someone who experiences a measure of reduced comprehension. There is also provision for one younger adult who has a learning disability to live in the Service. The premises are five older properties, which have been converted into one building. The accommodation is arranged on three floors. There is a passenger lift giving step-free access to each of the levels. There are 43 single occupancy bedrooms and 15 bedrooms, which can be shared by two people. At the time of the inspection visit, all of the bedrooms were being used as singles. The Registered Provider says that this will remain the case, unless two people specifically request to share. There is a call bell system which is designed to assist service users to request assistance from most locations in the accommodation. The Home is located close to the centre of Herne Bay. To the front, there are views across the promenade and the sea. The Laleham is operated by Kent County (Residential Homes) Ltd (the Registered Provider). This is a private company for which there are two Directors. The Acting Manager who is in day to day charge of the Service, reports directly to the two Directors. The Registered Provider supplies information to prospective service users through a variety of routes. These include the provision of a Service Users’ Guide. This is a brochure which outlines the principal features of the facilities and services available in the Service. Also, the Registered Provider ensures that a copy of the most recent Inspection Report from the Commission, is available for reference in the Service. The current range of fees charged by the Registered Provider runs from £305.00 to £380.00. The Laleham DS0000023571.V338524.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This Report is based upon a number of sources of evidence. These include a review of the correspondence, which the Commission has received in relation to the Service since the last inspection. Another source of evidence involves any written information received from service users and from their relatives. Also, the Inspector completed an unannounced site visit to the Service. This took about five hours to complete. During this time, the Inspector spoke in some detail and/or spent time with three of the service users. Some of these discussions/periods of time were in private. The Inspector consulted with one of the Directors and with the Acting Manager. Also, he spoke with two of the care workers, with the cook and with the handyman. The Inspector examined various parts of the accommodation and he reviewed a selection of the key records and documents. The Inspector concludes that the Registered Provider operates the Service in a suitable manner to enable the service users in residence to receive the support and assistance they need. There is one Required Development at the end of this Report. The Registered Provider has said that this matter will be completed within the stated timescale. What the service does well: Service users say that the Service provides them with a relaxed and comfortable setting within which to make their home. They say that they receive all the assistance they need. Also, that the care workers are attentive and kind in their manner. Sensible arrangements are in place to assist service users to manage potential risks to their health and safety. Service users say that they receive good quality meals. The Laleham DS0000023571.V338524.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. The Laleham DS0000023571.V338524.R01.S.doc Version 5.2 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 The Laleham DS0000023571.V338524.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 3 and 6. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this Service. Prospective service users have their needs and wishes assessed before moving into the Service. EVIDENCE: The Acting Manager said that she completes an assessment of each prospective service user’s needs for assistance, before a decision is made about whether or not the Service is a suitable place for the person’s residence. She said that she is aware of the need to ensure that information is collected about someone’s established lifestyle and preferences. This is very important The Laleham DS0000023571.V338524.R01.S.doc Version 5.2 Page 9 because it enables care workers to promote the continuation of the person’s chosen way of living, if this is their preference. Care workers say that they are briefed fully about the needs of new service users. Also, that this is a useful introduction upon which they can build as they get to know someone better with time. Some service users are admitted to the Service for shorter periods of time. This might be done in order to allow some free time for relatives who provide care at home for the person. Or, it might be to enable someone to leave hospital before they are quite ready to return to their own home. Suitable arrangements are in place to help people return home as and when this is appropriate. The Laleham DS0000023571.V338524.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7, 8, 9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this Service. The health and personal care which service users receive, is based upon their individual needs. The principles of respect, dignity and privacy are put into practice. EVIDENCE: Service users say that the care workers offer them all the assistance they need and that this is provided in a reliable and consistent manner. There is a written individual plan of care for each service user. These are important documents. This is because they form one of the means by which a service user can be informed about and can agree to the assistance he or she will receive. Also, The Laleham DS0000023571.V338524.R01.S.doc Version 5.2 Page 11 the plans are a source of information for staff. This then helps them to provide support in a consistent manner. Sensible arrangements are in place to anticipate and manage potential risks to the service users’ personal health and safety. Service users are assisted to maintain their health. Care workers are alert to the need to identify occasions when someone is becoming unwell. This is so that medical assistance can be sought promptly. Suitable arrangements are in place to enable service users’ medication to be retained and to be dispensed in accordance with the doctors’ instructions. Some of the service users are assisted to manage their own medication. Service users say that the care workers are cordial in their approach. Also, that they are respectful of their individual preferences. The Laleham DS0000023571.V338524.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this Service. There is a variety of social activities taking place. Service users are able to choose their life style and to keep in touch with family and friends. Service users eat well. EVIDENCE: There is a calendar of social events held in the Service. Service users say that they are suitably occupied. They can join in with activities or not, according to what they want to do. Service users consider the pace of daily life in the Service to be relaxed and unhurried. They are free to decide what to do each day. As appropriate, they can retire to the privacy of their bedroom. The Laleham DS0000023571.V338524.R01.S.doc Version 5.2 Page 13 Service users are assisted to keep in touch with members of their families, if this is necessary and if it is their wish. Family members and friends are welcome to call to the Service at any reasonable time. Service users are free to spend time in private with their relatives and friends, should they choose to do so. Service users say that they receive good quality meals and that they have enough to eat. They consider meal times to be a relaxed and pleasant experience. The Laleham DS0000023571.V338524.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this Service. There is a suitable system for addressing complaints. Service users’ wellbeing is promoted and they are protected from abuse. EVIDENCE: There is a written complaints procedure. This explains how service users and their representatives can go about raising a concern. Service users say or indicate by their relaxed manner, that they feel themselves free to speak up if there is anything troubling them. Since the last inspection visit, the Registered Provider has received a complaint about aspects of the assistance given to a service user. The Registered Provider investigated the complaint fully and did not uncover any evidence to support the concern. The care workers have a sound understanding of what is recognised to be good care practice. As part of this, they are aware of the need to be alert to The Laleham DS0000023571.V338524.R01.S.doc Version 5.2 Page 15 instances in which the well being of a service user might become compromised. Service users say or indicate that they feel safe living in The Laleham. The Laleham DS0000023571.V338524.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19, 22, 25 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this Service. Service users are provided with a generally comfortable environment, which promotes their independence. EVIDENCE: Service users say that they are comfortable living in The Laleham. They consider the accommodation to be homely and welcoming. The Laleham DS0000023571.V338524.R01.S.doc Version 5.2 Page 17 Some parts of the exterior of the rear of the property look rather run down. There are areas where paintwork on the window frames is peeling away or where it has become discoloured with age. The Registered Provider intends to renew all of these windows in the next few months. It also intends to clear away some of the general rubbish which is stored at the rear of the property. Some of the bathrooms and toilets are rather bare. More could be done to make them into welcoming and personal spaces. In one of the bathrooms in particular, the damaged linoleum flooring should be replaced. The Registered Provider says that this will be done by 1 September 2007. Most areas of the accommodation have a light and fresh atmosphere. However, one of the bedrooms is not as fresh as it might be. The Registered Provider is going to sort this out by 1 August 2007. The property is fitted with a modern automated fire detection and fire containment system. This is designed to give a high level of protection to service users. The Registered Provider has completed an organised assessment of the adequacy of the fire safety measures in use in the Service. This has been done so that any potential obstacles to the operation of the fire safety system can be identified and managed effectively. This assessment now needs to be submitted to the Kent Fire and Rescue Service. This is so that this agency can update its assessment about the adequacy of the fire safety provisions in use in the Service. This submission is going to be made by 1 July 2007. The local Department of Environmental Health is understood not to have recommended any improvements in the kitchen, which remain outstanding. The kitchen is well equipped, orderly and clean. The cook has a good understanding of how to maintain suitable levels of food hygiene. Suitable arrangements are in place to assist those service users who have difficulty getting about. There are hoists in the bathrooms. Also, there is a mobile hoist. Care workers say that they have all of the equipment they need to enable them to safely assist the service users. Service users say that the accommodation is kept comfortably warm. Most of the radiators are protected with guards. These are one of the ways often used to reduce the risk that someone might be burnt if they have a fall near to a radiator. The Registered Provider says that all of the remaining radiators are due to be fitted with guards by 1 September 2007. Care workers say that there is always an adequate supply of hot water. Hot water taps which are used by the service users, are fitted with special valves. These reduce the temperature of hot water to a level that is not likely to scald someone. The Laleham DS0000023571.V338524.R01.S.doc Version 5.2 Page 18 Service users say that the laundry arrangements work well in that their clothes are promptly returned to them in a presentable condition. The Laleham DS0000023571.V338524.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27, 28, 29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this Service. There are enough care workers on duty. Care workers know what they are doing. EVIDENCE: There are seven care workers on duty during the day to meet the service users’ needs for assistance and four care workers on duty in the evening. These care workers are supported in their work by other members of staff, who complete most of the catering tasks or who do most of the housekeeping duties. At night time, there is a waking staff presence in the Service. The care workers have a detailed knowledge of the needs and preferences of each service user. The Service is adequately staffed given the needs for assistance of the service users who are currently in residence. The Laleham DS0000023571.V338524.R01.S.doc Version 5.2 Page 20 More than half of the care workers have acquired a National Vocational Qualification (NVQ) in health and social care. Others are in the process of doing so. This Award is useful because it provides care workers with a range of opportunities to confirm elements of good care practice and to extend their range of skills. The Registered Provider completes a number of security-related checks. These are designed to ensure that only trustworthy people have access to service users who may be vulnerable. All new care workers receive introductory training. This is designed to ensure that they have the basic knowledge and skills they need in order to be able to work effectively without direct supervision. The Registered Provider is going to strengthen parts of the way this training is delivered and recorded. This is so that it can be re-assured that all of the necessary subjects have been covered. This development is going to be completed by 1 September 2007. After their introduction to the Service, care workers undertake a number of further training courses. These are designed to enhance their capacity to deliver care. The Registered Provider is going to complement this provision by completing a specific review of the adequacy of the knowledge and skills possessed by each of the existing care workers. This is a very good idea, because it will help to double-check that everyone knows what they should be doing and how best to do it. The development is going to be completed by 1 September 2007. The Laleham DS0000023571.V338524.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31, 33, 35, 36 and 38. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this Service. Suitable arrangements are in place to ensure that the Service operates reliably. There is a quality assurance system. Sensible steps have been taken to promote the health and safety of people who live and work in the Service. EVIDENCE: The Acting Manager has a good knowledge of what is going on in the Service and of any issues to be addressed. She receives good support from the The Laleham DS0000023571.V338524.R01.S.doc Version 5.2 Page 22 Registered Provider. The Registered Provider is in the process of proposing to the Commission that the Acting Manager becomes the Registered Manager. The need to complete this process is reflected in the score given to this Standard (Standard 31) at the end of this Report. Suitable arrangements are in place to enable the care workers to coordinate their activities. This means that there is good team-work in the Service. The Service is run without there being any unnecessary rules or routines. This means that service users can continue to experience a normal home life of their choosing. In addition to everyday informal consultation, the Registered Provider has a more formal system whereby service users and their relatives are invited to comment about the Service. More is now going to be done to ensure that more of the service users are enabled to take part in the process. As a first step, the Registered Provider is going to prepare a Quality Report. This will summarise the outcome of the consultations already completed and it will be shared with the service users. This is going to be done by 1 September 2007. The Registered Provider assists most of the service users to administer aspects of their weekly personal spending allowance. Suitable arrangements are in place to complete this task. Care workers say that the Acting Manager is knowledgeable about residential care provision and that she is supportive. They feel that they can ask advice as and when they need it. The Registered Provider says that all items of equipment in use in the Service remain in good working order. There are various contractors’ certificates in place which confirm this account. Regular checks are completed to ensure that the Service’s automated fire detection and alarm system remains in good order. The Registered Provider needs to take additional steps to ensure that all members of staff know how to operate the Service’s fire safety systems. This is important because the actions taken by members of staff, largely determine the level of fire safety protection provided in the Service. There is a Required Development about this matter at the end of this Report. A limited number of accidents have occurred since the last inspection visit. Their nature and frequency does not indicate the need for any special concern. The Registered Provider monitors the premises and the accommodation so that potential hazards to health and safety can be identified and resolved. It is understood that there are no significant hazards waiting to be addressed. The Laleham DS0000023571.V338524.R01.S.doc Version 5.2 Page 23 The Laleham DS0000023571.V338524.R01.S.doc Version 5.2 Page 24 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 3 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 2 X X 3 X X 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X 3 X X 2 The Laleham DS0000023571.V338524.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? Yes 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 OP38 Regulation 23 Requirement The Registered Provider should ensure that all members of staff (including those who work at night) are included within a suitably detailed system which is designed to validate their competency to avoid the occurrence of a fire safety emergency and to respond effectively to one should the need arise (this Required Development is outstanding from the last Inspection Report. It should have been completed by 01/01/07). Timescale for action 01/08/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations The Laleham DS0000023571.V338524.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: 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 © 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 The Laleham DS0000023571.V338524.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!