Inspection on 16/10/06 for The Lawn

This inspection was carried out on 16th October 2006.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

The Lawn 24/09/07

The Lawn 10/02/06

The Lawn 11/08/05

The Lawn 31/01/05

The Lawn 08/06/04

The Lawn 04/02/03

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE The Lawn 119 London Road Holybourne Alton Hampshire GU34 4ER Lead Inspector Keith Hopkins Unannounced Inspection 16th October 2006 12:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address The Lawn DS0000011920.V312660.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 Lawn DS0000011920.V312660.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Lawn Address 119 London Road Holybourne Alton Hampshire GU34 4ER 01420 84162 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) manager@thelawn.fotc.org.uk Friends of the Elderly Mrs Sarah Judith Ruscombe Lee Uff Care Home 31 Category(ies) of Old age, not falling within any other category registration, with number (31) of places The Lawn DS0000011920.V312660.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 10th February 2006 Brief Description of the Service: The Lawn is registered to provide support for 31 older people in the village of Holybourne, near Alton. The home is a Victorian house with a purpose built extension and provides 31 single bedrooms. The home has extensive gardens that service users are able to freely access. Communal space includes a drawing room, library and dining room. In addition the home also has a chapel and guest rooms that can be hired out to service users’ visitors. The Lawn DS0000011920.V312660.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Five and a quarter hours were spent visiting the home, during which time the opportunity was taken to look around the home, view records and policies and to talk to the manager and deputy manager. The inspector also spoke privately with two members of the care staff. Most of the service users were observed making use of communal areas and their bedrooms and a number were spoken with briefly. Three service users were spoken with at greater length in the privacy of their bedrooms. The inspector was unable to speak with any visitors on this occasion. What the service does well: 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 Lawn DS0000011920.V312660.R01.S.doc Version 5.2 Page 6 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 Lawn DS0000011920.V312660.R01.S.doc Version 5.2 Page 7 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): 3 and 6. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has assessed the needs of its current service users well. These needs are clearly recorded and known to staff. EVIDENCE: Three service users’ files, one relating to a more recently admitted person, were inspected and needs assessments seen within these files contained a good level of detail. There was, for example, information regarding sight, hearing, mobility, and nutrition. The more recently admitted service user explained that as she had returned after living abroad for several years her family had been fully involved in her choice as to where to live. The deputy manager explained that a pre-admission assessment was undertaken prior to any decision regarding admission and that service users initially had a temporary contract. The inspector was informed of a recent instance where, after an assessment, it had been decided that the person’s needs could not be met and alternative arrangements were made. The inspector also saw evidence that assessments were reviewed after admission and that service users were The Lawn DS0000011920.V312660.R01.S.doc Version 5.2 Page 8 involved in this process. Service users spoken with also explained, for example how staff helped them with things like hospital appointments Staff spoken with were clearly aware of the needs assessments, which provided them with enough information to enable them to meet service users’ needs. The home does not admit service users for intermediate care, although does offer short-term respite care on occasion. The Lawn DS0000011920.V312660.R01.S.doc Version 5.2 Page 9 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): 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 home has a good care planning regime, which addresses identified personal, social and health care needs and involves service users. EVIDENCE: Three care plans were examined and contained information for staff to ensure that all aspects of health, personal and social care needs could be met. Plans are reviewed on a regular basis and service users confirmed their involvement in this process. Staff and the service user sign reviews. Service users also said that staff knew how to help them. One person, for example, said that the staff ‘were all very helpful’ and another service user confirmed that they ‘always come when I ring’. Plans contained information regarding more specific needs such as chiropody and dentistry and of any need to access the community psychiatric nursing service. One service user confirmed that she could access her GP when she The Lawn DS0000011920.V312660.R01.S.doc Version 5.2 Page 10 wished and the deputy manager explained that one GP held a regular surgery at the home, which was much appreciated by his patients. A chiropodist visits the home every six weeks and also on demand. The inspector was informed that some service users are able to access an optician in the nearby town but that a service was provided in the home for those service users who wanted this. The home has a policy and procedure for dealing with medication, which enables service users to exercise choice over whether they wish to deal with their own medication. One service user spoken with is currently doing this and the inspector saw a risk assessment in place in the care documentation relating to this person. Other service users commented that they were happy for the home to deal with their medication. The drugs cupboard, including the separate controlled drugs cabinet, was secure at the time of the inspection. Records relating to three service users were examined and were in order and up to date. A check was made on one person’s controlled medication with the amount tallying with the record held. Medicines requiring refrigeration were kept in a separate dedicated fridge and the temperature of this was regularly checked. Staff responsible for dealing with medication have been trained. Staff were observed to be providing assistance to service users in a calm and dignified manner, and knocked on doors, awaiting a response, before entering. Service users’ wishes regarding the way in which they are addressed by staff are recorded in their care plan and respected by staff. The Lawn DS0000011920.V312660.R01.S.doc Version 5.2 Page 11 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): 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. Service users enjoy varied lifestyles and undertake activities of their choice. Visitors to the home are encouraged. Service users enjoy attractively presented meals in congenial surroundings. EVIDENCE: Care plans clearly detail what each service user’s interests are and service users themselves confirmed, variously, that they enjoyed activities such as painting, drawing and doing crossword puzzles. The home aims to provide a wide range of opportunities for stimulation and the inspector was told that a guest speaker was booked for later in the week on 18th October. Activities are organised on a weekly basis, the inspector noting that a film was to be shown that afternoon. Visitors to the home are welcomed at all times and the inspector was told by a service user of the contact that she had maintained with her family since her admission to the home. Service users are able to move freely around the building and were seen to be making use of all communal areas as well as their The Lawn DS0000011920.V312660.R01.S.doc Version 5.2 Page 12 bedrooms. The inspector noted that service users had chosen to bring into the home treasured personal items with which to decorate their bedrooms. Menus at the home were varied and service users told the inspector how nice the meals were. Service users are able to choose a week before which of two alternative meals they want and individual requests are also met. The dining room was well-decorated and provided an attractive environment. One service user said that he chose to have his breakfast in bed, his lunch in the dining room and that he prepared his own tea. The Lawn DS0000011920.V312660.R01.S.doc Version 5.2 Page 13 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): 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a suitable complaints procedure, which service users are aware of and feel able to use. Service users are protected through an adult protection policy and procedure known to and understood by staff. EVIDENCE: The home has a complaints policy and procedure, a copy of which was included in the information available to potential service users. One service user recalled that a copy of the complaints procedure was included with her contract when she moved into the home. Two of the service users spoken with privately said that they had no complaints and were aware of what to do if they had. Service users appeared to have a good degree of confidence that any issues raised would be dealt with. The home has had no complaints to deal with in the previous 12 months. The inspector noted that there was a facility for service users to comment specifically on catering arrangements and there was evidence of suggestions being followed up. Staff when interviewed said that they would report to a more senior person any complaints made to them by service users. The home also has a policy and procedure relating to adult protection, with information produced by Hampshire Social Services being available for staff to consult. Staff have been trained in this and when interviewed confirmed their The Lawn DS0000011920.V312660.R01.S.doc Version 5.2 Page 14 understanding of what to do in the case of suspected abuse. Both members of staff interviewed said that they would report anything they needed to. The Lawn DS0000011920.V312660.R01.S.doc Version 5.2 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): 19 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides a comfortable environment, which is suitably furnished and well maintained. EVIDENCE: The tour of the building showed this to be clean and tidy throughout and there were no undue odours. Communal areas were well furnished and adequate bathroom and toilet facilities with aids were available. Communal areas include an attractive, light and airy dining room and well-furnished lounge areas. The inspector noted that new carpeting had been laid in some areas and was informed of plans to continue replacing carpets in further areas which were showing signs of wear and tear. The inspector visited three service users in their rooms, which were all adequate in size, and had clearly been personalised, to considerable degrees. Comments made variously by service users included that it was ‘nice to bring in my own furniture’. The Lawn DS0000011920.V312660.R01.S.doc Version 5.2 Page 16 Service users were observed to be freely making use of communal areas, such as the lounge and other communal areas and accessed their bedrooms as they wished. The home’s laundry was inspected with machines being automatically fed with detergent and capable of meeting disinfection standards. The laundry is small and the inspector was told of plans to enlarge this. Members of staff spoken with were clearly aware of good practice and there were procedures in place to deal with soiled items. Staff were aware of these procedures and confirmed that gloves and aprons were available. The building is well maintained with the manager reporting that she felt well supported by the owning organisation. Necessary aids, such as hoists and handrails were available which service users appreciated. The Lawn DS0000011920.V312660.R01.S.doc Version 5.2 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 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): 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. Service users are well supported by a well-trained staff team who are deployed in sufficient numbers to meet their needs. EVIDENCE: Two staff files were inspected, both relating to staff members on duty. These contained evidence of written references being obtained following the completion of an appropriate application form and interview. There was evidence of Criminal Record Bureau (CRB) disclosures having been obtained, and an appointment letter contained a clear indication that the person concerned would not be able to start until the CRB check had been completed. Staff have job descriptions and one staff confirmed that ‘shadowing’ a more experienced person formed a part of the induction programme. Files contained evidence of the various short courses undertaken which included First Aid, Basic Food Hygiene, Health and Safety, Dementia and Fire Training. The home has a comprehensive training plan. Staff files examined confirmed the home’s supervision and appraisal system, staff being supervised every other month. During the inspection the inspector observed staff members interacting with service users in a friendly yet professional manner. It was explained to the The Lawn DS0000011920.V312660.R01.S.doc Version 5.2 Page 18 inspector, and confirmed by the rota, that there were usually four members of care staff on duty in the mornings and three in the afternoons who were backed up by ancillary staff. There are two members of staff on waking duty at night. Staff were observed to be attending to service users’ needs in a calm and unhurried manner, although said that they were busy at times. Service users without exception commented positively about staff saying variously that ‘nothing is too much trouble’, that the ‘staff are wonderful’ and that ‘they always come when I ring’. It is understood that almost 50 of the care staff have a National Vocational Qualification at Level 2 and that other staff are undertaking this. The Lawn DS0000011920.V312660.R01.S.doc Version 5.2 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 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): 31, 33, 35 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is managed by a qualified and competent manager, supported by comprehensive policies known to staff. EVIDENCE: The home’s manager has worked in the home for a considerable number of years and has obtained the Registered Manager’s Award. The manager is well supported by the organisation and able to fulfil her responsibilities. A quality audit of the home’s services was undertaken in January 2006 with a very positive outcome. The manager further explained that various visits were made to the home by head office staff and also that the results of service user surveys were published. The Lawn DS0000011920.V312660.R01.S.doc Version 5.2 Page 20 The home has very limited dealings with service users’ monies, it being confirmed by the manager that service users handle their own financial affairs with varying degrees of support from their families or Social Services. The home has a policy for the control of substances hazardous to health known to staff. Chemicals and other items were securely stored in locked cupboards and staff were aware of health and safety issues. Water temperatures at hot water outlets are thermostatically controlled and a record kept. The home has a health and safety policy known to staff and environmental risk assessments are in place. A sample of policies, procedures and records required by regulation were inspected and were in order and up to date. This included the home’s fire records, accident book and various maintenance certificates for items of equipment. The Lawn DS0000011920.V312660.R01.S.doc Version 5.2 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 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 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 Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 The Lawn DS0000011920.V312660.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations The Lawn DS0000011920.V312660.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 The Lawn DS0000011920.V312660.R01.S.doc Version 5.2 Page 24 - 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!