Inspection on 24/09/07 for The Lawn

This inspection was carried out on 24th September 2007.

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 16/10/06

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 Pat Griffiths Unannounced Inspection 24th September 2007 11:30 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.V351827.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.V351827.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.fote.org.uk www.fote.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.V351827.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 16th October 2006 Brief Description of the Service: The Lawn is registered to provide personal care and support for thirty-one older people in the village of Holybourne, near Alton. Friends Of The Elderly bought the house and opened it as a home in 1954. The home is a large listed Georgian building, which was built in 1807 and was once the home of the Victorian novelist Elizabeth Gaskell. The home also has a purpose-built extension and provides thirty-one single bedrooms with en-suite basins and lavatories and has communal areas that include a drawing room, library and dining room. The home also has it’s own chapel where weekly interdenominational services are held and there are guest rooms that can be hired by residents’ visitors. The Lawn is set in five acres of grounds with the Bourne, a tributary of the river Wey, running through the grounds which are maintained by a full time gardener. There are plenty of sitting areas for the residents to enjoy the extensive views of the garden. There is also a paved walkway around the house providing a level path for people living in the home to walk round the house and garden. This is ample parking at the rear of the home. The Lawn DS0000011920.V351827.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The evidence used to write this report was gained from a review of the information the provider sent to the Commission for Social Care Inspection (CSCI) and an unannounced visit to the home on 24th September 2007. The information provided included an Annual Quality Assurance Audit [AQAA], which had been completed by the manager and returned to the commission and other information that has been provided since the last inspection, such as accident reports. The registered manager was on holiday on the day of the visit, but the deputy manager was on duty and supported the inspector during the day. During the site visit the inspector spoke with eight residents, the care and domestic staff on duty and the chef. The inspector was able to see different parts of the home, such as the kitchen, dining room, bathrooms, the garden and some of the bedrooms. Documents relating to the residents, staff, policies and procedures and documents regarding the running of the home were seen during the visit. The manager wrote in the AQAA that weekly fees are currently £521 - £550, depending on the care needs of the resident and the size of the room they occupy. The fees for hairdressing, chiropody and toiletries are paid separately. What the service does well: What has improved since the last inspection? The Lawn DS0000011920.V351827.R01.S.doc Version 5.2 Page 6 Different communal areas of the home and six of the bedrooms have been decorated and had new carpets laid. New boilers have been fitted and the heating system improved. A new generator has also been installed to override any power-cuts that may occur. 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 Lawn DS0000011920.V351827.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 Lawn DS0000011920.V351827.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): 3 and 6 Quality in this outcome area is “good”. This judgement has been made using available evidence including a visit to the service. People wishing to use this service benefit from a comprehensive pre-admission assessment of their needs before moving into the home. The home does not provide intermediate care. EVIDENCE: All potential residents are provided with information about the home, which is very clear about the type of care provided. The manager completes a comprehensive pre-admission assessment for all potential residents, whether they are coming in for respite care or long term residency. Care management assessments are also sought and both of these pre-admission assessments form part of the care planning process for each resident. Areas of assessment include mobility, communication, medication, medical history, social activities and spiritual needs. The Lawn DS0000011920.V351827.R01.S.doc Version 5.2 Page 9 The home does not provide intermediate care The Lawn DS0000011920.V351827.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): 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. Care planning ensures residents have all their needs met. Medication administration practices protect the residents EVIDENCE: As part of the inspection process the care plans of three residents were looked at to assess the information provided about how the staff planned to meet the individual needs of the people living there. Everyone living in the home had care plans in place, those looked at by the inspector were seen to contain information about personal hygiene, mobility, nutrition, continence, mental health and well being, equipment needed, communication, risk of falls and moving and handling assessments, ensuring a person-centred care plan. A separate page in the file was used by the visiting GP or other healthcare professionals to record their visits. The Lawn DS0000011920.V351827.R01.S.doc Version 5.2 Page 11 The home has medication policies and procedures in place for the receipt, storage, return and administration of medication, which are followed by the staff. Three residents administer their own medication independently and risk assessments have been completed to ensure their safety and minimise any risks to them. The home has homely medicines guidelines signed by the GP, which allows staff to give certain ‘over the counter’ medications that have not been prescribed, such as paracetamol for a headache. People living in the home and their visitors said that they were happy with the care provided at the home and that the staff were very helpful and friendly. They felt they were always treated with dignity and respect and their right to privacy is upheld – Their comments included ‘lovely girls, nothing is too much trouble’ ‘excellent care’ Observations made during the day by the inspector confirmed that the residents and staff have developed good relationship together and staff were seen to treat the residents with dignity and respect, speaking to them quietly and knocking on doors and waiting for a response before entering. The Lawn DS0000011920.V351827.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): 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. People who use this service have good quality food and their diverse needs are generally well supported. EVIDENCE: The people who live in the home are encouraged to maintain contact with their friends and families and to get out and about as they wish. Visitors that spoke to the inspector said that they were always made welcome by the staff and felt able to visit at any time. The home has an activities co-ordinator, who is in the home for three hours every afternoon. The activities, which are varied and aimed at all levels of intellect and abilities, include outings to gardens, theatres, shopping, films, quizzes and art afternoons. There have been talks by outside speakers and a visiting zoo with ‘petting’ animals. A concert with a marquee and buffet supper was recently held on the lawn at the home and was attended by all the residents, their families and guests. There is an activities room, which is light The Lawn DS0000011920.V351827.R01.S.doc Version 5.2 Page 13 and airy where people living in the home have space to do paintings and a potting bench where some look after their plants. There is a chapel in the home where Holy Communion is held evey Wednesday morning and is for all denominations. There is also a village church which some of the residents attend on a Sunday. Some of the more independent residents have joined the local gardening clubs, the Womens Institute and NADFAS, which is an arts based charity. One of the residents still helps in the garden at The Lawn. There is also a support group of local ladies who visit the home for talks and chats and sometimes the residents go to their homes for afternoon tea. One of the residents has recently adopted a cat who was ‘confined to quarters’ on the day of the visit to ensure he did not stray away from the home and become lost. The catering contractor has recently been changed, but the same chef has worked at the home for several years. The home operates a rolling menu, which is written by the senior chef and is based on the known likes and dislikes of the residents. The deputy manager said that breakfast is served in the residents bedrooms for those who are no longer able to get their own. The more independent people living in the home are encouraged to prepare their own breakfasts in one of the pantries in the home. There are seven pantries in different areas of the home that are equipped with kettles, toasters and microwaves and a supply of tea, coffee and breakast cereals. The manager wrote in the AQAA that meal times are recognised as a very important part of the residents activites and they are encouraged to go to the dining room to socialise with the other residents, but more residents are choosing to stay in their rooms as they become frail. There is a choice of menu, which is ordered in advance, and the daily menu is displayed on a table near the dining room. Afternoon tea is served in residents rooms with homemade cakes and they are able to make tea or coffee at any time in their pantries. The residents that spoke with the inspector said that they enjoyed their meals and that there was usuallly a choice of three desserts at lunchtime. They agreed that their likes and dislikes were catered for and they felt able to comment about their meals and the menu choices, either to the chef or the manager. When the residents have guests they are able to make refreshment for them in their own pantries, but if this is not possible the staff will supply them with tea and cakes. The inspector saw several bedrooms and it was evident that residents are encouraged to bring in some of their own possessions to personalise their bedrooms, rooms were seen where residents had their own furniture, pictures, ornaments and lamps in place. The Lawn DS0000011920.V351827.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): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff training in adult protection, and the knowledge that all complaints are dealt with appropriately usually safeguard the people who use this service. EVIDENCE: The home has a written complaints procedure, which is also included in the Statement of Purpose which all residents receive before entering the home. There is also a copy of the statement posted in a prominent position on the residents notice board. Residents that spoke with the inspector said that they would take any concerns to the manager or her deputy and were certain that they would be properly dealt with. The deputy manager said that all complaints are taken seriously and acted on promptly, with records being kept. She also said that all staff are fully trained in adult protection and are aware of the need for observation to safeguard the residents against abuse, to ensure the safety and protection of all of the people living in the home. Staff spoken to said that they had received training in adult protetcion and felt confident that they would report any suspicions to the manager. The Lawn DS0000011920.V351827.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. 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. People who use this service live in a safe, well maintained, clean, and hygienic home. EVIDENCE: The home has a history of being built around 1807 by Tom Eggar and owned by the authoress Elizabeth Gaskell, who died in the drawing room in 1865. Friends Of The Elderly bought the house and opened it as a home in 1954. The Lawn is set in five acres of grounds, with a stream called the Bourne, a tributary of the river Wey running through the grounds which are well maintained by a full time gardener. There are plenty of sitting areas for the The Lawn DS0000011920.V351827.R01.S.doc Version 5.2 Page 16 residents to enjoy the extensive views of the garden. There is also a paved walkway around the house providing a level path for people living in the home to walk round. The accommodation consists of thirty one single rooms with en-suite toilets and wash basins. There are five ordinary domestic baths with various grab rails, a Parker Bath and two baths with auto-lift hoists, as well as three walk-in showers. During the course of the visit the inspector saw various parts of the home, which were seen to be clean and tidy throughout and there were no undue odours. Since the last inspection new carpets have been laid in some of the corridors on the ground floor to match those laid last year upstairs, as well as six bedrooms which were also decorated. A small area of torn carpet was noticed near the dining room entrance, which could be a trip-hazard for people using walking aids. The deputy manager arranged for the area to be mended by the maintenance staff. The communal areas in the home include a large Georgian-style drawing room with views across the lawns, a library with large print and talking books and a large, light and airy entrance hall, all of which are places where the residents are able to sit. The large dining room seats approximately forty people and lunch is served there at 12.30pm and supper at 6.30pm. The residents have the use of seven pantries for their own personal use, which contain a kettle, toaster and microwave. The laundry is well equipped but very small and the deputy manager said that it is due to be enlarged and will include the adjacent room, which is currently a store room for the handyman. The kitchen is medium sized and well furnished, with a separate washing-up area. The area looked clean and foods were stored appropriately in the cupboards and fridges and freezers. The kitchen has recently won a ‘Gold Award’ from East Hants District Council for their excellent hygiene standards. There is a programme in place for routine maintenance and decoration of the home and records are kept. The care staff are supported by three domestic cleaners who clean all of the communal areas daily. The home has a policy in place for the control of infection and the safe handling and disposal of clinical waste. Protective clothing, such as aprons and gloves, is supplied. The Lawn DS0000011920.V351827.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. 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. Robust recruitment practices and staff training protect people who use this service. EVIDENCE: The home is staffed with three senior healthcare assistants and fifteen care assistants. There are usually four staff on duty in the morning and three in the afternoon and two waking staff at night. The manager indicated in the AQAA that morning staff numbers have recently increased to five because of the increased care needs of some of the people living in the home. The AQAA indicated that all staff have an in-house induction period of three months, with a probation period of 6 months. During this time staff complete training in manual handling, adult protection, dementia and personal skills. The home has an activities co-ordinator, who works part-time but will be increasing her hours later in the year. There is also a part-time administrator to assist the manager. The care staff are supported by three part-time domestic staff as well as a full time maintenance person, a full time gardener and a part-time gardener The Lawn DS0000011920.V351827.R01.S.doc Version 5.2 Page 18 The home has a robust recruitment policy and all appropriate checks, such as obtaining satisfactory references and Criminal Records Bureau disclosures, are completed before staff start work in the home. European and overseas staff had the appropriate work permits. Staff receive regular supervision and training needs are identified through this process. Training records showed that staff are able to access a wide range of training and those staff spoken with said the training was of a good quality. The training records seen indicated that training was up to date and ion-going and included manual handling, fire safety, health and safety, hygiene, adult protection and dementia awareness. The inspector and the deputy manager discussed the use of the Skills for Care induction training, Eight of the seventeen care staff have obtained or are working towards their National Vocational Qualification in care [NVQ], which is approximately 50 of the staff, which meets the national expectation that 50 of the staff in a care home will have an NVQ in care. The Lawn DS0000011920.V351827.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. 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. People using the service are usually safeguarded by good management and their privacy, independence and dignity is promoted. EVIDENCE: The registered manager of the home is very experienced and has the necessary skills and qualifications to manage the home. She has many years experience in care home management and has managed the Lawn for the last five years. She has completed the City and Guilds foundation course for management in care and has completed an NVQ 4 in care and the Registered Managers Award. The Lawn DS0000011920.V351827.R01.S.doc Version 5.2 Page 20 The manager was away on the day of the visit and the deputy manager supported the inspector during the visit. She said that the manager had an ‘open door’ style of management, welcoming comments and suggestions from residents, staff and relatives The AQAA indicated that quality audits are undertaken annually, with questionnaires going out to residents, their families or advocates and the staff. The feedback enables the home to measure their success in meeting the needs of the people who live in the home as well as obtaining the views of the residents and their families. The deputy manager said that the residents usually manage their own money, except when they are asked to keep a ‘kitty’ for them in the safe. This is recorded and signed for and balances checked. Records indicated that staff attended regular and compulsory fire and other health and safety training, the home’s fire alarm system was checked regularly and emergency plans were in place. There was a fire risk assessment for the premises and regular risk assessments of the premises were undertaken. There were also in-date certificates for the homes fixed electrical wiring, portable appliance testing and for gas safety. No outstanding health and safety issues were observed during the inspection visit and records showed that all equipment was regularly serviced. The Lawn DS0000011920.V351827.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.V351827.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.V351827.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: 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 Lawn DS0000011920.V351827.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!