Inspection on 20/07/05 for The Lawns

This inspection was carried out on 20th July 2005.

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

The inspector 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 Lawns 06/06/06

The Lawns 26/01/06

The Lawns 25/10/04

The Lawns 29/06/04

Similar services:

Fairfields Country Rest Home

Queensmount

Poldhu

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE The Lawns Fernhill Avenue Weymouth Dorset DT4 7QU Lead Inspector Gloria Ashwell Unannounced 20 July 2005 & 4 August 2005 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 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 Lawns D55 S32130 The Lawns V240078 200705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service The Lawns Address Fernhill Avenue Weymouth Dorset DT4 7QU 01305 760881 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Dorset County Council Ann Vallins CRH PC - Care home only 42 Category(ies) of DE(E) Dementia - over 65 (12) registration, with number of places OP Old age (30) The Lawns D55 S32130 The Lawns V240078 200705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Staffing levels must be those determined in accordance with guidance recommended by the Department of Health The condition was met. Date of last inspection 25th & 28th October 2005 Brief Description of the Service: The Lawns is a purpose built home providing care and accommodation for elderly people, situated approximately ½ mile from the town centre. The home is owned and managed by Dorset County Council Social Services Directorate; Mrs Ann Vallins is the manager and Mr Harry Capron the registered person. The manager has overall responsibility for the home which provides care for up to 42 residents with 30 places for persons in the category of old age (OP) and 12 places for persons in the category of dementia over 65 years of age (DE (E)). Residents are accommodated in mostly single bedrooms on the ground and first floor; the home has four double bedrooms and 34 single bedrooms. None of the bedrooms has an ensuite toilet; all contain a wash hand basin and close to all bedrooms are toilets and bathrooms suitable for residents with mobility difficulties. The home is divided into three units, each providing a lounge, dining room and kitchenette facilities for the preparation of drinks and light snacks. There is an ‘8 person’ passenger lift to the first floor and two stair lifts on first floor corridors to enable service users with mobility problems to negotiate the short flights of steps connecting different levels of the first floor. There are level gardens with wide footpaths, lawns and a summerhouse. There is a car park and a nearby bus stop, for buses to and from the centre of Weymouth. The Lawns D55 S32130 The Lawns V240078 200705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was one of the two statutory inspections required in accordance with the Care Standards Act 2000. Since the previous inspection no complaints against the home have been received or investigated. The inspection took place over two days; the inspector arrived (unannounced) at 14.00 on 20 July 2005. During that afternoon she spoke to 18 residents, 5 members of staff and the visiting relatives of two residents. The inspector observed staff interaction with service users, the carrying out of routine tasks and toured the premises. A selection of information and comment forms were left with the home for residents and other persons involved with the home. Additional information used to inform the inspection process included formal notifications of events and monthly reports regularly provided to the Commission by the registered provider, and 13 completed Comment Cards. As arranged following the visit on 20 July 2005, the inspector returned to the home at 10.00 on 4 August 2005 and together with the manager considered other evidence relating to the National Minimum Standards, as described in this report. The duration of the inspection (both days combined) was 4 hours and 20 minutes. What the service does well: Residents are assisted to maintain as much independence as possible and are encouraged to maintain contact with the local community. The premises are comfortable and well-equipped, with a number of communal rooms, wide corridors, passenger and stair lifts and attractive gardens. Staff are kind and helpful to residents. Residents are treated with respect and their privacy is protected. The quality of daily life is very good with provision of a variety of recreational and social activities and well-presented nutritious and plentiful meals. The Lawns D55 S32130 The Lawns V240078 200705 Stage 4.doc Version 1.40 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 Lawns D55 S32130 The Lawns V240078 200705 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection The Lawns D55 S32130 The Lawns V240078 200705 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2, 3, 4, 5 & 6 The home does not provide intermediate care so Standard 6 does not apply. Prospective residents (or their representatives) are provided with comprehensive information about The Lawns and are encouraged to visit in advance of admission to establish their impressions of life at the home and the standard of available accommodation. Prior to admission, the needs of each proposed resident are assessed to ensure the home will be properly able to meet them. EVIDENCE: A resident told the inspector that he had recently been admitted for continuing care; he said he was entirely satisfied with the home, having been made welcome and put at his ease by staff and residents alike. The records of this resident included details of pre-admission assessment which had been carried out by the manager when she visited him in hospital, to identify his and determine if the home will be able to meet them. The Lawns D55 S32130 The Lawns V240078 200705 Stage 4.doc Version 1.40 Page 9 The resident’s close friend confirmed that prior to his admission he had visited The Lawns and viewed the room in which the resident was to be accommodated, because the resident had at that time been unable to himself visit the home. All admissions are for an initial trial period of six weeks, to give the resident the opportunity to ‘try out’ life at the home, and for the home to assess their ability to properly care for the resident. Residents are issued with a contract describing Terms & Conditions of occupancy including the fees. The Lawns D55 S32130 The Lawns V240078 200705 Stage 4.doc Version 1.40 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9 & 10 The standard of health, personal and social care is good and is delivered in accordance with a written plan of care, to ensure staff have information necessary to provide correct care to each resident. The plan of care for one resident did not provide sufficient information to ensure that appropriate action would be taken in the event of health emergency. Doctors and nurses visit the home to carry out specific actions for individual residents, ensuring their health care needs are met. Medicines prescribed by doctors are administered to residents by staff, unless the residents have chosen to store and administer their own medicines, in accordance with risk assessment. Arrangements for handling medicines be improved to ensure that residents receive the correct medicines and that all medicines held in the home are properly accounted for. Residents said they are treated with respect and their privacy and dignity is protected at all times. The Lawns D55 S32130 The Lawns V240078 200705 Stage 4.doc Version 1.40 Page 11 EVIDENCE: All residents with whom the inspector spoke said they felt well cared for and safe. Comments included: “It’s very homely – the staff couldn’t be more helpful…they’re always cheerful” “They’re very good; they’re real carers”. Staff to whom the inspector spoke were aware of each residents health and social care needs. Although the home does not provide nursing care, community nurses may visit to carry out particular tasks (e.g. wound dressing) for residents. Risk assessments form the basis for care plans and daily records describe the care of each resident. The care plan of a resident with a particular health condition did not provide sufficient information regarding actions to be taken in the event of sudden deterioration in health. A related short-dated requirement was issued during the inspection. Residents wishing to do so can manage their own prescribed medicines, although most prefer this to be done by the staff. Staff involved in handling medicines have received related training. Medication administration records (MARs) must be improved to ensure that residents receive correct medicines and doses, and that the home can properly account for all medicines held; stock balances were not recorded for Temazepam tablets dispensed from bottles, handwritten amendments to the printed MARs were not signed, dated and countersigned, records did not indicate that all medicines had been administered as prescribed, the reason for administration of ‘as required’ medicines was not stated on the MAR and there was not a summary of all medicines prescribed for each resident, describing purpose and possible sideeffects. A related Immediate Requirement was issued during the inspection. Residents are treated with respect and their privacy and dignity is promoted; staff are kind and considerate, and keen to assist residents. The Lawns D55 S32130 The Lawns V240078 200705 Stage 4.doc Version 1.40 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14 & 15 The quality of daily life in the home is extremely good with residents assisted to maintain as much independence as possible. Social and leisure activities are varied and suited to the preference and ability of each resident. Residents are encouraged to maintain contact with the local community and visits by their friends and relatives are welcomed by the home. Meals are appetising and of good quantity and quality. Most residents take meals in the dining rooms, some receive them in their bedrooms. EVIDENCE: The inspector spoke to a number of residents; all expressed satisfaction with the home, including the range of activities, meal provision, staff and premises. The home employs a Social Inclusion Officer who coordinates social and leisure activities. Residents described to the inspector recent excursions including trips to the steam railway at Swanage and a picnic lunch at West Bay. Visitors are welcome at any time and residents can go out of the home whenever they wish, and for as long as they wish. The Lawns D55 S32130 The Lawns V240078 200705 Stage 4.doc Version 1.40 Page 13 Residents select meals in advance, from a planned menu. Residents said the food is good and plentiful and attractively served. The Lawns D55 S32130 The Lawns V240078 200705 Stage 4.doc Version 1.40 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 Complaints are managed properly and residents said they are confident their concerns are listened to and taken seriously. EVIDENCE: The ‘service user guide’ includes a clear complaints procedure and policy. All complaints are recorded, together with details of investigation and outcome. No complaints against the home have been received or investigated since the last inspection. The Lawns D55 S32130 The Lawns V240078 200705 Stage 4.doc Version 1.40 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 standard(s) 19, 22 & 26 The home is comfortable, clean, well equipped and suited to the needs of the residents. EVIDENCE: The home is attractively furnished and decorated and subject to continuous improvement. Since the previous inspection an ‘8 person’ passenger lift has replaced a smaller lift and there are intentions to provide a sluice room and a shower room and to replace one of the two stair lifts with a platform lift, with these works all expected to complete by the end of 2005. Since the previous inspection the manager has obtained a copy of the report written by an Occupational Therapist who has assessed the home and has confirmed it is suitable to meet the needs of residents. The home is clean and well maintained. The Lawns D55 S32130 The Lawns V240078 200705 Stage 4.doc Version 1.40 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 & 29 The home employs enough staff to meet the needs of residents and to ensure their safety and comfort. Recruitment and employment practices protect against risks of unsuitable staff being employed. EVIDENCE: Staffing levels are provided in accordance with the assessed needs of residents. The inspector spoke to a number of staff; all stated that in their opinion there is sufficient provision for good care and encouragement for training although some said they felt “disillusioned” because of recent changes to their working practices. Later discussion with the manager indicated that changes had been made to ensure that good care standards are reliably maintained at all times. With the exception of one household position, the home is fully staffed with no vacancies for care staff. Staffing levels are determined by use of the ‘Staffing Forum’ and consideration of dependency levels of currently accommodated residents. Employment records of a recently employed care worker were examined and found to be in order, containing 2 written references, record of interview and CRB disclosure. The Lawns D55 S32130 The Lawns V240078 200705 Stage 4.doc Version 1.40 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31 & 38 Staff have good leadership – from the registered manager and senior care staff. Fire safety equipment is routinely checked and tested but records indicate that fire fighting equipment has not been recently checked; in consequence, if an accidental fire breaks out, fire fighting equipment may not function as expected and may thereby place service users and staff at risk of harm. The home has recorded a brief assessment for Health & Safety in the Workplace; this omits reference to a number of significant considerations and must be improved to ensure that all foreseeable risks have been identified and minimised. EVIDENCE: Mrs Ann Vallins is the registered manager of The Lawns; she possesses NVQ4 in management in care and is suitably experienced. The Lawns D55 S32130 The Lawns V240078 200705 Stage 4.doc Version 1.40 Page 18 A Comment card completed by a social care professional stated that Mrs Vallins “is not only very professional but compassionate…enabling service users to receive a quality service which meets their needs”. Fire alarms and emergency lighting were recorded as tested at the required intervals but the last recorded visual check of fire fighting equipment was stated to have taken place on 25 May 2005, not at the required monthly frequency. During July 2005 a brief Health & Safety in the Workplace assessment has been recorded; it is not comprehensive e.g. it omits reference to Legionella, use of domestic gas, risks of falling from upper floor windows and a number of other significant considerations. The document must be improved and expanded to ensure that all parts of the premises and working practices have been adequately assessed and any identified risks minimised. The Lawns D55 S32130 The Lawns V240078 200705 Stage 4.doc Version 1.40 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 x x 3 x x x 3 STAFFING Standard No Score 27 3 28 x 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x 3 x x x x x x 2 The Lawns D55 S32130 The Lawns V240078 200705 Stage 4.doc Version 1.40 Page 20 YES Are there any outstanding requirements from the last inspection? 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 7 Regulation 15[1] Schedule 3[1b][m] Requirement For service users with particular conditions (including diabetes) the care plan must provide clear information about the condition and instructions for action to be taken in the event of emergency (e.g. hypoglycaemia). Timescale of previous requirement 1/12/04 - not met. There must be robust evidence that medicines are accurately administered and recorded in accordance with the instructions of the prescriber and in accordance with current guidelines for the control and administration of medicines. Timescale of previous requirement 1/12/04 - not met. The stock balance of Temazepam must be recorded following each administration of the medicine. The reason for administration of as required medicines must be stated on the MAR. Fire fighting equipment must be visually checked at least monthly and accurate records must be kept of these checks. A comprehensive assessment for Health & Safety in the Workplace Timescale for action 11/08/05 2. 9 13(2) 4/08/05 3. 4. 5. 9 9 38 13 13 23(2)(4) 4/08/05 5/09/05 5/09/05 6. 38 13 1/11/05 Page 21 The Lawns D55 S32130 The Lawns V240078 200705 Stage 4.doc Version 1.40 must be recorded, including evidence of actions to minimise any identified risks. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 9 Good Practice Recommendations For each service user, there should be a record of all currently prescribed medicines, the reason for prescription and other relevant information e.g. likely side effects. This recommendation is repeated from previous reports. Handwritten amendments and additions to medicine admnistration records should be signed and dated by the writer, and countersigned by somewhat who has checked the entry for accuracy. 2. 9 The Lawns D55 S32130 The Lawns V240078 200705 Stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection Unit 4, New Fields Business Park Stinsford Road Poole Dorset BH17 0NF 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 Lawns D55 S32130 The Lawns V240078 200705 Stage 4.doc Version 1.40 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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