Inspection on 23/02/06 for The Lawns

This inspection was carried out on 23rd February 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 Lawns 28/02/07

The Lawns 26/07/05

The Lawns 13/12/04

The Lawns 12/08/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

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

CARE HOMES FOR OLDER PEOPLE Lawns, The School Lane Alvechurch Birmingham West Midlands B48 7SB Lead Inspector R McGorman Unannounced Inspection 23rd February 2006 13:30 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 Lawns, The DS0000018523.V279704.R01.S.doc Version 5.1 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. Lawns, The DS0000018523.V279704.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Lawns, The Address School Lane Alvechurch Birmingham West Midlands B48 7SB 0121 445 4098 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) Mr Darren Terence Oliver Mrs Lisa Marie Oliver Mr Darren Terence Oliver Care Home 24 Category(ies) of Dementia - over 65 years of age (24), Old age, registration, with number not falling within any other category (24), of places Physical disability over 65 years of age (24) Lawns, The DS0000018523.V279704.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 26th July 2005 Brief Description of the Service: The Lawns is registered to provide residential care for up to 24 older people, who are unable to live independently, who may have a physical or sensory disability, or who may experience mental health problems. The home is also able to offer care to people who may have a dementia type illness. The Lawns stands in large, well-maintained, secluded gardens in close proximity to the Parish Church in the village of Alvechurch. The home is within walking distance of the local shops and services. The property is well maintained, and has been sensitively upgraded and extended to provide a good standard of accommodation, and the lovely gardens are accessible to residents. The home is owned and run by Mr. and Mrs. Darren Oliver, with the assistance of Mrs. Chris Caldicott, who has recently applied to become the registered care manager. The stated aim of the management and staff at The Lawns is to create a warm, welcoming, friendly and safe environment, where the very best care and attention is provided, in an environment as close as possible to home conditions. Lawns, The DS0000018523.V279704.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The purpose of this routine, unannounced inspection was to follow up any previous requirements and recommendations, and to monitor care provision at the home, in relation to the stated aims and objectives. The inspection took approximately 3 hours, and time was spent in conversation with the management of the home, residents and staff, to ascertain their views on living and working at College House. A tour of the building was undertaken, and discussions held with the Proprietor and Deputy Manager about developments that have taken place recently, and also future proposals for maintaining and upgrading the premises. Care records were seen, and the care provision for service users was discussed. The documentation kept in respect of the maintenance of equipment, and safe working practices, including the fire log book and the accident book, was also checked. What the service does well: The Lawns is a happy home, where each person is treated as an individual, and where their opinions and views are considered to be valid. A friendly, welcome is given to everyone, and there is a calm and relaxed atmosphere evident throughout the house. A high standard of care is maintained, and the ongoing training provided for staff, ensures that they are given the relevant skills to deliver appropriate care to residents. Comprehensive information is available for residents, their families and interested parties, about the home and what can be provided for the people living there. A professional, organised approach is evident from the management, who create a supportive environment for staff. Lawns, The DS0000018523.V279704.R01.S.doc Version 5.1 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. Lawns, The DS0000018523.V279704.R01.S.doc Version 5.1 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 Lawns, The DS0000018523.V279704.R01.S.doc Version 5.1 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 the following standard(s): 1,2, & 5 Extensive information is available to residents, and their family or representative, and relevant documentation is in place, to enable an informed decision to be made about future care arrangements. The admission procedure ensures that the home is able to meet the assessed needs of service users. Lawns, The DS0000018523.V279704.R01.S.doc Version 5.1 Page 9 EVIDENCE: A statement of purpose has been produced, which together with the service users’ guide, provides prospective residents with the relevant information to enable them to make a decision with regard to their future care needs. A statement of Terms and Conditions of residence is provided to each service user as a formal document, which requires a signature by the registered provider, and the resident or their representative to confirm acceptance. There is a well-established admission procedure in place at the home. A detailed assessment is undertaken, to determine if the home is able to meet the needs of the service user. Prospective residents are encouraged to visit The Lawns, and to stay for a meal or a period of respite care, before deciding on their future care arrangements. Following admission a minimum of four weeks trial stay is recommended, concluding with a review, when the placement is confirmed, if mutually acceptable. Unplanned admissions are not accepted at The Lawns. Lawns, The DS0000018523.V279704.R01.S.doc Version 5.1 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 the following standard(s): 8,9, & 11 The health and personal care needs of service users are identified and recorded, and risk assessments completed, to enable effective care to be provided. Arrangements for the safe administration of medication are in place. Training is provided for staff to ensure a greater understanding of the issues regarding death and bereavement. Lawns, The DS0000018523.V279704.R01.S.doc Version 5.1 Page 11 EVIDENCE: The personal and healthcare needs of service users are closely monitored, and additional specialist support and advice is sought from the primary health care team, and other health professionals, when necessary. Risk assessments are completed with regard to moving and handling, and the activities of daily living, for each service user. Assessment is also undertaken for tissue viability and the nutritional needs of service users, when appropriate. A new format has been introduced and training provided for staff. A Monitored Dosage System (MDS) for the administration of medication is in place at the home, and training given to staff. Medication is reviewed regularly, and appropriate records are maintained. An issue has been identified in regard to staff responding to verbal instruction from a GP to change prescribed medication, which is not considered to be good practice. The involvement of the Pharmacist Inspector has been sought, and she will visit to discuss the concerns and seek resolution. A policy relating to death and dying has been produced at The Lawns. The wishes of service users regarding terminal care are discussed with them, and their family or representative, and a record is maintained. Training for staff on death and bereavement is arranged, to increase their understanding, and guidance on bereavement care has been sought from a local undertaker. An issue relating to resuscitation was discussed, and the management were advised that an individual procedure would need to be produced for a service user who makes a specific request, in consultation with the family, and the General Practitioner. The Commission should be kept informed of the outcome. Lawns, The DS0000018523.V279704.R01.S.doc Version 5.1 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 the following standard(s): 12,13 & 15 The wishes and preferences of service users are constantly respected, in regard to all aspects of their daily lives, which enables a good quality of life to be maintained. The extensive programme of leisure activities provides opportunities for stimulation, and enables the social needs of service users to be met. Service users are offered a choice of nutritious, wholesome and well-balanced meals, and the records provide evidence that a satisfactory diet is taken by everyone. Lawns, The DS0000018523.V279704.R01.S.doc Version 5.1 Page 13 EVIDENCE: Residents at The Lawns have complete freedom of choice in regard to their contacts, both within and outside the home, and they are enabled to make choices with regard to all the activities of daily living. The social, cultural, religious and recreational needs of service users are considered by staff at the home, and opportunities are provided to undertake a variety of interesting and stimulating activities. Service users are consulted individually about their particular interests and a record is maintained. For those who wish to be involved, activities are arranged with the support of the Amenities Co-ordinator, on an individual basis, or for group participation, either within or outside the home. The daily menu is posted on the notice board, and the menu plan indicated that a good variety of food is available, and that service users also have a choice. Special dietary requirements can also be provided. Comments made by service users were complimentary about the standard of the meals served at the home. Many of the dishes are home made, and the majority of vegetables are freshly prepared. A record of the food provided to individual service users is now being maintained at the home. Lawns, The DS0000018523.V279704.R01.S.doc Version 5.1 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 the following standard(s): 16,17 & 18 The culture of the home positively encourages comments, and the procedure for dealing with any concerns ensures that the home is run in the best interests of the service users. The policies and procedures implemented at the home ensure that service users are protected, and their rights are promoted. Further training on abuse is to be provided for staff to ensure their full understanding of all the issues. EVIDENCE: The home operates an appropriate complaints procedure, and information about how to make comments, suggestions or complaints is given to each service user and their representative. A record is maintained of any complaints made, although none have been received recently. Compliments should also be recorded. The policy of the home acknowledges the rights of service users in every respect, and residents are assisted to access medical, legal, advocacy and civic services depending on their individual needs and wishes. Arrangements are made for postal voting where service users are not able to attend the polling station in person. A policy on the Protection of Vulnerable Adults has been produced. A senior carer has undertaken training on adult protection, which is now to be arranged for all staff at the home, to ensure their understanding of the many forms of abuse. Lawns, The DS0000018523.V279704.R01.S.doc Version 5.1 Page 15 Lawns, The DS0000018523.V279704.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,23,25 & 26 The standard of cleanliness is excellent, the décor and furnishings are in good condition and the building is well maintained throughout, providing a very comfortable and homely environment for residents. The needs of residents are met in relation to the environment in which they live, and their safety and wellbeing is assured as far as possible at The Lawns. The premises are suitable for their purpose. The provision of a conservatory will greatly improve the dining facilities for service users. Lawns, The DS0000018523.V279704.R01.S.doc Version 5.1 Page 17 EVIDENCE: The Lawns is a lovely Victorian building, dating back to 1856, when it was originally built as the Rectory for the adjacent church. In 1953 it became a nursing home, and about 20 years later changed to a residential care home. The home has the distinction of being one of the longest established care homes in the country. The house has been sensitively developed to provide a pleasant environment for service users. The standard of cleanliness is excellent, the décor and furnishings are in good condition and the building is well maintained throughout. Accommodation is provided on two floors, which are accessed by stairs or a chair lift. The extensive lounge is designed to create a homely and comfortable sitting area, and overlooks the beautiful landscaped gardens, to which there is access through patio doors. The arrangements for dining are not satisfactory at present, as part of the lounge is being used for this purpose. A new, all weather dining conservatory is planned, and work is due to commence within the next few weeks. There are 23 bedrooms, all of which have en suite facilities, with 2 exceptions. There are 5 bedrooms large enough for shared occupancy, although the policy of the home is to only let rooms on a shared basis if this is the wish of both service users. One bedroom is below the recommended minimum size, and the management plans to extend this room when it becomes vacant. Bedrooms are personalised by service users, and the provision of furniture and fittings complies with National Minimum Standards. The provision of bathrooms/showers and toilets is adequate, and they are suitably located throughout the home. There are two adapted bathrooms on the first floor and one shower room on the ground floor. All bedrooms are centrally heated, and the radiators are guarded. The rooms are naturally ventilated and restrictors are fitted to the windows. Emergency lighting is provided throughout the house and records indicate that this is regularly checked. The home received a visit from the Fire safety Officer a few months ago, when the fire protection procedures were found to be compliant with requirements. A Fire Risk Assessment has been completed, and is reviewed regularly, and an Emergency Evacuation Contingency Plan is also in place. There are no outstanding requirements following a recent visit from the Environmental Health Officer. The home is clean and odour free. Documentation in respect of the servicing and maintenance of equipment at the home is completed to a satisfactory standard. Lawns, The DS0000018523.V279704.R01.S.doc Version 5.1 Page 18 Lawns, The DS0000018523.V279704.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 & 30 The home is adequately staffed with employees who are experienced and competent to care for older people. Staff are well trained and understand the needs of residents, which enables the appropriate delivery of care. EVIDENCE: The rotas indicate that appropriate numbers of staff are on duty, to meet the needs of service users, and this was confirmed in conversation with residents, who are very positive in their views about the staff and the care they receive. There is a minimum of four care staff on duty in the mornings, three carers during the afternoons, and two waking care staff at night with a senior on call. In addition, catering, domestic and maintenance staff are also employed, at the home. Discussions with staff, confirmed they are happy in their work, and that opportunities for training are provided. All staff have completed the NVQ Level 2 course in Customer Care, and other recent training courses include, Health & Safety in the Workplace, Food Safety, the Advanced Award in Medication Administration and Nutritional Assessments. A questionnaire has also been formulated for completion by staff, to increase their awareness of fire protection issues. Lawns, The DS0000018523.V279704.R01.S.doc Version 5.1 Page 20 Lawns, The DS0000018523.V279704.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,34,36 & 37 The management arrangements at the home are satisfactory, and residents and staff benefit from the positive approach and the leadership they receive. The quality assurance system, when fully implemented, should ensure that the home is run in the best interests of the service users. The arrangements for the formal supervision of staff, ensure that staff fully understand their role within the home, and that their career development needs are identified and met. The policies, procedures, and records maintained at the home, comply with legislative requirements, and therefore help to safeguard the rights of service users. Lawns, The DS0000018523.V279704.R01.S.doc Version 5.1 Page 22 EVIDENCE: The Lawns Residential Care Home has been owned and run by Mr Darren Oliver and his wife Lisa for almost 6 years, and Darren is also the Registered Care Manager. He is supported in the day to day running of the home by Mrs Chris Caldicott, the Deputy Manager. Both have undertaken the NVQ Level 4 Management course. Mrs Caldicott has submitted an application for registration as care manager at the home, which is currently being processed by the Commission. Darren has many years experience of residential care, and prior to purchasing The Lawns he had pursued a career in sales and marketing, and also gained experience in management. A formal quality assurance system has been introduced at the home, and the views of service users and their families are regularly sought through questionnaires. The need for full implementation of the process was identified, and the results of the surveys should be published when audited. A copy should also be submitted to the Commission on completion. The Proprietor verbally confirmed the financial viability of the business. Appropriate insurance cover is provided, to the relevant level, as evidenced by the certificate. A business and financial plan is currently being produced. A procedure for the formal supervision and appraisal of staff has been implemented, with appropriate records maintained. The records were not checked in detail during the inspection, although those seen had been completed to a satisfactory standard. Contracts are in place for the regular servicing and maintenance of equipment. The Fire Log indicated that weekly checks of the fire alarm system, and practice evacuations are undertaken. The Accident records had been completed appropriately, and Regulation 37 Notifications are made to the Commission, when appropriate. Lawns, The DS0000018523.V279704.R01.S.doc Version 5.1 Page 23 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 3 3 X X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 X 8 3 9 3 10 X 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 2 3 2 3 X 2 X 3 3 STAFFING Standard No Score 27 3 28 X 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 3 X 3 3 X Lawns, The DS0000018523.V279704.R01.S.doc Version 5.1 Page 24 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. 1. Standard 18 Regulation OP13 Requirement Training must be provided for staff on all aspects of abuse and the protection of vulnerable adults. Timescale for action 30/06/06 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 2 3 4 5 6 Refer to Standard OP9 OP10 OP16 OP20 OP23 OP33 Good Practice Recommendations Further information should be sought on issues relating to the administration of medication The Commission should be informed of the outcome of discussions regarding resuscitation All comments made about care provision, including compliments, should be recorded. Building of the planned conservatory should be commenced without further delay Arrangements to extend the undersize room should be implemented when it becomes available The quality assurance system should be implemented, and a copy of the published audit submitted to the Commission Lawns, The DS0000018523.V279704.R01.S.doc Version 5.1 Page 25 Lawns, The DS0000018523.V279704.R01.S.doc Version 5.1 Page 26 Commission for Social Care Inspection Worcester Local Office Commission for Social Care Inspection The Coach House John Comyn Drive Perdiswell Park, Droitwich Road Worcester WR3 7NW 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 Lawns, The DS0000018523.V279704.R01.S.doc Version 5.1 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!