Random inspection report
Care homes for older people
Name: Address: The Lawns 1A Knighton Rise Oadby Leicestershire LE2 2RF three star excellent service 02/12/2008 The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Carole Burgess Date: 2 3 0 9 2 0 0 9 Information about the care home
Name of care home: Address: The Lawns 1A Knighton Rise Oadby Leicestershire LE2 2RF 01162448864 01162448864 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : FSHC Newco 2 Ltd care home 41 Number of places (if applicable): Under 65 Over 65 41 0 old age, not falling within any other category physical disability Conditions of registration: 0 4 The maximum number of service users who can be accommodated is 41. The registered provider may provide the following categories of service only:- Care home only - Code PC To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories:- Old age, not falling within any other category - Code OP Physical disability - Code PD Date of last inspection Brief description of the care home The Lawns is a purpose built home and provides care for up to for up to forty-one older people, and older people with a physical disability. It is a spacious, well-appointed home set in well-kept gardens. There is a TV lounge and quiet sitting room, and separate dining room. All rooms are en suite and there are
Care Homes for Older People Page 2 of 10 0 2 1 2 2 0 0 8 Brief description of the care home additional toilets and assisted bathing facilities. The home is situated in the pleasant area of Stoneygate and is close to local shops and the nearby village of Oadby. It is close to the A6 where there is a regular bus service into Leicester. The Statement of Purpose, Service Users Guide & Inspection Report are available in the reception hall of the home, and on request (these provide information on how the home is organised and what services they provide). The Statement of Purpose and Service Users Guide are provided for all new residents. At the time of the last key inspection, fees ranged from £520 to £657 per week (this includes some chiropody and relexology treatments). Extras include: Hairdressing, newspapers and dry cleaning. Care Homes for Older People Page 3 of 10 What we found:
On 27th August 2009 we received a complaint from a relative whose elderly parent lived at The Lawns. She raised concerns about the quality of the food. The complaint was returned to the provider and a response received, which appeared satisfactory. The complainant was contacted but remained concerned. It was decided that a Random Unannounced Inspection should be carried out to establish if care practices relating to food and nutrition were satisfactory. We case tracked four people to check if their nutritional needs were being met. This included two of the oldest residents, one new resident and one other. Likes and dislikes were recorded in care plans and a copy of individual food preferences was kept in the homes kitchen. All of the care plans viewed contained a nutritional assessment, Malnutrition Universal Screening Tool (MUST) score, Body Mass Index (BMI) and weight. These had been completed on admission and had been re-assessed on a monthly basis; weights were completed monthly, as required. However, one persons weight had been recorded as follows: 28/02/09: 39.1Kg & BMI 17; 14/04/09: 25.9Kg (originally as 39Kg then crossed out) & BMI 17; 10/08/09: 36.5Kg & BMI 16. The anomaly and recorded weight loss had not been followed up, re-checked or reported to the Registered Manager, or senior person, so that an appropriate advice could be sought. This was discussed with the Registered Manager as of serious concern. She was unaware that this had occurred and stated that the carer who had written the weights was no longer employed and that any drop in weight of 2Kg, or more, had to be reported to her to action, and that more regular (2 weekly) weight checks were then undertaken. We visited the dining room at lunch time to check the food provided. The dining-room was clean, well decorated, tables had clothes, napkins and a pre-lunch sherry had been provided if required. The lunch consisted of a Starter: French Onion Soup, Main Course: choice of Haddock Fishcakes or Gammon & Pineapple, new potatoes, green beans, glazed carrots and peas. Pudding: Fresh Fruit Salad or homemade Egg Custard Tarts. The chef said that he would always provide an omelet or sandwiches for people who did not want what was offered for lunch. The food looked and smelled very appetising. The gammon was tender and the vegetables well-cooked and well-presented, and served individually to people by the care staff. Tea was turkey sandwiches, ice cream and homemade cakes, Spanish omelet, salad and fruit scones. Home made biscuits and cakes were served with morning coffee and afternoon tea respectively. We spoke with three of the people case tracked, the fourth person had gone out for the afternoon. The complainants relative, who lived in the home, said that the food had not been too good, but had improved over the last few weeks and that care overall was better since Linda (the Registered Manager) had returned to work. She said that the
Care Homes for Older People Page 4 of 10 gammon at lunchtime had been like straw and there was only a small piece. However, we saw the gammon and there were two pieces on each persons plate, and we noted that people found it easy to cut and eat. The resident said that she must have had a hard piece. Another person was asked what she thought of the lunch meal and said, Everything was wrong with it, but when asked to explain what was wrong she could not say. Four other people were spoken with and all said that the meals were very nice and that choice and alternatives were provided. One lady had stayed for respite care on two occasions and said that she always enjoyed the food and that she was very well cared for during her stay. There had been problems with catering as the regular chef was on long-term sick leave. During that time the home had used agency cooks. It was during this time, and whilst the Registered Manager was also away, that complaints about the food and some other minor issues had escalated. The home now have a bank chef, who has an NVQ 2 in catering and has worked as a chef and head chef in other establishments. He acknowledged that, at first, he found it a bit daunting having to prepare lunch for 41 people at the same time, and to cater for the elderly, but felt that he was now more in control and able to cook as the residents preferred. We suggested that he should make time to talk to the people who live at The Lawns, and ask their opinions about food so that he built up a relationship with them and had a greater understanding of their particular dietary needs and general likes and dislikes. He also said that he worked until 6pm so could prepare an alternative at tea time if this was required. Food was sourced locally, meat from butchers Patrick & Godwin and fruit and vegetables from wholesalers Brian Cleaver. This had not changed since Four Seasons took over from the previous private owners of the home. Staff said that they ate in the home and that the food was usually very nice. They said that there had been occasions, recently, when people had complained about the vegetables being undercooked, but this had been addressed. The chef said that he was used to serving vegetables Al dente but had now altered this to suit this older client group. Staff were provided with some guidance on how to complete the nutritional assessments and MUST scores by the deputy manager during their induction but had not received any further in-depth or mandatory updates after this to ensure a continued understanding of the nutritional needs of the elderly. The Registered Manager said that she now kept a separate record of days when she inspected and tasted the meals and recored her finding to ensure that she quality assured the food on a regular basis. We later spoke again with the complainant, and her relative. They said that the food could be better but acknowledged that both the food and care had improved since Lindas return to work. What the care home does well:
Care Homes for Older People Page 5 of 10 The home maintains high standards of decor and cleanliness in both the dining room and kitchen to enhance the dining experience. Food is sourced from well known suppliers that the home has used for many years. The service bake their own biscuits and cakes for morning coffee and afternoon tea. All residents had had a nutritional assessment on admission and were regularly weighed. All of the people visited in their room had a variety of drinks available. People can dine in their rooms if they prefer and most people breakfast in their own room. Visitors are able to dine with relatives if they wish. A pre-lunch sherry is provided at no extra cost, if required. Assistance at meal times was provided in a discreet and unobtrusive way. On the day of the visit food looked well presented and nutritious with alternatives available. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2.
Care Homes for Older People Page 6 of 10 Care Homes for Older People Page 7 of 10 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements
These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 8 of 10 Requirements and recommendations from this inspection:
Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours.
No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set.
No. Standard Regulation Requirement Timescale for action 1 8 13 An accurate record of 30/10/2009 peoples weights is maintained, including weight gain or loss, and appropriate action taken. To ensure that people maintain optimum nutritional health. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service.
No Refer to Standard Good Practice Recommendations 1 30 We recommend that all staff should receive training relating to the importance of nutritional management for older people, which should be revisited on a regular basis. We recommend that, in the absence of the Registered Manager, staff are supervised and supported in house by an appropriate, competent person to ensure the continued high level of care expected at The Lawns. 2 31 Care Homes for Older People Page 9 of 10 Reader Information
Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 10 of 10 - 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!
