CARE HOMES FOR OLDER PEOPLE
The Lawns School Lane Alvechurch, Birmingham West Midlands B48 7SB Lead Inspector
Annie OMara Unannounced 26 July 2005 9:30 am 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 E52 S18523 The Lawns V238968 260705.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service The Lawns Address School Lane, Alvechurch, Birmingham, West Midlands B48 7SB 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) 0121 445 4098 Mr Darren Terence Oliver Mrs Lisa Marie Oliver Mr Darren Terence Oliver Care Home 24 Category(ies) of DE(E) Dementia over 65 (24) registration, with number OP Old age (24) of places PD(E) Physical disability over 65 (24) The Lawns E52 S18523 The Lawns V238968 260705.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: There are no conditions of registration. Date of last inspection 13 December 2004 Brief Description of the Service: The Lawns offers residential care for up to 24 service users (over 65 years of age). The home caters for older people who may have a dementia type of illness and/or a physical disability The home stands in large well maintained secluded gardens on the outskirts of the village of Alvechurch. The home is within short walking distance of the local shops and services. The first floor is accessed by a stair lift. On the first floor there are twelve bedrooms ten of which are ensuite. On the ground floor there are eleven bedrooms all of which are ensuite. There are two adapted bathrooms on the first floor and one shower room and separate shower on the ground floor. There is a large lounge which has access to the well maintained gardens. The current arrangements for dining are in the reception area as a large conservatory is being built to provide a large dining area. The Lawns E52 S18523 The Lawns V238968 260705.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection took place during a weekday morning over a period of three and a half hours. Four residents were spoken to, one member of staff and a visiting professional. Care records and staff recruitment files were also examined and a brief tour of the building was undertaken. What the service does well: What has improved since the last inspection? The Lawns E52 S18523 The Lawns V238968 260705.doc Version 1.40 Page 6 The majority of the requirements made at the last inspection have been actioned. These include some of the health and safety issues, recruitment practices and staff training. 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 E52 S18523 The Lawns V238968 260705.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 E52 S18523 The Lawns V238968 260705.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) 1, 2, 3, 4, 5. The home provides information and an opportunity to visit which helps prospective residents and their families to make an informed choice about moving in to the home. The assessment process ensures that residents’ needs are understood and planned for prior to admission EVIDENCE: Information was provided to all new residents prior to them moving into the home. A resident confirmed that staff had visited him to undertake an assessment and this was documented by the home and supported by information from other agencies. The statement of terms and conditions for residents still required some amendments. The resident had also visited the home prior to admission. It was stated that “I was greeted so well”. The Lawns E52 S18523 The Lawns V238968 260705.doc Version 1.40 Page 9 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 10. Residents’ health and welfare was promoted by the care planning systems in place. The care practices in the home promote residents’ privacy, dignity and independence. EVIDENCE: Residents care plans were examined and were seen to address all areas of residents care needs. All majority of residents health care needs were recorded with the exception of a risk assessment for nutritional needs. The records indicated that the primary health care team were consulted as necessary and this was confirmed by the district nurse who was spoken to during the inspection. She stated that the communication between staff was “Very good” and that any instructions left were carried out by staff. Residents who were asked said the “Care could not be bettered”, and “I think its marvellous”. Staff were observed to be respectful to the residents. Relationships were seen to be warm and affectionate. The Lawns E52 S18523 The Lawns V238968 260705.doc Version 1.40 Page 10 Residents stated that the staff were “Very polite”, “Always willing to help” and “Everyone treated so well and the same”. Staff who were spoken to were very conversant in the practice of promoting privacy and dignity of the residents. The Lawns E52 S18523 The Lawns V238968 260705.doc Version 1.40 Page 11 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 15. The activities provided in the home promote the health and welfare of the residents and are tailored to meet individual and collective needs. The food provided by the home was well prepared and cooked but did not allow residents’ to be involved with menu planning which took away some of their choice. EVIDENCE: The routines of the home were flexible to meet the residents’ individual needs. There was a varied and interesting activities program available which met individual and collective needs. Visitors were encouraged at the home and community links were apparent with the provision of some of the activities provided. Residents said that the food was “Well cooked”, “Varied”, “Nowhere will you get better food”. It was noted however, that there was little consultation with residents about menu planning. Individual likes and dislikes were known and alternatives were offered. There was no daily menu on display and there was no complete record of food provided kept. Requirements have been made in respect of these issues. The Lawns E52 S18523 The Lawns V238968 260705.doc Version 1.40 Page 12 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 The ethos of the home is such that residents feel able to voice any concerns. EVIDENCE: There was a complaints procedure in place and residents who were spoken to felt confident in raising any concerns. The home welcomes feedback as a way of improving their service. The Lawns E52 S18523 The Lawns V238968 260705.doc Version 1.40 Page 13 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, 20, The overall environment is maintained to a high standard, providing the residents with a very comfortable and homely place to live. Although the dining arrangements are not currently satisfactory, residents have been kept informed and the end result will be of benefit to them. EVIDENCE: The home provides a safe and comfortable environment for the residents which is decorated and maintained to a very high standard. The interim arrangements for the dining room are not satisfactory and the registered provider said that he hopes the new conservatory will be constructed within three months. The residents have been kept informed. Two radiators were observed without covers on them in the dining area. The registered manager stated they would be covered before they were switched back on for the winter. The Lawns E52 S18523 The Lawns V238968 260705.doc Version 1.40 Page 14 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. Staffing arrangements ensure that residents needs are met by well trained staff who are committed to their work. The recruitment practices promote the safety of the residents. EVIDENCE: The rotas and numbers of staff on duty indicated that staffing levels were appropriate to the needs of the residents. Staff who were spoken to and observed working were efficient and knowledgeable in their jobs. Training records indicated that training was on-going and covered specialist areas as well as health and safety issues. Staff files inspected indicated that staff were being recruited safely and the necessary checks were being undertaken. The Lawns E52 S18523 The Lawns V238968 260705.doc Version 1.40 Page 15 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, 32, 33, 36. The managers of the home are committed to providing an open and inclusive atmosphere which continues to improve the standard of care offered to the residents. EVIDENCE: The registered manager and deputy manager are both completing their NVQ level 4 training. The managers are both experienced in providing care for the residents at the home. The ethos of the home is open and residents felt that the manager was approachable as did the staff. There are regular staff meetings and a resident committee. The home asks for feedback from residents and other stakeholders but there is no formal quality assurance program in the home. Staff receive regular supervision and regular staff meetings are held.
The Lawns E52 S18523 The Lawns V238968 260705.doc Version 1.40 Page 16 There are some outstanding environmental risk assessments to be carried out. The deputy manager stated that an outside agency was to be employed to carry out these risk assessments. Fire safety checks were carried out at the required frequency. The Lawns E52 S18523 The Lawns V238968 260705.doc Version 1.40 Page 17 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 3 2 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 2
COMPLAINTS AND PROTECTION 2 2 x x x x x x 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 2 3 2 x x 3 x x The Lawns E52 S18523 The Lawns V238968 260705.doc Version 1.40 Page 18 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 2 Regulation 5 Requirement The statement of terms and conditions must be amended so that it includes all the information detailed in standard 2.2. Timescale of March 2005 not met. Nutritional risk assessments must be kept for all residents. Residents must be consulted about the provision of food. A complete record of food served must be kept. Radiators in the communal areas must be covered. A suitable dining area must be provided for the residents. A formal quality assurance program must be put in place which meets with the details in standard 33 The home must ensure that environmental risk assessments are carried out for all areas of the building. Timescale of February 2005 not met. Timescale for action 30th September 2005 2. 3. 4. 5. 6. 7. 8 15 15 19 20 33 13(4) 12(2)(3) (2) Schedule 4 13(4) 23(2)(g) 24 30th September 2005 30th September 2005 30th September 2005 30th September 2005 31st October 2005 31st October 2005 30th September 2005 8. 38 13(4) The Lawns E52 S18523 The Lawns V238968 260705.doc Version 1.40 Page 19 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. Refer to Standard 15 Good Practice Recommendations A menu should be displayed in the home. The Lawns E52 S18523 The Lawns V238968 260705.doc Version 1.40 Page 20 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
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