Inspection on 28/02/07 for The Lawns

This inspection was carried out on 28th February 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 Lawns 23/02/06

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 Rachel McGorman Key Unannounced Inspection 28th February 2007 10:00 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.V327298.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. Lawns, The DS0000018523.V327298.R01.S.doc Version 5.2 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 Mrs Christine Margaret Caldicott 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.V327298.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 16th February 2006 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 house is large detached property, originally built in1856 as a Rectory for the adjacent Parish Church in the village of Alvechurch. The building is well maintained, and has been sensitively upgraded and extended to provide a very pleasant environment for the people who live there. The home stands in lovely gardens, which are well laid out and kept to a high standard. They are accessible to service users and well used, particularly in the summer months. The home is also situated within walking distance of the local shops and services. The home is owned and run by Mr Darren & Mrs Lisa Oliver. Mrs. Christine Caldicott is the registered care manager, and has responsibility for the day-today running of the home. The range of fees varies between £500 and £600 per week. 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. A major new building programme is currently underway, and when completed later in the year, will provide greatly improved facilities for service users. Lawns, The DS0000018523.V327298.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The purpose of this routine key inspection, was to monitor the care provided at the home, to assess how well the service meets the needs of the people who live there, in relation to the stated aims and objectives, and to follow up previous requirements and recommendations. Preparation for the inspection included viewing previous reports, and documentation relating to the home, and considering the various contacts made with the home since the last inspection. The pre inspection questionnaire provided updated information about the establishment, and any recent changes that have taken place. Comments were received from service users, and their families or a representative in response to surveys that had been sent to them. The views of health and social care professionals in contact with the home were also sought. The visit was unannounced and took approximately 6 hours, when some time was spent with service users, discussing with them what is like living at the home, and observing their interactions with the staff, and in addition, visitors to the home on the day of the inspection were also consulted. The care records of two service users were checked for case tracking purposes, and their care provision discussed. The Medication Administration Records were also seen. During conversations with staff, comments were made about what it is like to work at the home. Two staff files were also seen, and recruitment procedures reviewed. The inspector was able to speak with the staff member responsible for the maintenance of the building, and to check the records relating to the facilities and services, and health and safety matters. 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. Time was spent with the Amenities Co-ordinator and the Head Cook in discussing their individual roles within the home, and how they can enable service users to been involved in the running of the home. Discussions were held with the Registered Care Manager, Ms Christine Caldicott, about her role, and the day-to-day management of the home. A tour of the building was undertaken, and discussions held with the Proprietor about recent developments, and also the extensive future proposals for the service, which will further improve facilities for service users. Lawns, The DS0000018523.V327298.R01.S.doc Version 5.2 Page 6 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 warm welcome is given, and this was mentioned in the comments from families, and professionals visiting the home on a regular basis. There was a lovely atmosphere and the home was calm and relaxed. Relevant information about the service, and what can be provided, is available to service users and their families, and is reviewed regularly to ensure that it is up to date and accurate, and therefore able to assist prospective residents and their families to make the right decisions about their care. A high standard of personal and health care is provided for each resident at the home, and the staff work well with other professionals and agencies, to help improve and maintain their health, with obvious benefit to service users. The individual needs of service users are regularly reviewed and recorded. The arrangements regarding the provision of food reflect the individual likes and dislikes and the preferences of each service user, and everyone was very complimentary about the lovely food. The provision of a wholesome diet will help to maintain the health and wellbeing of service users. Opportunities are available for service users to do the things they enjoy, and they are able to choose if they wish to be involved in the activities that are provided, which are many and varied. Many service users said how much pleasure they had from all the interesting things that go on at the home. There is evidence that service users are at the centre of everything at the home. Residents are very obviously involved in making decisions about their daily lives, and they also confirmed that they are treated with respect and consideration at all times. Staff confirmed that they are given appropriate training opportunities, and the ongoing training provided for staff, ensures that they are given the relevant skills to deliver appropriate care to residents. A professional, organised approach is evident from the management, who create a supportive environment for staff. The building has been sensitively extended and upgraded, and is maintained to a high standard. It is nicely furnished, warm, comfortable, safe and clean. Lawns, The DS0000018523.V327298.R01.S.doc Version 5.2 Page 7 What has improved since the last inspection? What they could do better: The management should ensure that Notifications under Regulation 37, which requires reports to be sent to the Commission of the death, injury or serious illness of a service user, or other events in the home, are submitted when necessary. Service users will be better protected by the recruitment procedures at the home being implemented more rigorously. Specifically, two written references, a health declaration and a photograph should be obtained for all applicants. Lawns, The DS0000018523.V327298.R01.S.doc Version 5.2 Page 8 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. Lawns, The DS0000018523.V327298.R01.S.doc Version 5.2 Page 9 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.V327298.R01.S.doc Version 5.2 Page 10 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): 1,2,3,5 & 6 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Extensive information is available to service users, and their family or representative, to enable an informed decision to be made about future care arrangements. The pre-admission assessment provides relevant information, to ensure that the home is able to meet the identified needs of service users. The admission procedure can be adapted to suit each person and provides an appropriate introduction to the home. Lawns, The DS0000018523.V327298.R01.S.doc Version 5.2 Page 11 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, and intermediate care is not available at The Lawns. Lawns, The DS0000018523.V327298.R01.S.doc Version 5.2 Page 12 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): 7,8,9,10 & 11 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The service users plan of care is based on the initial assessment, which clearly identifies their assessed needs, and how these will be met. Risk assessments are completed, to support service users in being as independent as possible. The procedures followed in the administration of medication ensure the protection of service users. The privacy and dignity of service users is respected, and the atmosphere throughout the home is one of mutual esteem and regard. Training is provided for staff to ensure a greater understanding of the issues regarding death and bereavement. Lawns, The DS0000018523.V327298.R01.S.doc Version 5.2 Page 13 EVIDENCE: The care plans provide evidence that the personal and healthcare needs of residents are being met. An individual plan of care is developed with each service user, and is based on the initial assessment undertaken during the admission process. This document is very comprehensive and covers all the aspects of care in relation to the daily living needs of the service user. It includes, a preadmission assessment, health and personal care details, visits from health professionals; it explores physical and emotional well-being and social interests, identifies needs and solutions, the likes and dislikes of the resident and their preferred plan of daily routines, and their relationships with friends and family. The document is discussed with the service user and their family, if that is their wish, and a signature obtained whenever possible. The care plans of three service users were seen for case tracking purposes. They were well maintained, and had been reviewed regularly. The actual frequency of the review is determined by the needs of each person, the inspector was told, and is at least monthly. The care plans were signed and dated accordingly, and reflected the care given to service users. 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, and relevant training provided for staff. 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. Detailed records are maintained of any specialist care needs. E.g. food and fluid intake for a service user who eats and drinks very little, and for a resident who challenges the service, an ABC (Antecedent/Behaviour/Consequence) record is made. The Community Psychiatric Nurse assists staff in caring for this resident, and a relative who was visiting the service user confirmed to the inspector his satisfaction with the care provided. The file of another service user, whose assessment indicated high dependency needs, contained additional documentation that included an oral assessment tool, a sleep pattern record, Waterlow pressure sore chart, and other risk assessments relating to health and safety. 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. Lawns, The DS0000018523.V327298.R01.S.doc Version 5.2 Page 14 Evidence to indicate that service users are treated with dignity and respect was observed in the interactions between staff and service users, and was also confirmed in discussions with several residents. Their comments included: • • • • • • • • • • • • • • • This is a lovely place We are well cared for here The staff are very kind and helpful I like my room, it’s so light and airy The staff always respect my wishes I take part in all the activities There’s always plenty to do here We have a residents committee They listen to my views I can always see the doctor when I want The staff make a fuss of me Everyone is very friendly I love the garden and the lovely trees Someone’s always around when I need them This place is spotless A policy and procedure relating to death and dying has been produced at the home. The wishes of service users regarding terminal care and after death arrangements are discussed with them, and their family or a representative, when appropriate, and a record is maintained in the plan of care. Training for staff on death and bereavement has been organised to increase their understanding, and guidance on bereavement care has been provided by a local undertaker. An issue relating to resuscitation discussed previously with the management of the home has since been resolved. Lawns, The DS0000018523.V327298.R01.S.doc Version 5.2 Page 15 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 & 15 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. The wishes and preferences of service users are constantly respected, and they are encouraged to make choices about all aspects of their daily lives, in a way that encourages and promotes independence. The extensive programme of leisure activities provides opportunities for stimulation, and enables the social needs of service users to be met. Service users have complete freedom in regard to their contacts, both within and outside the home, which enables a good quality of life to be maintained 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.V327298.R01.S.doc Version 5.2 Page 16 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, for example, when to get up or go to bed, and how to spend their day, or whether to join in the various pastimes. The social, cultural, religious and recreational needs of service users are also monitored by staff at the home, and opportunities are provided to undertake a variety of interesting and stimulating activities. The spiritual needs of residents are considered, and the local vicar visits the home regularly and holds a service for those who wish to attend. Pastoral care is also provided by another minister who frequently attends the home, and also plays the harp for service users. Service users are consulted individually about their particular interests and a record is maintained in their plan of care. 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 inspector was able to enjoy the relaxing serenade being provided for service users, during the morning of the visit. A pianist comes to the home regularly and plays the piano in the most delightful way, to the great pleasure of residents, and the session concluded with audience participation, as they joined in and sang many of the old familiar tunes. The Amenities Co-ordinator discussed her role with the inspector, and her enthusiasm for involving service users in everything that is going on is commendable. She has worked closely with Social Services on a project entitled ‘Have Your Say’, and the home has achieved a Gold Kite Award in recognition of their success in developing the scheme. A group was formed that is representative of the service users living at The Lawns, but excludes the management of the home. The regular meetings are formal and minuted, and effectively decide what happens at the home in regard to everything that affects the residents themselves. The activities that are available are many and varied, and any suggestions made are implemented whenever possible. E.g. board or card games are sometimes organised, and there is the regular Bingo spot, which is very popular. In addition gentle exercise to music, or a manicure or a hand massage are enjoyed by some residents, then there are coffee mornings and raffles, flower arranging and cake decoration, and guest speakers and natural history events. In addition, seasonal activities are organised at Easter, Christmas and New Year, and a summer fete and theme days are also arranged. Lawns, The DS0000018523.V327298.R01.S.doc Version 5.2 Page 17 There are no specific visiting times and the involvement of family and friends is actively encouraged. Visitors are made very welcome, and their comments were all very positive, both in person and in their written responses, about the care provided to their relatives and friends at the home, and about the kindness of staff. They included the following: • • • • • • • • The Lawns provides excellent care The home is well run and organised My mother is a changed person since living there Residents have a good quality of life The staff are wonderful, nothing is too much trouble I have peace of mind now about my mother Many activities are organised regularly We are encouraged to be involved at the home The inspector spoke at length with the Kitchen Manager, who was appointed to her present position twelve months ago, having commenced working at The Lawns as a kitchen assistant about three years ago. A visit was made to the kitchen, which was clean, tidy and very organised. The report following a very recent inspection by the Environmental Health Officer, was shown to the inspector, and stated, ‘the kitchen was in excellent condition, and the practices observed were of a high standard.’ 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 of two main meals. The cook said that residents are consulted about the food, and that their suggestions are met whenever possible. Two recent requests have included bread and butter pudding and spotted dick. Special dietary requirements can also be provided, and at present these include, diabetic diets and a liquidised diet. One person has fish every day, and very occasionally a chicken meal. A cooked breakfast is always available. Many of the dishes are home made, and the majority of vegetables are freshly prepared. Lunch today was very colourful and nicely presented, and consisted of salmon fish cakes or cold boiled bacon with a selection of pickles, and peas, carrots and mashed potatoes, followed by a choice of queen of puddings, fruit and ice cream, yoghurt or cheese and biscuits. A record of the food provided to individual service users is being maintained at the home, the fridge/freezer temperatures are recorded, and cleaning schedules are also in place. Service users were all very complimentary about the lovely food, and meals were observed to be a very social and leisurely occasion, with several people stopping in the dining room for a chat after lunch. Their comments included, ‘I enjoy all my meals’, and, ‘the meals here are always very good’. Lawns, The DS0000018523.V327298.R01.S.doc Version 5.2 Page 18 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): 16,17 & 18 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. 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. The policy and procedures in place at the home relating to abuse, and the training provided for staff, should ensure the protection of the people who live there. Lawns, The DS0000018523.V327298.R01.S.doc Version 5.2 Page 19 EVIDENCE: A clear procedure for investigating complaints has been developed, and any issues are dealt with immediately. Information about how to voice concerns or make comments and suggestions, is given to each service user and their family or representative, who all confirmed that they felt confident that any concerns raised about the home, would be listened to and addressed in an appropriate way. People felt that their views were welcomed, and their comments included, ‘Staff are all approachable’, and ‘I wouldn’t be worried about asking anybody’, and, ‘we have a committee where we can voice our opinions’. A record is maintained of any concerns brought to the attention of the management, and there were two recorded recently, both of which had been dealt with immediately, and resolved to the satisfaction of all concerned. One was about the laundry arrangements, as an item of clothing was misplaced on one occasion, and also clothing belonging to one person was found in the bedroom of another resident. The matter had been dealt with by the care manager and discussions held with staff to ensure that the care of residents clothing is handled properly, in order to preserve their dignity. The other issue raised was by the residents committee, when concerns were expressed about an aspect of the building work that was again dealt with appropriately. A recommendation made at a previous inspection, was for all compliments received at the home to also be recorded, in order to give a more balanced view of the service. A separate file is now held for this purpose, and contains letters and cards of appreciation. 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 when service users are not able, or do not wish to attend the polling station in person. A policy on the Protection of Vulnerable Adults has been produced. Training on adult protection, has been organised for staff at the home, to ensure their understanding of the many aspects of abuse, and staff confirmed their understanding of these matters during discussions with them, at the time of the visit. Lawns, The DS0000018523.V327298.R01.S.doc Version 5.2 Page 20 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, 20, 22, 23 & 26 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Service users live in a well-maintained house that is clean and comfortable, attractively decorated and furnished, and in an environment that is safe and secure. The location of the house is convenient to local services and facilities, and the layout provides adequate communal space for the needs of service users. The premises are suitable for their purpose, and the ongoing maintenance and upgrading programme, will help to enhance the quality of life for the residents who live there. Lawns, The DS0000018523.V327298.R01.S.doc Version 5.2 Page 21 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 and upgraded to provide a pleasant and relaxed environment for service users. The communal areas of the home are spacious, and include a large lounge, and an extensive all weather conservatory, which is now the dining area, and where a variety of activities can also take place. There are lovely views across the pleasant landscaped gardens that are easily accessed by service users. There are 23 single occupancy bedrooms, all of which have en suite facilities, with 2 exceptions. There are 11 rooms situated on the ground floor, and a further 12 bedrooms on the first floor. These rooms are accessed by stairs, or for the convenience of service users who may have limited mobility, a chair lift is provided. The inspector visited several bedrooms, and all were seen to be very comfortable, and furnished and decorated to a high standard. One bedroom is below the recommended minimum size, and the management plan to extend this room when it becomes vacant. The home is clean and fresh throughout and staff confirmed that they are familiar with the procedures regarding the control of infection, and that they have also been given training in health and safety matters. The inspector met briefly with the housekeeper who is responsible for ensuring that the standards of hygiene and cleanliness throughout the home are consistently maintained. Comments from service users, their families and visitors to the home were all very complimentary about how lovely it is at The Lawns. Discussions with the member of staff with responsibility for the maintenance and upkeep of the property, and the records seen by the inspector, confirmed that everything at the home is in good working order. Relevant contracts are in place, for the servicing and maintenance of equipment, water temperatures are controlled and regular checks undertaken, which should ensure the comfort and safety of service users. Several rooms have been redecorated as part of the ongoing programme, and the ground floor toilets, off the main hall, have been upgraded. A small room that was previously used as an office has been transformed into a very functional hairdressing salon, which is popular both with residents and visiting hairdressers, and has further improved facilities within the home for service users. Lawns, The DS0000018523.V327298.R01.S.doc Version 5.2 Page 22 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 & 30 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The home is adequately staffed with employees who are experienced and competent to care for older people. The recruitment and selection procedures need to be implemented more rigorously to ensure the protection of service users. The training programme for staff ensures that each member of staff has a clear understanding of their role, and is able to provide appropriate care for service users Lawns, The DS0000018523.V327298.R01.S.doc Version 5.2 Page 23 EVIDENCE: The staff rotas indicate that staffing is maintained at a level that is adequate for 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, although some relatives suggested that staffing levels were an issue, particularly at the weekends. ‘Service users are not always supervised’, was one comment. The care manager was advised about the concerns, which she felt should have been directed to her via the complaints procedure. However they will be investigated thoroughly to ensure that there is no shortfall at these times. There is usually 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. There have been several staff changes during the last 12 months, although the group is now fairly stable. The staff with whom the inspector spoke, confirmed that they enjoy their work, and all were very positive about being employed at the home, and also about the training opportunities they are given. The files of two recently appointed members of staff were inspected, and the correct procedures appeared to have been followed, in regard to recruitment and selection, although there were some omissions. Relevant information was recorded and appropriate documentation was in place, and included an application form, evidence of Criminal Record Bureau (CRB) checks undertaken prior to employment, proof of identity, and training certificates that provided evidence of qualifications. A detailed health declaration had not been completed, and there were not always two written references, neither was there a photograph on file, although the care manager explained that there had been some recent problems with the camera. A training programme is in place, and the records indicate that ‘core’ training has been provided for staff in health and safety, basic first aid, fire safety, basic food hygiene, and moving and handling. In addition, some staff have attended training sessions on the administration of medication, bereavement, abuse awareness, continence management, infection control and also COSHH (Control of Substances Hazardous to Health). The need for all care staff to have dementia awareness training was discussed with the care manager. A commitment to The NVQ (National Vocational Qualification) training is also evident at the home. Four domestic staff have the NVQ Level 1 in Cleaning Science, and three catering staff have the NVQ Level 2. Six carers have the NVQ Level 2 or 3 in Care, and a further twelve care staff are doing the course. The Care Manager has the Registered Managers Award and is also a NVQ assessor. Lawns, The DS0000018523.V327298.R01.S.doc Version 5.2 Page 24 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, 36 & 38 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. 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 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.V327298.R01.S.doc Version 5.2 Page 25 EVIDENCE: The Lawns Residential Care Home was purchased in the year 2000 by Mr Darren Oliver and his wife Lisa. Mrs Christine Caldicott, the Registered Care Manager, has responsibility for the day-to-day running of the home. She has been employed at the home since April 2004, and prior to that had several years experience in the residential care of older people. A formal quality assurance system has been introduced at the home, and the views of service users and their families and friends are regularly sought through questionnaires. In addition, professional visitors to the home are also requested to complete a questionnaire from time to time. The process has been further developed, and continues to be implemented. The results of the surveys are audited, and a copy is to be found in the Service Users Guide. The management of the home have said that the information contained in these surveys is essential in maintaining and improving the quality of the service provided at the home, and that the results will be used to support the improvements and address any potential areas of concern. The inspector was told that staff do not have responsibility for managing the financial affairs of any service users. The family or a representative deal with any financial matters, on behalf of service users who are unable, or do not wish to manage their own affairs. Safe storage of valuables is available, and appropriate records are maintained. A procedure for the formal supervision and appraisal of staff has been implemented, with appropriate records maintained. Staff confirmed that they felt well supported in their work, and the care manager discussed some issues relating to the management of staff, and was able to demonstrate that matters had been dealt with appropriately. The records seen during the inspection had been completed to a satisfactory standard. The fire log indicated that fire safety checks are being carried out, with the required frequency, the fire risk assessment for the home is up to date and fire drills are undertaken regularly, and an Emergency Evacuation Contingency Plan is also in place. The Accident records had been completed appropriately, and a quarterly audit undertaken. Regulation 37 Notifications, which requires reports to be sent to the Commission of the death, injury or serious illness of a service user, or other events in the home, are usually made to the Commission, when appropriate, although there had been a recent omission. Lawns, The DS0000018523.V327298.R01.S.doc Version 5.2 Page 26 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 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 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 3 18 3 3 3 X 3 3 X X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 X 2 Lawns, The DS0000018523.V327298.R01.S.doc Version 5.2 Page 27 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 OP29 Regulation 19 Requirement Two written references must be obtained prior to an offer of employment being made, and a health declaration provided Notifications must be made to the Commission without delay of any event in the care home which adversely affects the wellbeing or safety of any service user Timescale for action 30/06/07 2 OP38 37 30/06/07 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 Refer to Standard OP19 OP23 OP26 Good Practice Recommendations The management should ensure that the building work does not adversely affect service users. Arrangements to extend the undersize room should be implemented when it becomes available More attention should be given by staff to the laundering and care of service users clothing Lawns, The DS0000018523.V327298.R01.S.doc Version 5.2 Page 28 Lawns, The DS0000018523.V327298.R01.S.doc Version 5.2 Page 29 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: 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. 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