Inspection on 15/02/06 for The Lawns, Brixton

This inspection was carried out on 15th 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, Brixton 29/05/09

The Lawns, Brixton 21/05/08

The Lawns, Brixton 21/03/07

The Lawns, Brixton 04/08/05

The Lawns, Brixton 28/02/05

The Lawns, Brixton 09/09/04

Similar services:

The Vicarage

Fairfields Country Rest Home

7 Hyde Road

5 Seafield Road

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

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

CARE HOMES FOR OLDER PEOPLE The Lawns Brixton Plymouth Devon PL8 2AX Lead Inspector Mandy Norton Unannounced Inspection 15th February 2006 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 The Lawns DS0000003611.V269103.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. The Lawns DS0000003611.V269103.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service The Lawns Address Brixton Plymouth Devon PL8 2AX 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) 01752 880465 01749 677385 Wells House Limited, Mrs Kim Weller Care Home 22 Category(ies) of Old age, not falling within any other category registration, with number (8), Physical disability over 65 years of age of places (18), Terminally ill over 65 years of age (4) The Lawns DS0000003611.V269103.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. The Home is registered as a Care Home with Nursing for a maximum of 22 Service Users in the categories of PD(E) 18, OP 8, TI(E) 4 4th August 2005 Date of last inspection Brief Description of the Service: The Lawns care home is situated in the village of Brixton, in the South Hams area of Devon. The home is a detached country house, set in its own grounds. Accommodation is provided on two floors with a mezzanine floor between. The home provides 16 single and 3 double bedrooms. Communal facilities comprise: - a lounge, conservatory and dining room. Most parts of the home are wheelchair accessible. The home is registered to accept a maximum of 22 persons, aged over 65 years of either gender whom suffer from physical frailty, illness or disability. The home benefits from a stable staff team. The home provides a comfortable friendly atmosphere, service users are encouraged to furnish their rooms as they choose, and each room is individual in its character. The Lawns DS0000003611.V269103.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place over 2 hours and was conducted with the nurse in charge. The inspector spoke to a number of staff and 2 residents during the inspection. The home had 16 residents on the day of the inspection, 11 of whom are assessed as requiring nursing care. The focus of this inspection was to assess the core standards not assessed during the last inspection. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The Lawns DS0000003611.V269103.R01.S.doc Version 5.1 Page 6 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 The Lawns DS0000003611.V269103.R01.S.doc Version 5.1 Page 7 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): None of these standards were assessed during this inspection EVIDENCE: The Lawns DS0000003611.V269103.R01.S.doc Version 5.1 Page 8 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): 9 The medication at the home is well managed, promoting good health. EVIDENCE: The treatment room was seen during the inspection, confirming that medicines are stored, handled and administered according to laid down legislation. The nurse in charge showed the inspector the new documentation that has been introduced for ordering, receipt, administering and disposal of medicines. (The documentation would benefit from the amount of medicine ordered being written on the same form). The treatment room and drug trolley were very tidy and well organised. A new drug fridge has been purchased and is in use. There were no residents able to self medicate at the time of the inspection. The Lawns DS0000003611.V269103.R01.S.doc Version 5.1 Page 9 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): 13,14 & 15 The staff encourage residents to remain as independent as possible allowing them to make personal choices and maintaining some control over their life. The staff have a good understanding of the patients cultural, social and recreational needs and the importance of maintaining contact with family and friends and engage the patients in a variety of ways. The meals in the home offer both choice and variety and cater for special dietary needs. EVIDENCE: During the inspection residents and visitors were seen coming and going freely. Staff were seen accompanying a resident for a walk outside. It was clear, during the inspection, that the staff knew the residents well and were overheard chatting with them in a friendly and supportive way, encouraging residents to use their abilities where they can. A tour of the home confirmed that residents are able to personalise their rooms with their own possessions and style. The Lawns DS0000003611.V269103.R01.S.doc Version 5.1 Page 10 Residents who are able to manage their own finances are able to do so and each room has lockable storage provided should they wish to keep their own money with them. The staff spoken to said that they feed residents that need help at 12 midday to approximately 12.30 and then are free to help the rest of the residents in the dining room or their own rooms who eat from 12.30 onwards. They said that this allows time to help those who need feeding without having to rush them. There are drinks and snacks available 24 hours a day. The Lawns DS0000003611.V269103.R01.S.doc Version 5.1 Page 11 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): None of these standards were assessed during this inspection EVIDENCE: The Lawns DS0000003611.V269103.R01.S.doc Version 5.1 Page 12 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): 24 (partially) The overall quality of the furniture and fittings is satisfactory providing a safe environment. EVIDENCE: Following the last inspection it was recommended that some curtains needed to be more suitable for the size of the windows they were at. The nurse in charge said the matron has been working towards replacing the curtains but has found getting the right size quite difficult as they are such big windows (not standard size). The Lawns DS0000003611.V269103.R01.S.doc Version 5.1 Page 13 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): None of these standards were assessed during this inspection EVIDENCE: The Lawns DS0000003611.V269103.R01.S.doc Version 5.1 Page 14 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): 33, 35 & 38 The systems in place in the home promote and protect the health and safety and welfare of the clients and staff. EVIDENCE: The matron was not on duty during the inspection but has shown in the past her commitment to measuring the quality of the service provided by issuing regular quality questionnaires to residents/ relatives ands staff. The results of which are used to improve practice as necessary. Staff, residents and relatives bring any issues to the attention of the matron as necessary and the issues are dealt with accordingly. The nurse in charge said that there is a policy for dealing with residents money in the policies and procedures file (which is available for staff at all times). She said that all residents have their own sheet where any money coming in or going out is recorded and e receipt kept as evidence of expenditure. This The Lawns DS0000003611.V269103.R01.S.doc Version 5.1 Page 15 information is kept locked away in the office. All residents rooms have a small safe attached to the wall for safekeeping of money or personal possessions. An immediate requirement was made during the last inspection about one radiator was that was very hot to the touch and was not covered. It was disabled during the inspection. The radiator still has no cover on it but was warm to the touch and not too hot (it is in a corridor that is not used as a through fare). Radiators throughout the home remain uncovered and appropriate risk assessments have yet to be seen by CSCI. (This was not discussed in detail as the matron was not on duty during the inspection). A new drugs fridge has been purchased following the last inspection where it was noted that the temperatures had started to fluctuate. The need for a more in depth risk assessment for the use of bed rails was discussed with the nurse in charge. (Standard 38 was only partially assessed). The Lawns DS0000003611.V269103.R01.S.doc Version 5.1 Page 16 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 X X X X X X HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X X X X X X 3 X X STAFFING Standard No Score 27 X 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X 3 X X 2 The Lawns DS0000003611.V269103.R01.S.doc Version 5.1 Page 17 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP38 Good Practice Recommendations The matron or proprietor should complete a risk assessment for all uncovered radiators and submit this to CSCI. A detailed risk assessment needs to be completed before the use of bed rails with a resident. This should be signed by the resident or their representative and kept as part of the care plan. 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