Inspection on 04/08/05 for The Lawns, Brixton

This inspection was carried out on 4th August 2005.

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 15/02/06

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 Announced 4 August 2005 th 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 D54-D07 S3611 The Lawns V231729 040805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service The Lawns Address Brixton, Plymouth, Devon, PL8 2AX 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) 01752 880465 01752 880465 wellshouseltd@aol.com Wells House Limited, Mrs Kim Weller Care Home with nursing 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 D54-D07 S3611 The Lawns V231729 040805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 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 Date of last inspection 16.02.05 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 D54-D07 S3611 The Lawns V231729 040805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The announced inspection took place over 4 hours and 40 minutes between 09.00am and 1.40pm and was conducted with the matron. The inspector spoke to a number of residents and staff on duty during the inspection. Prior to the inspection 5 completed relatives/visitors comment cards were received and 4 service user comment cards, the comments will be reflected in the report. A tour of the premises took place and a variety of records were inspected 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 D54-D07 S3611 The Lawns V231729 040805 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection The Lawns D54-D07 S3611 The Lawns V231729 040805 Stage 4.doc Version 1.40 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 standard(s) 3 and 5 Comprehensive pre-admission assessments are made and therefore people are admitted to the home appropriately. Opportunities to visit the home are given to people to help them to decide if they want to live at The Lawns. EVIDENCE: The matron said that she carries out all of the pre-admission assessments. A completed form was seen during the inspection. The matron said that prospective patients and/or their representatives are able to visit the home when they like to look around, have a drink and a meal and meet with staff and other clients if appropriate. The Lawns D54-D07 S3611 The Lawns V231729 040805 Stage 4.doc Version 1.40 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 standard(s) 7,8 and 10 There is a clear care planning system in place that provides staff with the information they need to meet the residents’ needs. The health care needs of the residents are identified and met. Interactions between staff and residents promotes and protects patients privacy and dignity EVIDENCE: The plans of care examined were well maintained and included general information about the resident and a daily statement about their wellbeing, tissue viability, nutritional and manual handling assessments, catheter history and were reviewed appropriately. Some of the care plans examined demonstrated improvements in residents’ condition and ability since they were admitted. Equipment necessary for the care of skin and prevention and treatment of pressure sores was seen during a tour of the home. The care plans seen contained information about the residents GP and dental services used. The Lawns D54-D07 S3611 The Lawns V231729 040805 Stage 4.doc Version 1.40 Page 9 Service User comment cards completed (4) indicated that patients feel well cared for and safe and have their privacy respected. The Lawns D54-D07 S3611 The Lawns V231729 040805 Stage 4.doc Version 1.40 Page 10 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 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. EVIDENCE: Care plans examined contained some information about interests complemented by a profile form containing information about previous occupation and hobbies/interests. Completed Service User comment cards indicated that the home sometimes provides suitable activities. A tour of the home saw some residents chatting with each other and visitors whilst some were resting in their rooms. The matron is keen that residents spend their time during the day as they wish to and the routines are flexible enough to allow for this. The Lawns D54-D07 S3611 The Lawns V231729 040805 Stage 4.doc Version 1.40 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 standard(s) 16 and 18 The home has a satisfactory complaints system. Residents in the home are protected by staff having a knowledge and understanding of Adult protection issues. EVIDENCE: The complaints procedure is displayed in the entrance hall. The matron said that no complaints have been received since the last inspection. She sees the clients and their relatives regularly and feels that any issues or concerns are raised at the time and dealt with straight away. She said that clients, relatives and staff can see her at any time to discuss any concerns. The policies and procedures around protection examined were up to date and available to staff at all times. The matron has had elder abuse training and has purchased a video on adult protection, which she intends to use when training the rest of the staff in protection issues. All staff are given information about adult protection during their induction period and it is included in the NVQ training, which many staff have undergone. The maintenance man is currently fitting wall safes in all of the rooms for residents to store any money or personal items. The Lawns D54-D07 S3611 The Lawns V231729 040805 Stage 4.doc Version 1.40 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 standard(s) 19,20,23,24 and 26 The standard of the environment within the home and the grounds is good providing clients with attractive and homely place to live. The overall quality of the furniture and fittings is satisfactory providing a safe environment. The home is clean and hygienic. EVIDENCE: A tour of the home confirmed that all of the communal facilities (1 ground floor lounge, conservatory and the dining room) and the gardens are accessible to residents. The decoration makes the rooms light and airy however 1 room has very big windows with a curtain pole and hooks insufficient to hold the weight of the large curtains properly, making them look untidy. Residents’ rooms seen were comfortable, clean and contained many of their own possessions. All of the shared rooms are above the 16sq m of space The Lawns D54-D07 S3611 The Lawns V231729 040805 Stage 4.doc Version 1.40 Page 13 required. Some of the rooms have locks fitted and anyone wishing to have a key to their room can have one following a risk assessment. Lockable storage (a safe) has been purchased for all rooms and the maintenance man is fitting each one to the wall of the residents’ rooms in an accessible position for them, this was confirmed during a tour of the home. Two over-bed tables were very rough and worn around the edges and one commode was in a poor condition. These were replaced the day after the inspection (confirmed by the provider). Domestic staff were seen cleaning the home during the inspection. The laundry has equipment and space sufficient for the washing generated by the home. The Lawns D54-D07 S3611 The Lawns V231729 040805 Stage 4.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) 27,28,29 and 30 The residents’ needs are met by a satisfactory mix of nurses, carers and ancillary staff who are trained and competent to do their job. Staff are motivated resulting in low staff turnover and sickness levels leading to consistent care offered to residents. EVIDENCE: The duty rota provided with the pre inspection questionnaire details the number of staff on duty and during the inspection people looked well cared for. The pre inspection questionnaire indicates that staff turnover is low. All 5 of the completed relatives/visitors comment cards returned prior to the inspection indicated that they feel that there are ‘sufficient staff on duty at all times’, and all 5 of the completed Service users comments cards returned prior to the inspection indicated they felt ‘well cared for’. There is currently a vacancy for 1 full time carer. Training records examined were up to date and covered a variety of subjects, including care of skin, continence care, infection control, basic care (level1) and management of aggression. First aid courses are being booked to ensure qualified first aider is on duty at all times. The pre inspection questionnaire and the matron stated that 50 of the 16 care staff have completed NVQ levels 2 and /or 3 in care. The Lawns D54-D07 S3611 The Lawns V231729 040805 Stage 4.doc Version 1.40 Page 15 The staff records examined had all the required information in them including CRB information, 2 written references, a copy of their contract and an interview question proforma. The Lawns D54-D07 S3611 The Lawns V231729 040805 Stage 4.doc Version 1.40 Page 16 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, 36 and 38 There is good leadership and guidance for staff to ensure residents receive consistent quality care. Some of the systems in place do not effectively safeguard the health, safety and welfare of the residents. promote and protect the health and safety and welfare of the clients and staff. EVIDENCE: The matron manages the home well and has recently achieved her registered managers award. During a tour of the home the following were noted: - The Lawns D54-D07 S3611 The Lawns V231729 040805 Stage 4.doc Version 1.40 Page 17 • • • • • Several tubes and pots of cream were noticed in residents’ rooms that did not have an opening date written on them and the drug fridge temperatures have started to fluctuate recently. The radiators throughout the home are not covered and no risk assessment is in place to identify potential hazards relating to this. One radiator was on and very hot, despite the rest of the heating being turned off (an immediate requirement was issued for this). The provider was contacted and an engineer came and disabled the radiator during the inspection. Work will be carried out to identify why the radiator was still on and able to reach such high temperatures. Some of the windows on the first floor did not have their restrictors in place and therefore were able to be open wider that they should be. Some door wedges were in use and should be replaced with appropriate hold open devices. The catering staff food hygiene certificates are out of date. The Lawns D54-D07 S3611 The Lawns V231729 040805 Stage 4.doc Version 1.40 Page 18 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 x x 3 x 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 x 15 x COMPLAINTS AND PROTECTION 3 3 x x 3 2 x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 x x x x 3 x 2 The Lawns D54-D07 S3611 The Lawns V231729 040805 Stage 4.doc Version 1.40 Page 19 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 38 Regulation 12 (1) (a) Requirement All radiators must be risk assessed and risk of scalding must be removed. The radiator near to the treatment room must not exceed safe temperatures and work must be done to ensure the radiator cannot work independantly of the rest of the central heating system. Provision and maintenance of window restrictors, based on assessment of vulnerability and risk to service users must be ensured. Wedges must not be used to hold fire doors open. Timescale for action Immediate 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 24 Good Practice Recommendations The curtains in the 1st floor room should be supported by a suitable pole with hooks strong enough to hold the curtains in place properly. D54-D07 S3611 The Lawns V231729 040805 Stage 4.doc Version 1.40 Page 20 The Lawns Commission for Social Care Inspection Unit D1 Linhay Business Park Ashburton TQ13 7UP National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI The Lawns D54-D07 S3611 The Lawns V231729 040805 Stage 4.doc Version 1.40 Page 21 - 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. 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