Please wait

Please note that the information on this website is now out of date. It is planned that we will update and relaunch, but for now is of historical interest only and we suggest you visit cqc.org.uk

Inspection on 28/03/09 for The Lawns Neighbourhood Care Centre

Also see our care home review for The Lawns Neighbourhood Care Centre for more information

This inspection was carried out on 28th March 2009.

CSCI found this care home to be providing an Excellent service.

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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The pre-admission assessment processes ensure that placement is only offered to those people whose needs can be met. The information about the home that is provided, is clear and detailed and means that people can know what to expect when they live at The Lawns. The homes care planning processes, the delivery of individualised packages of care and management of medications ensure that people will be well cared for in respect of their health, personal and social care needs, in the way that they want. People are able to spend their time as they wish and have the opportunity to participate in a range of different activities. They are supported to maintain contact with family and friends and are provided with good food. People can be assured that any complaints or concerns they may have will be listened to and acted upon. The staff esnure that they are safeguarded from harm, but know what to do if concerns are raised. The Lawns is a comfortable, safe, clean and well maintained home. It is equipped to meet the needs of the people who live there and therefore matches their individual personal requirements. People are cared for by staff who are skilled and competent to do their jobs, they can be assured that their needs will be met. Robust recruitment procedures ensure that the right staff are employed at the home. People live in a home that is well managed, has clear and effectice leadership, and is run in their best interests. Their interests are at the centre of all decision making processes. Their welfare is always paramount.

What has improved since the last inspection?

After the previous inspection, a requirement was made in respect of some of the recording practices around wound care documentation, moving and handling assessments, and risk assessments about the likelihood of pressure sore development. The records were all in order evidencing compliance. All staff had a CRB check in place and the sample seen evidenced that these had been in place before their employment had started. Staff have received training in safeguarding vulnerable adults. These measures ensure that the people who live at The Lawns are safeguarded.

What the care home could do better:

The home should ensure that the appropriate records are kept when decisions are made about a person`s future care. The records must evidence that the person`s GP has been involved and that the individual and/or their family are consulted appropriately.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: The Lawns Neighbourhood Care Centre Bristol Road Quedgeley Gloucester Glos GL2 4QW     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Vanessa Carter     Date: 2 8 0 3 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 29 Information about the care home Name of care home: Address: The Lawns Neighbourhood Care Centre Bristol Road Quedgeley Gloucester Glos GL2 4QW 01452721345 01452723628 anna.carrier@btconnect.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: The Lawns NCC LLP care home 31 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability old age, not falling within any other category physical disability Additional conditions: Date of last inspection Brief description of the care home The Lawns is a care home providing nursing care, for adults over the age of 18 years. A qualified nurse is on duty 24 hours a day. The home is currently caring for some service users who have very specialist needs. The main accommodation is provided in a converted older style house, with a contemporary extension, and is provided on two floors. Staircases, a shaft lift and stair lift provide access to the upper floor. Various equipment and adaptations have been provided for assisting service users and staff, which includes assisted bathing facilities and hoists. Service users private 2 0 15 Over 65 0 31 0 Care Homes for Older People Page 4 of 29 Brief description of the care home accommodation is provided in single rooms on both floors, though there is one shared room on the upper floor. Many of the rooms have an en suite facility. There are several lounge areas and a dining room. An adjoining day centre provides an additional spacious room. A pleasant and accessible garden also includes a sensory patio area. There are many opportunities for social activities available inside and outside the home. Two specially adapted wheelchair buses are available to transport service users. The Statement of Purpose and Service User Guide are available from the office. Care Homes for Older People Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This report has been written following an unannounced visit to the service. A total of 6.5 hours was spent in the home. Prior to the inspection we had sent surveys to the home for people who live at The Lawns, staff and healthcare professionals who visit. We had received back completed survey forms from each group. We have assessed the performance of this service against the National Minimum Standards for Care Homes for Older People only, despite there being a number of Younger Adults who live in The Lawns. This is because the majority of people are within this age group. During the site visit, we spent time speaking to people who live in the home, staff who were on duty, the manager and visitors who were visiting their relatives. We also looked around the home and looked at the homes records. Care Homes for Older People Page 6 of 29 We were told that at the current time the fees ranged between 550 and 1,500 per week. There are a number of items where an additional charge is made, and these are detailed in the homes brochure. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking Care Homes for Older People Page 8 of 29 following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 29 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The pre-admission assessment processes ensure that placement is only offered to those people whose needs can be met. The information about the home that is provided, is clear and detailed and means that people can know what to expect when they live at The Lawns. Evidence: The homes Statement of Purpose and Service Users Guide were not looked at on this inspection but has been seen previously, and contain all the necessary information to enable any prospective person and their representative, to make an informed choice about moving to The Lawns. We looked at the homes brochure and this provided a clear picture of the facilities available at the home. People who completed CSCI survey forms said that they had been provided with enough information about the home before deciding it was the right place for them. Upon admission each person is provided with a statement of Terms and conditions of Care Homes for Older People Page 11 of 29 Evidence: residency at The Lawns - this details the admission procedure, the period of trial and notice required amongst other things. Some people are privately funded whilst others are partly funded by the local authority or the primary care trust. The home will have also drawn up contracts with the other relevant party. Two of the beds at The Lawns are used for planned respite stays that are funded by Gloucestershire Council. The home always undertakes a pre-admission assessment of needs for all new admissions, prior to any placement being offered. They use a Decision Support Tool to record the outcome of the assessment and evidence how they decided they could meet the persons needs. It is a comprehensive document that covers all aspects of a persons personal care needs, daily living, health and social care needs. We saw the assessments that had been completed for two people who had recently moved to The Lawns. They had been completed prior to the admission date, and along with the supporting documentation from healthcare and social care colleagues, were used to formulate care delivery plans. People, where possible, and/or their relatives, are invited to visit The Lawns and have a look around so that they can see what the home has to offer. One person wrote on the CSCI survey form my relatives organised everything because I was in hospital. Care Homes for Older People Page 12 of 29 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The homes care planning processes, the delivery of individualised packages of care and management of medications ensure that people will be well cared for in respect of their health, personal and social care needs, in the way that they want. Evidence: Three care planning files were looked at in order to determine the processes that the home follows to arrange the care of each person. The plans were each person-centred and had been written in conjunction with the person and/or their family. There was evidence that the person had been involved in the care planning process as signatures of agreement were recorded. The plans include the persons preferred choices, information about their family and any other specific care and support needs. The identified needs were set out in the care plans, with detailed instructions for the staff in how these needs should be met. The quality of the care plans were excellent. For one person there were specific instructions that the staff needed to know about as the person liked to get dressed in a particular way, and for another person, a plan about how they needed to be communicated with. Where equipment is identified as being essential to maintaining the persons comfort this was detailed upon the plan of care. Care Homes for Older People Page 13 of 29 Evidence: The plans are reviewed on a monthly basis and amended where necessary. The plans are supported with a number of risk assessments in respect of the likelihood of developing pressure sores (waterlow scores), nutrition, and lifting and handling tasks. The lifting and handling assessment results in a safe method of work being devised. This means that staff will know how they have to safely move or transfer a person from one place to another. Other specific risk assessments are completed for people where risks have been identified. Examples of these include risks around the likelihood of choking and risks around diet choices. Daily notes are maintained for each person and the sample looked at contained recordings about observations made and notes of concern. It was possible to evidence the care given and how people have spent the day or the night. The entries were detailed and provided a clear insight into what care the person had received. Each entry was signed in line with good record keeping guidelines. The home maintains records for each person detailing contacts with other healthcare professionals such as the GP, speech and language therapists, and chiropody. One GP completed a CSCI comment card and stated they provide expert care to people with complex nursing needs, combined with love and dignity. The medication procedures were discussed with the manager and one registered nurse. There are robust procedures in place for the ordering, receipt, administration and disposal of medications. People can be assured that they will receive their medications correctly. A number of people need to have oxygen therapy as part of their treatment and oxygen cylinders or an oxygen concentrator unit is in their bedroom. For all but one person, appropriate warning signs were in place to alert everyone about the presence of the oxygen. The manager arranged for appropriate hazard warning signs to be displayed outside the room where this was missing and must always ensure that this is in place. People who were spoken with during the course of the inspection said that they were cared for with respect to their dignity and their privacy. The GP commented I am able to see my patients in private and stated that people were always treated well. Observations made were that personal care is provided in private and staff are polite and courteous in their dealings with the people they are looking after. One vistor in the home said that their relative received the best possible care and that the staff genuinely cared for Mum. The home always ensures it knows how people want to be cared for if they have a sudden illness or deterioration in their health - an emergency treatment information Care Homes for Older People Page 14 of 29 Evidence: plan. This is a sensitive subject, but when appropriate they consult with the person and their family. They must however ensure that when do not resuscitate decisions are considered, that the GP is consulted and evidence is recorded of the consultations and the decisions made. People can be assured that the staff will look after them in the manner in which they wish, when it comes to end-of-life care. Care Homes for Older People Page 15 of 29 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are able to spend their time as they wish and have the opportunity to participate in a range of different activities. They are supported to maintain contact with family and friends and are provided with good food. Evidence: There is a day centre located on the same site as The Lawns and each person will go out to the centre a minimum of twice a week. Other people from the local community will also attend the day centre and this means that people have the opportunity to mix with others who do not live in the home. A number of people also attend other day care facilities, are supported to visit their family on a regular basis, or could be assisted and supported to arrange a holiday. Several of those people spoken with during the course of the inspection said that they liked going over to the day centre. One said they particularly liked the bingo and another said they liked making things. The day centre was colourful and bright and full of peoples art work. The day centre has a programme of activities each day that people can choose whether or not to participate in. One person wrote on the CSCI survey form I am limited in what I can join in with but I enjoy watching the others. The home has a minbus and regular outings are arranged - this may be for shopping or visits to places of interest. If it a persons wish to remain in their own room and not join in any of the activities, this will Care Homes for Older People Page 16 of 29 Evidence: be respected. The home would ensure that it met the cultural and religious needs of all persons who lived in the home. They will go to great lengths to find out the necessary information to ensure that they support they offer is appropriate for that person. We were told that there is a non-denominational religious service each week. The home has an open visiting policy and it is evident from observations made during the inspection that relatives and friends are welcomed and seen as being important to maintaining a persons well being. One visitor stated that the staff are always so friendly and welcoming, and we enjoy visiting the home. Observations were made of positive and friendly interaction between staff and visitors. There is a very happy and positive atmosphere in the home, with each of the people who live in the home looking out for the others and caring about their well-being. People are encouraged to make decisions about all aspects of their daily life. This may include choosing where to take a meal, where to spend their time, or what time to get up in the morning and what time to retire to bed at night. A choice of menu is offered at each mealtime and residents are able to choose what they want to eat. Roast meals are served twice a week, plus there is a variety of chicken, fish and vegetarian options throughout the week. On the day of inspection cottage pie or omelette was served. Some people needed to be supported to eat and this was done sensitively. Others needed gentle encouragement to continue with their meals. Those people who were spoken to after lunch said that the meal had been good, as usual. Care Homes for Older People Page 17 of 29 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can be assured that any complaints or concerns they have will be listened to and acted upon. The staff ensure that they are safeguarded from harm, but know what to do if any concerns are raised. Evidence: The homes complaints procedure is contained within the Statement of Purpose and the information that is provided to each person upon admission to the home. A copy of the complaints procedure is displayed in the main hallway. Those people spoken with during the inspection said that they were aware that the home had a complaints procedure, but that they had no reason to make any complaints. Those who completed CSCI survey forms stated they knew how to make a complaint. The home has received just one complaint in the last year and records are kept to evidence how this was dealt with, what action was taken as a result of the complaint and of the outcome. We have received no complaints about this service. The manager told us that the people who live at The Lawns hold the seat of power and any complaints or grumbles are looked upon positively with a view to looking at work practices and possible satisfactory solutions. This approach will ensure that the service remains appropriate for the needs of the people who live in the home. Staff who were spoken with during the inspection demonstrated awareness of adult protection or safeguarding issues and stated what they would do if something unacceptable were observed or they were told about something that had happened. Care Homes for Older People Page 18 of 29 Evidence: Junior staff would always report concerns to the person in charge or the home manager. A copy of the Gloucestershire Safeguarding Adults protocol is kept in the staff room. All staff are expected to undertake abuse awareness training as part of their induction training programme and will also watch a dvd about abuse on at least an annual basis. Observations made of interactions between staff and residents, demonstrated that the people are well cared for and safe. This was confirmed in discussions with those spoken with as part of the inspection. Care Homes for Older People Page 19 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The Lawns is a comfortable, safe, clean and well maintained home. It is equipped to meet the needs of the people who live there and therefore matches their individual personal requirements. Evidence: The Lawns is a large and impressive detached property, built in the 1770s and set within a half acre of landscaped gardens on the outskirts of Gloucester. It has been sympathetically extended to the rear of the property to provide extra living accommodation and is located within a short walking distance from shops, the library and the post office. Behind the home there is a day centre and training unit, used by people who live in the home and others who visit from the local community. Car parking is available at the front and to the rear of the home. There is level access from each of the car parking areas. The home is well maintained throughout with some of the corridors being in the process of being redecorated. In respect of communal space there are three lounge/dining rooms on the ground floor plus a further quiet room. The corridors are all able to accomodate wheelchair users, and where there are changes in the floor levels, different coloured carpetting is used to identify this. This raises the awareness of the ramps for people with impaired mobility or impaired eyesight. There is one passenger lift to the first floor however two of the bedrooms on the upper floor can only be reached via a stair lift. These rooms Care Homes for Older People Page 20 of 29 Evidence: would not be used by any person who needs to use a wheelchair. There are several bathrooms and one wet room. Each of the baths is fitted with equipment - either a swivel bather of a hoist. One bath is also fitted with a jacuzzi. A number of the bedrooms have en-suites that include a shower. Due to the high dependency level of most of the people who live in The Lawns, emergency evacuation equipment is located by each of the stairways. All beds are of the specialist hospital variety and the standard mattresses are tempur made. There is a plentiful supply of hoisting equipment, standaids and pressure relieving equipment to meet the collective needs of the people in residence. We were told that specialist communication equipment is currently being sourced to improve the quality of life for one person. There are 29 single bed sitting rooms and one shared room. Each room looks out over the gardens that surround the property. A sensory patio has been established behind the new wing and is a pleasant area to sit out in, in the warmer weather. The majority of rooms were seen during the inspection. Each was well furnished and had been made their own by the occupant. The home was warm and well lit, clean and tidy and fresh smelling on the day of the inspection. Visitors who were spoken with said the home was always well kept and that their relatives room was always clean and tidy. People who returned CSCI survey forms said that the home was always fresh and clean. Care Homes for Older People Page 21 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are cared for by staff who are skilled and competent to do their jobs, they can be assured that their needs will be met. Robust recruitment procedures ensure that the right staff are employed at the home. Evidence: The home is generally always running at full occupancy with any vacancies usually filled promptly. The numbers of staff on duty at any given time are based upon the collective dependency levels of each person but there are always two qualified nurses on duty during the day time. The numbers of care staff is adjusted according to the dependency levels and whether any particular activities are planned. In the mornings the start times for care staff may be 7am, 8am or 9am - this staggered start is in order to meet peoples needs as and when they want them met. Finishing times are also staggered from 1pm till 11pm. This is commendable and evidences that peoples needs are at the centre of service delivery planning. There are 76 members of staff, including qualified nurses, care staff, catering, domestic, administrative and day centre staff. Of the 36 care staff, 21 have already obtained at least a Level 2 National Vocational Qualification (NVQ) in Care (60 ). From information provided by the home, 6 staff have an NVQ Level 3 and two others are working towards a Level 2. The commitment to providing trained members of care staff is to be commended and reflects upon the Care Homes for Older People Page 22 of 29 Evidence: quality of the service provided. The home has recruited new staff since the last inspection, and the procedures that the home uses to select suitable staff show that a robust recruitment procedure is followed. Prospective employees are expected to complete an application form and attend for interview. Two written references, CRB and POVA1st clearance is obtained for all new recruits. The staff files of five recent recruits confirmed this to be the case. We were also told that people who come to the home for interview will meet a group of people who live in the home and their opinions will be used as part of the decision making process. The homes procedures ensure that the right staff are employed at the home and that people will be cared for by staff who will safeguard and protect them. A training matrix shows details about the training that each staff member has attended. Some training is arranged in-house whilst others is organised by an external trainer. Those staff spoken with confirmed that they have received mandatory training and this includes manual handling, fire safety awareness, abuse awareness and mental health act and deprivation of liberty safeguards. Examples of other training that has been completed includes specific health related tasks, basic life support and end-of-life and palliative care needs. Each staff member has a training file that evidences the training they have undertaken. We were told that training this year will be focussing on communication and listening skills, this need being identified in feedback from people who live in the home. All new recruits will complete an induction training programme. This meets the skills for care, common induction standards caring for the older person. One new member of staff confirmed that they were working through their induction booklet and that they had been allocated a mentor to oversee the process of learning. Care Homes for Older People Page 23 of 29 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a home that is well managed, has clear and effective leadership, and is run in their best interests. Their interests are at the centre of all decision making processes. Their welfare is always paramount. Evidence: The Lawns started as a nursing home in 1981 and was run by a mother and daughter team. Anna Carrier the daughter has been the registered manager since 1996. She has a degree in nursing and has completed additional management components to National Vocational Qualification (NVQ) Level 4. She has extensive experience in orthopaedics, acquired brain injuries, epilepsy and the care of people with profound physical disabilities. She is well qualified and has a wealth of experience in the care home sector. People spoken with during the inspection were very complimentary about the manager and all the staff who work at The Lawns. Residents meetings and staff meetings are held on a regular basis and ensure that the home is run in the best interests of those Care Homes for Older People Page 24 of 29 Evidence: who live there. A look at the minutes of the various meetings, show that the views and opinions of both the people who live in The Lawns and the staff team are valued and are acted upon. We were told that the manager has a hands on approach to her job and maintains a visible presence in the home. Staff reported that they felt listened to and that their opinions were valued. The home undertakes regular patient satisfaction surveys, and are asked What do you think about the Lawns, One thing you would like changed and Ideas for improvement. A number of audits are completed to ensure that the service remains on track. Any accidents and incidents are monitored in order to indentify trends so that actions can be taken to reduce the likelihood of events happening again. Care plan reviews, moving and handling reviews, body weights and waterlow reviews, and medication audits will ensure that the care and support people receive is as they need. The home holds personal monies for those people who require the service. Good administrative procedures and record keeping evidenced that peoples money is safe. A random sample of three accounts was checked against the funds held and each was correct. The home has a planned programme of staff supervision for all staff members, in addition to an annual appraisal where training and development needs are discussed. Staff working practices are observed on a regular basis and records are kept of these and the outcomes. Feedback about staff performance is obtained from the people who live there and this is used to direct supervision content. Newly recruited staff are allocated a mentor who will assist them to settle into their job, ensure they work to the homes policies and procedures and standards, and complete the induction training programme. Those home records that were examined were all in order. We have been notified throughout the year of all events that have occurred in the home, as they are required to do. The home has recently been visited by the Fire Officer who checked all fire safety arrangements in the home - all was in order. The Fire Risk assessment is up to date (reviewed in 2008) and includes an evacuation plan for each person living in the home. All the weekly or monthly checks had been completed of the fire alarm system, the fire fighting equipment and emergency lighting and the manager has attended a fire marshalling course. The staff follow safe working practices when moving people from one place to another and were observed using lifting equipment competently and safely. Records are Care Homes for Older People Page 25 of 29 Evidence: maintained when any restrictive measures (use of bed rails) need to be taken to secure a persons safety. The home has robust health and safety procedures to ensure that the home remains a safe place in which to live and to work. Care Homes for Older People Page 26 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 27 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 11 You should ensure that appropriate records are kept to record decisions made about a persons future care. This must include evidence that the GP, the individual involved and family are consulted with. Care Homes for Older People Page 28 of 29 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 29 of 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!