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Please note that the information on this website is now out of date.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 12/10/05 for The Lawns Nursing Home

Also see our care home review for The Lawns Nursing Home for more information

This inspection was carried out on 12th October 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.

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 home provides nursing care for residents who are both physically and mentally frail. Staff are kind and residents are happy in the home. The home is odour free and there is a continual refurbishment programme, rooms are light and airy. Training is a high priority and staff have the opportunity to attend training days. Recruitment procedures are robust.

What has improved since the last inspection?

Requirements from the last report were being addressed. There were no staff vacancies and overseas staff spoken to during the afternoon were aware of the care needs of the residents.

What the care home could do better:

The registered manager was continuing to develop a training matrix to ensure all staff received mandatory training and were updated as necessary. Medication policies and procedures had minor shortfalls.

CARE HOMES FOR OLDER PEOPLE Lawns Nursing Home, The Main Road Kempsey Worcester Worcestershire WR5 3NF Lead Inspector C Presley Unannounced Inspection 12th October 2005 03.00P 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 Nursing Home, The DS0000004121.V253561.R01.S.doc Version 5.0 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 Nursing Home, The DS0000004121.V253561.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Lawns Nursing Home, The Address Main Road Kempsey Worcester Worcestershire WR5 3NF 01905 821388 01905 828171 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) Frontsouth Limited Mrs Rosemary Ann Harris Care Home 40 Category(ies) of Dementia - over 65 years of age (8), Old age, registration, with number not falling within any other category (40), of places Physical disability over 65 years of age (40) Lawns Nursing Home, The DS0000004121.V253561.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. One named service user under 65 years Date of last inspection 27th June 2005 Brief Description of the Service: The Lawns Nursing Home is registered for 46 residents. The home provides 24 hour nursing care. Accommodation is provided on the ground and first floor, with a passenger lift enabling residents to access all areas of the home. The home is situated in the village of Kempsey, which is located within easy commuting distance of Worcester. The registered manager has the necessary qualification and experience to run the home. Lawns Nursing Home, The DS0000004121.V253561.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place during the afternoon and concentrated on standards not inspected at the last visit and requirements from the last inspection report. Time was spent with the registered manager and the registered nurse on duty. Seventeen comment cards from residents, relatives and General Practitioners were received prior to the inspection;There was evidence from these that the residents felt well cared for and had choice about their lives ‘content with staying in my room’. Two comments received one from a relative and one from a General Practitioner highlighted language difficulties with overseas staff ‘Always very good when matron present. Sometimes communication difficulties if Matron not present’ What the service does well: What has improved since the last inspection? Requirements from the last report were being addressed. There were no staff vacancies and overseas staff spoken to during the afternoon were aware of the care needs of the residents. Lawns Nursing Home, The DS0000004121.V253561.R01.S.doc Version 5.0 Page 6 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. Lawns Nursing Home, The DS0000004121.V253561.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Lawns Nursing Home, The DS0000004121.V253561.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of the standards in this section of the report were inspected during this visit. For further information refer to previous report. EVIDENCE: Lawns Nursing Home, The DS0000004121.V253561.R01.S.doc Version 5.0 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 9 & 10 Medication was handled and administered to residents within a risk framework, which ensured compliance, however there were some shortfalls. EVIDENCE: Medication policies did not reflect the current practice regarding disposal of medication. Residents who were self medicating were risk assessed to ensure they were safe to administer there own medication. Lockable space was provided. Staff had received medication training and more was planned. Medication to be given ‘as required’ (PRN) had been highlighted at set times this was not appropriate. Medication omission codes had not been used at all times when medication had been omitted. An instruction for one medication being given was incorrect. Residents questionnaires received evidenced they felt their privacy and dignity was respected and staff were heard speaking kindly to residents. Residents could chose when they got up and went to bed and where they ate their meals. Lawns Nursing Home, The DS0000004121.V253561.R01.S.doc Version 5.0 Page 10 There were a number of areas on the home where residents could see visitors in private. Lawns Nursing Home, The DS0000004121.V253561.R01.S.doc Version 5.0 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 13 & 14 Residents are encouraged to retain links with family and friends and are encouraged to take care of their finances if they are able. EVIDENCE: The home has an open visiting policy and visitors were seen during the afternoon visiting their family. There are a number of areas in the home where residents can receive visitors in private. Arrangements for Christmas are underway in the home; festivities planned include a carol service evening, families and friends will be invited and arrangements for Christmas Lunch. There is a monthly Communion service held in the home. Residents are encouraged to take care of their finances if they are able and are provided with keys to their bedrooms and lockable storage space. Due to the physical and mentally frailty of a number of residents in the home arrangements to support residents with their finances can be arranged and extras can be invoiced to families. Lawns Nursing Home, The DS0000004121.V253561.R01.S.doc Version 5.0 Page 12 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of the standards in this section of the report were inspected during this visit. For further information refer to previous report. EVIDENCE: There have been no complaints to the Commission or the home since the last inspection. Lawns Nursing Home, The DS0000004121.V253561.R01.S.doc Version 5.0 Page 13 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of the standards in this section of the report were inspected during this visit. For further information refer to previous report. EVIDENCE: Lawns Nursing Home, The DS0000004121.V253561.R01.S.doc Version 5.0 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 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): 28, 29 & 30 Recruitment procedures are robust and ensure staff employed to work with vulnerable adults are safe to do so. EVIDENCE: Staff files checked evidenced staff had a full employment history and gaps in employment had been explored. All staff had a POVA first and Criminal Record Check at enhanced level check before commencing employment in the home. A number of overseas staff working as carers had a nurse qualification; the registered manager agreed there were some problems with the language skills of overseas nurses. All staff follow an induction programme and staff are mentored by a more senior member of staff during this period. Mandatory training is continuing to be addressed. All staff have moving and handling training, fire safety training, infection control training and health and safety training during their six week induction. Further training specific to the needs of the residents in the home is being addressed. Some staff have attended a dementia training day. Training in the protection of the vulnerable adult is addressed during the induction period and continues through NVQ training. The registered manager ensures there is a first aider on duty at all times. Lawns Nursing Home, The DS0000004121.V253561.R01.S.doc Version 5.0 Page 15 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 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): 31,33 & 35 The registered manager has the necessary experience and qualifications to ensure residents are kept safe in the home. EVIDENCE: The registered manager has a number of years experience in caring for elderly residents. She has continued to update her training and ensures staff are suitably qualified to care for residents. A quality assurance programme is in place and continues to be developed to ensure all members of the multidisciplinary team are involved in this process. Residents are encouraged if possible to take care of their finances, and are provided with lockable storage space, however due to a number of residents being physically and mentally frail this is not always possible the home will invoice residents or their families for extras if requested. Lawns Nursing Home, The DS0000004121.V253561.R01.S.doc Version 5.0 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 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 3 15 x COMPLAINTS AND PROTECTION Standard No Score 16 x 17 x 18 x x x x x x x x x STAFFING Standard No Score 27 x 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 x x x Lawns Nursing Home, The DS0000004121.V253561.R01.S.doc Version 5.0 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. 1 Standard OP9 Regulation 13(2) Requirement The medication policy must reflect current practice with regard to the disposal of medication Medication codes must be used when medication is omitted Medication that is for PRN usage must not be highlighted to set times and maximum doses must be recorded e.g. no more than 8 tablets in 24 hours Medication must be written out correctly to ensure right dosages are being given. A quality assurance system must be introduced in accordance with the requirements of Regulation 24 and Standard 13. There must be evidence of reasons why residents have not been involved in their care plan Outstanding from last inspection Timescale for action 30/11/05 2 3 OP9 OP9 13(2) 13(2) 12/10/05 12/10/05 4 5 OP9 OP33 13(20 24 12/10/05 31/12/05 6 OP7 15 30/09/05 Lawns Nursing Home, The DS0000004121.V253561.R01.S.doc Version 5.0 Page 18 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 OP30 Good Practice Recommendations It is recommended the registered manager develop a training matrix to ensure all staff have mandatory training updated. Lawns Nursing Home, The DS0000004121.V253561.R01.S.doc Version 5.0 Page 19 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: 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 Lawns Nursing Home, The DS0000004121.V253561.R01.S.doc Version 5.0 Page 20 - 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!