Inspection on 07/11/06 for The Lawns Nursing Home

This inspection was carried out on 7th November 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 Nursing Home 12/08/08

The Lawns Nursing Home 13/02/08

The Lawns Nursing Home 17/04/07

The Lawns Nursing Home 12/10/05

The Lawns Nursing Home 27/06/05

The Lawns Nursing Home 20/12/04

The Lawns Nursing Home 07/07/04

Similar services:

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

Maple Lodge

Heathlands

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

CARE HOMES FOR OLDER PEOPLE Lawns Nursing Home, The Main Road Kempsey Worcester Worcestershire WR5 3NF Lead Inspector Chris Potter Unannounced Inspection 11:30 7 November 2006 th 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.V313906.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Lawns Nursing Home, The DS0000004121.V313906.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Lawns Nursing Home, The Address Main Road Kempsey Worcester Worcestershire WR5 3NF 01905 821388 01905 828171 lynette@frontsouth.co.uk 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 Denise Clark (Acting) 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.V313906.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. One named service user under 65 years Date of last inspection October 2005 Brief Description of the Service: The Lawns Nursing Home is registered to provide 24 – hour nursing care for 40 elderly residents. Accommodation is provided on the ground and first floor in both single and shared bedrooms. A passenger lift enables residents to access all areas of the home. The home is surrounded by large well maintained gardens providing a pleasant outlook from the home. The home is situated in the village of Kempsey, which is located within easy commuting distance of Worcester. The acting manager is Denise Clark who has worked at the home for seven years, and has applied for registration with the CSCI. The homes fees range between £507.00 and £600.00; hairdressing, chiropody and newspapers are not included within the fees. Lawns Nursing Home, The DS0000004121.V313906.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the homes key unannounced key inspection and took place on the 7th of November 2006, over a five-hour period. Since the last inspection the registered manager has left. Denise Clark the acting manager was available throughout the inspection. The inspection focused on the requirements from the last inspection, care records, staff recruitment and staff training. Comment cards were received from residents, relatives and GP’s (General Practitioners) prior to the inspection. Some comments included that in their opinion there was not always enough staff on duty. Activities were limited, and not available for all the residents. Six residents, two relatives and four members of staff were spoken to during the inspection to ascertain their views about the home. Both the residents and staff expressed their satisfaction with the care provided at the home. What the service does well: What has improved since the last inspection? The management of medication has improved since the last inspection. The areas of the home, which have been redecorated, have further enhanced the homes appearance. Lawns Nursing Home, The DS0000004121.V313906.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Lawns Nursing Home, The DS0000004121.V313906.R01.S.doc Version 5.2 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.V313906.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3 standard 6 is not applicable to this home. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Family members and advocates are provided with adequate information about the home, and the services it offers. Residents’ needs are thoroughly assessed before admission to the home. All residents have a contract detailing terms and conditions of the home. EVIDENCE: The acting manager carries out visits to prospective residents and completes an assessment of their needs. This pre-admission assessment then forms the basis of the residents care records. Residents and relatives confirmed that they had been provided with the appropriate information to assist them with their choice. Potential residents and relatives are encouraged to visit the home prior Lawns Nursing Home, The DS0000004121.V313906.R01.S.doc Version 5.2 Page 9 to their admission. A record is available at the home of this visit. Residents confirmed that they were pleased with their choice of home and their bedroom. All residents are provided with a contract on admission to the home. The home was in the process of updating their Statement of Purpose and Service User’s Guide. A copy of the documents are available in the home. Lawns Nursing Home, The DS0000004121.V313906.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health and personal care of the residents are well met. The administration and storage of medication meet current guidelines. EVIDENCE: Three care records were reviewed at the time of the inspection. The care records showed the individuals care needs, and how staff should meet their assessed need. Staff spoken with demonstrated a good knowledge of the residents needs. It was reassuring to hear that care staff access the care record to assist them in meeting the residents care needs. It was recommended that the home further develop the social care needs for the residents, to build up a full life history of the resident. The inspector was confident that many of the staff have this knowledge, but it is not recorded Lawns Nursing Home, The DS0000004121.V313906.R01.S.doc Version 5.2 Page 11 anywhere. It was also recommended that the home records more frequent reviews in the residents care records. Currently the home keep a separate handover sheet, but the information from this is not included in the residents care record. Feedback received from relatives and GP’s confirmed that they were kept up to date with their relatives’, patients’ care changes. 2 of the 13 comments received made reference to the language difficulties and 1 commented that they felt the GP did not speak directly to them. These comments were shared with the acting manager. Residents confirmed that all staff treated them with dignity and respect. Staff were observed being most respectful to the residents. All residents appeared well cared for and at ease with the staff. The acting manager confirmed that they received very good support from their GP’s, and specialist nurses. The medication administration records were well maintained, and drugs were securely stored. Lawns Nursing Home, The DS0000004121.V313906.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Flexible routines of daily living give residents’ a choice in how they spend their day. Visitors are actively welcomed into the home. The home needs to introduce a programme of meaningful activities suitable for all residents. EVIDENCE: It was evident during the day that residents are encouraged to exercise their own personal choice on how they spend their day. Residents were in their bedrooms and communal areas of the home during the inspection and this was their choice. The home is currently without an activities organiser, and of the 11 comments received 2 commented that they would prefer more activities. One resident commented that they do not wish to participate with any activities. The home Lawns Nursing Home, The DS0000004121.V313906.R01.S.doc Version 5.2 Page 13 currently provides a mobile library service, religious services, monthly entertainment, and various outings to local pubs, country parks, and shops. A resident attends a local day centre. The home operates a four-week menu, which is varied and offers a good choice. All comments received prior to the inspection and during the inspection were most complimentary about the choice and quality of food provided at the home. The lunch was being served during the inspection this appeared appetising, and residents requiring a soft diet, the food was presented separately on the residents plate. Residents requiring assistance were helped by the staff. The dining room was pleasant and residents were provided with an alcoholic drink if they wished to have one. Lawns Nursing Home, The DS0000004121.V313906.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The complaints procedure in the home is satisfactory. Staff demonstrate a good awareness of adult protection issues. EVIDENCE: Since the last inspection the home has received one anonymous complaint. This was received by the CSCI and forwarded to the home to investigate using their complaints policy. The concerns raised in the anonymous complaint were to do with security at the home. The home investigated the complaint and addressed the issues appropriately the CSCI were advised of their findings. Feedback received from visitors and residents confirmed that they were aware of the complaints procedure. However comments received prior to the inspection indicated that relatives were unsure about the policy. It was recommended that the acting manager send a copy of their complaints procedure to all residents and relatives. Staff spoken to during the inspection confirmed that they were aware of their abuse policy. It was reassuring to hear that staff would have no hesitation in reporting any concerns if they had any potential worries. Further discussion Lawns Nursing Home, The DS0000004121.V313906.R01.S.doc Version 5.2 Page 15 with the acting manager indicated that no staff had received formal training it was recommended that this be initiated. Lawns Nursing Home, The DS0000004121.V313906.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,23,24 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides a warm and comfortable, well-maintained environment for the residents. The standard of housekeeping is commendable. EVIDENCE: The home provides accommodation for residents in both single and shared bedrooms. The home is a large traditional building well equipped to meet the needs of the residents. The home’s décor and furnishings are in keeping with the homes external appearance. It was pleasing to observe that the bedrooms have been personalised to reflect the resident’s choice. Residents who were Lawns Nursing Home, The DS0000004121.V313906.R01.S.doc Version 5.2 Page 17 asked stated that they were pleased with their bedrooms. The carpets in some corridors are appearing well worn and it was recommended that the home review these to further enhance the homes appearance. The home provided a record of all the maintenance and servicing of all the equipment and systems in the home. Staff spoken to confirmed that they had no problems meeting the needs of the residents in the home. It was commented that the lift is small, but able to accommodate a wheelchair. It was recommended that the home have the lift sensors checked given a recent accident that occurred to resident using the lift. The grounds around the home are well maintained providing a pleasant outlook from the home. Residents are able to sit outside when the weather permits. All areas of the home observed were commendably clean and tidy with no offensive odour noted. Lawns Nursing Home, The DS0000004121.V313906.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The numbers of staff on duty should be reviewed to ensure the needs of the residents could be met. Residents are not protected from abuse by the current recruitment procedure. Staff training should be reviewed for all staff to ensure the residents assessed needs can be fully met. EVIDENCE: The staffing rota showed that staffing levels for the afternoon shift are below the recommended minimal levels. Given the size of the home and dependency of the residents this should be reviewed. 6 out of the 13 comments received prior to the inspection felt that there was not enough staff covering the shifts. Staff also commented that they felt in the afternoons there was not enough staff on duty. The home has a fairly stable staff team with many staff having worked at the home for many years. Lawns Nursing Home, The DS0000004121.V313906.R01.S.doc Version 5.2 Page 19 Staff personal records reviewed for the most recently employed showed that POVA first confirmations and CRB checks had been completed prior to the staff commencing. Of the three files reviewed the completed application was not available in all three. References had not been requested for the overseas staff, failure to follow a thorough recruitment procedure could place residents at risk. Since the last inspection the home has developed a staff-training matrix, this showed that the majority of staff are up to date with the required moving and handling, fire, first aid and food hygiene training. The nurses have completed a medication course following the last inspection. Some staff have attended dementia training. The home must ensure that staff receive training in health and safety and infection control. During the inspection it was discussed that staff should attend a formal training on the protection of vulnerable adults. The home must also ensure that the nurses receive regular clinical training to ensure that they are clinically up to date. Lawns Nursing Home, The DS0000004121.V313906.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,36,37 and 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The acting manager adopts an open and approachable ethos to management in the home. Records kept in the home are well maintained, up to date and available for the inspection. EVIDENCE: The registered manager has left since the last inspection, the acting manager for the home is Mrs Clark who is in the process of applying for registration with CSCI. She has worked at the home for seven years. Staff spoken to say they felt adequately supported and they could approach Mrs Clark with any issues Lawns Nursing Home, The DS0000004121.V313906.R01.S.doc Version 5.2 Page 21 or concerns. Staff confirmed that they have regular meetings to air their views. Comments received from residents and relatives confirmed that they find the acting manager approachable. During the inspection the residents all related well with the acting manager and she demonstrated a good knowledge and understanding of the residents care needs. At present the home is not formally supervising staff this needs to be recommenced and a record included within the staff personnel record. The home is in the process of undertaking a quality audit about the service they provide the results of this were not available at this inspection. All records requested were available on request at the inspection. A review of the fire log maintained in the home showed that all checks were being carried out in line with current guidelines. All records required to show that appropriate health and safety checks have been completed were available, with the exception of the emergency nurse call system. The acting manager confirmed that this was currently being reviewed. Lawns Nursing Home, The DS0000004121.V313906.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 3 3 X 3 3 X 4 STAFFING Standard No Score 27 2 28 2 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 2 X X 2 3 3 Lawns Nursing Home, The DS0000004121.V313906.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP30 Regulation 12,18 Requirement The home must ensure that all staff are appropriately trained to ensure the assessed needs of the residents are met. The home must recommence a formal staff supervision program, and a record of this maintained on their personnel records. The home must ensure that the staffing levels are meeting the required minimal guidelines throughout the 24-hour day. This must take into account the size of the home and the number and dependency of the residents. The home must ensure that the appropriate checks are completed for all new staff prior to them commencing work. Review the nurse call system to ensure that both residents and staff can call for assistance when required. The home must review their quality assurance system based on seeking the views of residents, relatives and other professionals. The results should then be included in the homes DS0000004121.V313906.R01.S.doc Timescale for action 30/03/07 2 OP36 12, 18 31/12/06 3 OP27 18 (1)a 30/11/06 4 OP29 18 (1)a 30/11/06 5 OP38 13 31/01/07 6 OP33 12 30/06/07 Lawns Nursing Home, The Version 5.2 Page 24 7 OP12 15 (1) 8 OP18 12, 13 Statement of Purpose. The home must review the activities provided. More suitable activities must be available for the more highly dependent residents. The home must provide some formal training for staff to ensure that they are fully aware of the procedures to follow if they suspect any form of abuse or neglect. 31/01/07 31/01/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP19 Good Practice Recommendations It is recommended that the home review the carpets along the corridors, they appeared quite worn in areas. Lawns Nursing Home, The DS0000004121.V313906.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Worcester Local Office Commission for Social Care Inspection The Coach House John Comyn Drive Perdiswell Park, Droitwich Road Worcester WR3 7NW National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Lawns Nursing Home, The DS0000004121.V313906.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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