Inspection on 09/01/06 for The Lawns Residential and Nursing Home

This inspection was carried out on 9th January 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 Residential and... 30/01/08

The Lawns Residential and... 23/02/07

The Lawns Residential and... 29/03/06

The Lawns Residential and... 17/11/04

The Lawns Residential and... 23/04/04

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Claremont House

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Sun Court Nursing Home

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Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

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

CARE HOMES FOR OLDER PEOPLE The Lawns Residential & Nursing Home Lawn Lane Springfield Chelmsford Essex CM1 7JB Lead Inspector Carolyn Delaney Un-announced 9 January 2006 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 Residential & Nursing Home I06-I56 S15351 The Lawns V240836 090106 Stage 02.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service The Lawns Residential & Nursing Home Address Lawn Lane Springfield Chelmsford Essex CM 7JB 01245 450101 01245 464123 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) BUPA Care Homes Ltd Mrs Jacqueline Eunice Saville CRH 52 Category(ies) of OP Old Age 14, PD Physical Disability 14, PD (E) registration, with number Physical Disability 52, TI Terminally Ill 8. of places The Lawns Residential & Nursing Home I06-I56 S15351 The Lawns V240836 090106 Stage 02.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 17th & 19th November 2004 Brief Description of the Service: The Lawns provides accommodation in a modern and well maintained, purpose built two storey brick building. The home has nineteen single bedrooms and two double bedrooms on the ground floor and twenty-nine single bedrooms situated on the first floor. both floors are accessible via a passenger shaft lift. The home is situated in the grounds of Springfield hospital, within three miles of Chelmsford town centre and mainline train station. There is a bus stop outside of the home. The Lawns caters for a variety of people including Older People, Younger Adults with Physical Disabilities and people who have a diagnosed Terminal Illness. The Lawns Residential & Nursing Home I06-I56 S15351 The Lawns V240836 090106 Stage 02.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This routine unannounced inspection was carried out between 11.00 and 17.00 on 9th January 2006. Care plans and assessments in respect of potential risks to people living at the home were assessed and five residents were spoken with. Three visitors to the home were spoken with. Records in respect of staff recruitment and training were assessed and six members of staff including the registered manager were spoken with. The daily provision of care was observed and a tour of the premised was carried out. Key standards as identified in the intended outcomes sections of this report are inspected at least once every twelve months. Where key standards have not been inspected on this occasion they will have been inspected at the previous inspection. Reports in respect of previous inspections may be accessed via the Commissions website www.csci.org.uk. What the service does well: The Lawns provides a well-maintained and comfortable place for people with a variety of nursing and care needs to live. The home is well staffed with people who receive training and support in respect of the roles they are to perform and the needs of the people who live there. Information about the people who live at the home, and their individual nursing and care needs is clearly recorded so that staff are kept up to date with each persons needs and treatment. Residents said that the food provided by the home was particularly good in terms of the choice and quality. The Lawns Residential & Nursing Home I06-I56 S15351 The Lawns V240836 090106 Stage 02.doc Version 1.40 Page 6 Residents and visitors to the home were very complimentary about the care provided by staff working at the home and one resident said that the care provided was ‘first class’. 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 Residential & Nursing Home I06-I56 S15351 The Lawns V240836 090106 Stage 02.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection The Lawns Residential & Nursing Home I06-I56 S15351 The Lawns V240836 090106 Stage 02.doc Version 1.40 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 standard(s) 1 & 3 Each resident living at the home, or their relative, where this is more appropriate, are provided with detailed information about the facilities and services provided by the home. Assessment documents did not always evidence that a detailed assessment of each individuals nursing, care and welfare needs is carried out prior to the person being offered a place at the home. EVIDENCE: Each resident living at the home, or their relative, where this is more appropriate, are provided with detailed information in the service users guide, about the facilities and services provided by the home. Assessment documents for three people who have recently moved into the home were sampled. There was no pre- admission assessment documents available for two of these people. It was reported that one person had been an ‘emergency admission’ with no time to carry out a pre-admission assessment. The second person was admitted for a respite period and had been previously The Lawns Residential & Nursing Home I06-I56 S15351 The Lawns V240836 090106 Stage 02.doc Version 1.40 Page 9 admitted to the home. The manager said that the procedure for admitting people for a respite period was being reviewed so as to include a review and update of previous assessment documents before the person is admitted to the home. It was positive to note that upon each person’s admission to the home that key nursing, general and safety needs were clearly identified so that appropriate care and treatment can be planned and implemented. The Lawns Residential & Nursing Home I06-I56 S15351 The Lawns V240836 090106 Stage 02.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,10 & 11 Information about residents nursing, general and safety needs are recorded in a manner, which ensures that all staff, are aware of each individual’s care and treatment. Staff treat residents in an appropriate manner and their wishes are so far as it is practicable respected and met. EVIDENCE: Care plans were well written and updated on a regular basis and according to changes in residents nursing care and general care needs. In addition to the information recorded in care plans each person living at the home has a detailed record of their daily routines and preferences for daily activities of living such as washing, dressing etc. These ensure that staff working at the home are aware of residents care needs and preferences for how this care is delivered. There were detailed records in place in respect of identifying and managing actual and potential risks to resident’s safety and welfare. These assessments are kept under regular review so as to ensure that staff are aware of any changes to residents safety needs. The Lawns Residential & Nursing Home I06-I56 S15351 The Lawns V240836 090106 Stage 02.doc Version 1.40 Page 11 The standard in respect of medication was not fully assessed, however it was note that medicines were administered by appropriately qualified staff at the times for which they were prescribed. Residents capabilities in respect of retaining control of, and administering their own medication are carried out and where residents do retain control of their medication there are procedures in place for ensuring that this is carried out safely. Throughout the inspection the staff working at the home were seen to provide care and to assist residents in a caring and positive manner and all those residents and visitors who were spoken with complimented staff on their provision of care. The home has a detailed policy regarding cardiopulmonary resuscitation in the event that residents suffer a cardiac or respiratory arrest. Where information has been provided residents wishes in respect of treatment and wishes for end of life and preferred arrangements following death are recorded. The Lawns Residential & Nursing Home I06-I56 S15351 The Lawns V240836 090106 Stage 02.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12 & 15 The home provides a range of stimulating activities for the people who live there. Staff working at the home ensure that residents nutritional needs are assessed and reviewed periodically. The home provides a varied and nutritious diet, with meals presented in an appealing and attractive manner. EVIDENCE: The home employs an activities coordinator for thirty-seven hours per week. This includes some evening and weekend activities. A range of one to one and group activities are provided and those residents who are capable and who choose to, are offered the opportunity to go outside of the home to visit local amenities, shops etc. The homes manager said that she intends to employ a second activities coordinator solely for the provision of activities for the younger people living at the home. There were detailed assessments in place for each persons nutritional needs and residents weight is monitored on a regular basis. Residents who were spoken with said that the food was very good. The serving of the lunchtime meal was observed. Residents were offered a soup course followed by the The Lawns Residential & Nursing Home I06-I56 S15351 The Lawns V240836 090106 Stage 02.doc Version 1.40 Page 13 choice of sausages or salmon with mashed potatoes and a selection of vegetables, and crepes with Cointreau. One resident said that he has a three-course breakfast with grapefruit, cereal and scrambled eggs. Meals are served by hostess staff and are very well presented. The Lawns Residential & Nursing Home I06-I56 S15351 The Lawns V240836 090106 Stage 02.doc Version 1.40 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 & 18 The home has a policy and procedure for receiving and dealing with complaints made about the services provided. Staff are aware of the appropriate action to take so as to protect people living at the home from abuse. EVIDENCE: There had been a number of complaints made by two individuals living at the home. There was evidence that these were investigated and responded to appropriately. Each resident is provided with details regarding how to complain if they are dissatisfied with the services or care provided by the home. Staff working at the home receive training and information regarding the protection of vulnerable people and those who were spoken with could demonstrate that they were aware of Adult Protection issues and how to act if they suspected or witnessed any abuse of people living at the home. The Lawns Residential & Nursing Home I06-I56 S15351 The Lawns V240836 090106 Stage 02.doc Version 1.40 Page 15 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, 21, 22, 23, 24, 25 & 26 The Lawns provides attractive and well-maintained accommodation and facilities for the people who live there. EVIDENCE: Resident’s bedrooms are spacious and well maintained with ensuite facilities. Residents have access to three lounge areas including a quiet room and activities room. The home is well maintained and decorated to a very high standard throughout. The home has low level light switches, overhead tracking hoist system in the bathroom and other appropriate adaptations so as to promote the independence of the people who live there. The home employs dedicated cleaning, maintenance and laundry staff. The home was clean and free from any unpleasant odours throughout. The Lawns Residential & Nursing Home I06-I56 S15351 The Lawns V240836 090106 Stage 02.doc Version 1.40 Page 16 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, 29 & 30 Staff are recruited robustly, trained and employed in sufficient numbers so as to meet the needs of the people living at the home. EVIDENCE: The duty rota evidenced that staff working at the home do not work excessive hours and that they have appropriate off duty time. Staff are recruited according to a robust policy and procedure, which includes checking previous employment history, obtaining references and Criminal Records Bureau (CRB) disclosures and PoVA First checks so as to determine the suitability of each person to work at the home. In some instances staff are employed at the home under supervision prior to the receipt of a CRB disclosure. The arrangements for supervision is not always clearly evidenced. There was evidence that staff receive regular mandatory training including Health & Safety and Moving & Handling training as well as specialist training such as managing aggression, wound care and English for overseas staff. The Lawns Residential & Nursing Home I06-I56 S15351 The Lawns V240836 090106 Stage 02.doc Version 1.40 Page 17 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 & 35 A competent and well-qualified registered nurse manages the home. There are procedures in place so as to promote and safeguard the financial interests of the people who live at the home. EVIDENCE: A registered nurse who has over twenty years nursing experience manages the Lawns. At the time of this inspection the registered manager had reduced her hours to work part time and the Commission for Social Care Inspection had received an application for the deputy manager to be registered as manager of the home. This application was being processed at the time of this inspection. In general residents or their families deal with their financial matters. Residents are provided with lockable storage facilities in their bedrooms, however they are discouraged from keeping large amounts of monies or valuables in their rooms. At the time of this inspection residents personal The Lawns Residential & Nursing Home I06-I56 S15351 The Lawns V240836 090106 Stage 02.doc Version 1.40 Page 18 allowance monies were held separately in a pooled bank account. There are plans to change this account to one which interest can be earned on credit balances. Records in respect of monies held on behalf of people living at the home are maintained and audited regularly by the home’s bursar. The Lawns Residential & Nursing Home I06-I56 S15351 The Lawns V240836 090106 Stage 02.doc Version 1.40 Page 19 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 3 x 2 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 x 15 4 COMPLAINTS AND PROTECTION 4 3 3 3 3 3 3 4 STAFFING Standard No Score 27 3 28 x 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 3 x x x The Lawns Residential & Nursing Home I06-I56 S15351 The Lawns V240836 090106 Stage 02.doc Version 1.40 Page 20 NO 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 OP3 Regulation 14 Requirement The registered persons must ensure that a detailed assessment of each individuals nursing and general needs is carried out prior the person being offered a place at the home, so as to determine that the home can meet these needs. Timescale for action 30/02/06 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 OP29 Good Practice Recommendations It is recommended that where staff are being inducted or undertaking supervised practice while awaiting CRB disclosures that this be recorded as part of a risk assessment process so as to best protect the welfare and interests of the people who live at the home. It is recommended that the information provided to residents living at the home includes more detail about the arrangements for retaining valuables and monies at the home. 2. OP35 The Lawns Residential & Nursing Home I06-I56 S15351 The Lawns V240836 090106 Stage 02.doc Version 1.40 Page 21 Commission for Social Care Inspection Kingswood House Baxter Avenue Southend on Sea Essex SS2 6BG. 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. 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