Inspection on 07/01/08 for The Lindons

This inspection was carried out on 7th January 2008.

CSCI found this care home to be providing an Poor 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.

Other inspections for this house

The Lindons 26/01/09

The Lindons 12/03/08

Similar services:

The Vicarage

Fairfields Country Rest Home

7 Hyde Road

5 Seafield Road

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

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

CARE HOMES FOR OLDER PEOPLE The Lindons 120 Ashburton Road Newton Abbot Devon TQ12 1RJ Lead Inspector Andrea East Unannounced Inspection 10:00 7 8 and 9 of January 2008 th th 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 The Lindons DS0000070299.V350480.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. The Lindons DS0000070299.V350480.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Lindons Address 120 Ashburton Road Newton Abbot Devon TQ12 1RJ 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) 01626 368070 info@newcaredevon.co.uk Lindons Care Home Ltd Mrs Theresa Pepperell Care Home 25 Category(ies) of Dementia (25), Old age, not falling within any registration, with number other category (25), Physical disability over 65 of places years of age (25) The Lindons DS0000070299.V350480.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (Code OP) Physical disability - aged 65 years or over on admission (Code PD(E)) Dementia (Code DE) The maximum number of service users who can be accommodated is 25. This is the first inspection of this home since its purchase in July 2007 2. Date of last inspection Brief Description of the Service: The Lindons is a detached property set about a mile away from the centre of Newton Abbot, near to a bus stop and with parking facilities to the front of the property. ‘Lindons Care Home Ltd’, are the registered Company for the home with the responsible individual named as Mr Nathan Ost and a registered manager Theresa Pepperelle. The home provides care for up to twenty- five older people with physical and mental frailty. The accommodation provided varies in size and shape with some rooms used as doubles for shared occupation. The home has a lounge, conservatory and dining rooms and has a chairlift to access the first floor rooms. Fees are charged weekly; at present fees range between £372 and £475 per person. The homes service users guide had not yet been finalised the previous service users guide was displayed in the hall. As this was the first inspection of the home, under new ownership, no previous inspection record was available. The Lindons DS0000070299.V350480.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 0 star. This means the people who use this service experience poor quality outcomes. The inspection site visit was carried out over three days. A range of documents including staff and individuals’ files, policies and procedures were examined. People were spoken to in the homes lounge and in private rooms and members of staff were also spoken with. The homes manager was present throughout the inspection. The homes responsible individual was present on the second day of the inspection Feedback about the home was also received by post in survey questionnaires, and in the homes Annual Quality Assurance Audit. Shortly after the inspection site visit the responsible person, working with the manager and an outside agency began to address the issues raised. They confirmed in a detailed action plan the action they intended to take to address the issues raised at the inspection site visit and as part of their own audit of the property and services. What the service does well: What has improved since the last inspection? This is the first inspection of this home since its purchase in July 2007 The Lindons DS0000070299.V350480.R01.S.doc Version 5.2 Page 6 What they could do better: The new detailed service users guide and statement of purpose should be finalised, circulated and made available to people planning to come into the home. The assessment of peoples needs should be fully recorded including, where the assessments had been carried out, and if the person coming into the home or their relatives/ advocates had been involved in the discussion and assessment of their needs. People’s care needs were not clearly or fully set out in an individualised plan of care. Care and assessment records must be well completed. These records are important as they provide valuable information to staff, so that staff can monitor care. Poor care planning also put people at risk, as staff, were not fully aware of people’s ongoing needs. The assessment, care planning and recording of peoples needs and how people are to be cared for must be consistently completed and must include peoples mental and physical well being. People using the service did not have their care needs fully met and they had not been involved in making decisions in planning the care and support they received. Care plans (the service users plan) must be prepared with consultation with the service user and/or their representative. So that it is clear that people are involved in the care they receive. Call bells must be in place so that people can call for assistance. Medication administration systems were poor. The storage, cleanliness and recording of medicines of must be improved. So that, medication must be stored safely in clean lockable containers, medication administration must be consistently recorded and medication must not be left unattended. People did not have the opportunity to have a lifestyle that they chose, or that met their expectations, or satisfied their needs. This included if the meals provided, were varied, to their choice or taken at a time that suited them. People were not protected from abuse as there was poor management of equipment that could be used as forms of restraint. For example the use of bed rails, low sofas and reclining chairs, without clear guidance and records of how and why this equipment was used. People did not live in a safe, clean or well -maintained environment as large parts of the home were in need of redecoration and refurbishment. The Lindons DS0000070299.V350480.R01.S.doc Version 5.2 Page 7 For example communal rooms, corridors, furniture were dirty and Linen was worn frayed and faded. Health and safety practices were poor in that good fire safety practices or health and hygiene had not been followed. The numbers of staff employed in the home sometimes affected the care people received so that Peoples needs were not fully or consistently met. The numbers of staff on duty sometimes fell to three staff for up to nineteen older people with a range of physical and mental frailties. People did not live in a well managed home, as the home did not provide a stimulating or safe environment. For example the poor recording of care, the poor maintenance and cleanliness of the home and poor health and safety systems in the kitchen and in fire safety had not been monitored and addressed. In addition the monitoring of accidents had not been kept up to date, so that records were poorly completed and did not show how people had been protected from reoccurring incidents and accidents. 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. The Lindons DS0000070299.V350480.R01.S.doc Version 5.2 Page 8 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 The Lindons DS0000070299.V350480.R01.S.doc Version 5.2 Page 9 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): Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. The people using the service were confidant that their care needs had been assessed and that their needs could be met, right from the start of their stay in the home. The services provided did not include intermediate care. EVIDENCE: A service users guide and statement of purpose was available to the people using the service or their relatives and advocates. The service users guide was one that had been created by the previous owners of the home. The manager and owner said that this was being addressed and that a new detailed service users guide and statement of purpose was being finalised and these documents would be circulated to everyone in the home. The Lindons DS0000070299.V350480.R01.S.doc Version 5.2 Page 10 Two peoples’ files containing assessment information were examined. The records examined did not make clear where the assessments had been carried out, for example; at the person’s home or at hospital. This meant it was difficult to say if they had been completed before or after the person moved into the home. An ‘admission form’ had been completed for people once arriving at the home and information about peoples needs had been gained from social services. The manager and staff said that people had the opportunity to visit the home and talk about their needs and interests Records did not make clear if the person coming into the home or their relatives/ advocates had been involved in the discussion and assessment of their needs. One survey from a relative said “Shown room allocated and staff explained procedures all my enquiries were answered satisfactory”. Indicating that people had the opportunity to visit the home and talk about care needs. The manager said that policies and procedures on admission to the home, which would include a detailed assessment process were available to staff. The Lindons DS0000070299.V350480.R01.S.doc Version 5.2 Page 11 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): Quality in this outcome area is poor This judgement has been made using available evidence including a visit to this service. People’s care needs were not clearly or fully set out in an individualised plan of care People using the service did not have their health, personal and social care needs fully met. People were not involved in decisions about their lives, and did not play an active role in planning the care and support they receive. EVIDENCE: Three files, including a range of documents, on people’s needs, some which had not been completed, were examined. Two files were examined in the home. One file was examined out of the home as part of an agreed safeguarding strategy. Care and assessment records were not well completed, as they did not show how people’s care needs were being monitored and addressed. The Lindons DS0000070299.V350480.R01.S.doc Version 5.2 Page 12 For example one person had pressure areas (areas that are prone to breaking causing redness and open wounds if left unattended). It had not been clearly recorded how staff would ensure that pressure areas would be cared for and breakdown of skin minimised. A chart monitoring how often this person was moved had been poorly completed, so that members of staff were unable to determine the best seating and lying position to protect this person’s skin. When speaking to staff they were not clear exactly what areas of this persons skin needed care and attention. The files examined also held assessments formats that had not been consistently completed such as nutrition charts and weight charts. This was important as one person had identified nutritional needs but details of this had no been recorded in the nutrition charts or weight charts so that this person progress could be monitored. Care plans showing the care needs of the people using the service and the action staff take to address those needs are important as they provide valuable information to staff. Poor care planning puts people at risk as staff may not be fully aware of peoples ongoing needs. Very little information on how to care for people with memory loss, aggression, confusion or disorientation had been detailed in care plans or assessments. One person spoken to said that they did not feel cared for “staff are always so busy, they don’t get chance to do much caring”. People were unable to call for assistance, as call bells were placed out of reach or were missing. There was no evidence that People were involved in decisions about their lives, or that they played an active role in planning the care and support they received. Care plan and assessment information did not include information on how people had made choices in their care or make clear if they had been consulted about any events in the home. Most of the people living in the home that were spoken with had varying degrees of memory loss or communication difficulties so that they could not always clearly express themselves. Some were unable to express any opinion on the care they received. The numbers of staff on duty at the home sometimes fell to three staff to care for up to nineteen people with varying physical and mental health needs The Lindons DS0000070299.V350480.R01.S.doc Version 5.2 Page 13 Members of Staff were also carrying out domestic, laundry, medication administration and trying to record how people had spent the day. When the numbers of staff fell to three staff it would be difficult to ensure that peoples needs would be met given the range of tasks staff had to complete. Three Surveys from the relatives of the people living at the home were returned to the Commission. One said “My husband is always clean and well cared for”. One survey from a professional said “I find the Lindons are proactive in seeking my advice when needed”. Medication administration systems in the home were poor. Medication was not stored or administered safely. Medication records were poorly completed. Medication records showed that staff had not signed to say if medication had been administered. So that it was unclear if people had received medication as prescribed. Medication records had been added to in pencil, not dated or signed, so that medication was being administered by staff who were not clear if this medication had been prescribed by a doctor, or when it had been prescribed. Medication was left unattended in a kitchen area on trays and the homes fridge for storing eye drops and medicines that needed to be kept cool, was dirty and unlocked. The Lindons DS0000070299.V350480.R01.S.doc Version 5.2 Page 14 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): Quality in this outcome area is poor This judgement has been made using available evidence including a visit to this service. People’ s lifestyle in the home did not meet their expectations or satisfy their needs. People who used the services were able to make some choices about their life style, and were supported to develop some life skills. Social, educational, cultural and recreational activities did not meet individual’s expectations. People enjoyed the meals provide but it was not clear if peoples diets were, varied, to their choice or taken at a time that suited them. EVIDENCE: Care plans and assessments did not include details of how people wish to spend their time. Activities, recreational and social interests had not been consistently detailed or fully explored with the people living in the home. The Lindons DS0000070299.V350480.R01.S.doc Version 5.2 Page 15 Daily ongoing records did not consistently give information on how people had spent their time in the home. The manager said that lots of informal activities, took place in the home, these activities were not recorded. Surveys from the people using the service said that ‘sometimes’ activities were available. Three surveys said that people did not wish to join in activities. The homes Annual Quality Assurance Assessment gave no details of the kind of activities people could participate in. The numbers of staff on duty at the home sometimes fell to three staff to care for up to nineteen people with varying physical and mental health needs. This meant that despite staff wishing to offer more choice and more activities, staff were busy attending to basic care needs, such as helping people to the toilet and getting people ready for the day. People said that they continued to have visits from relatives and friends and that all visitors were welcomed into the home. People said “meals are very nice” and “generally well cooked”. People said that they were not aware that they had a choice of foods. The cook said there was a choice of food if people did not want what was on the menu but could not say how people are told of this. There were no records to show if people had been offered or received a choice of foods and drinks. There were no records to show people’s preferences and likes and dislikes for foods and drinks. People were identified as requiring assistance with food and drink and this was not consistently monitored or recorded. The cook said that that it was easy to remember peoples’ likes and dislikes. Records of cleaning schedules and the measurements of food and equipment temperatures had not been kept up –to- date or consistently completed. The lack of records meant that Food Hygiene legislation was not being followed. Poor food hygiene practices means that people are not safe from food contamination, food poisoning and sickness. Poor recording of people choices and preferences meant that people may not consistently receive foods and drinks they liked or had chosen. The manager said that one of the cooks had left the home before Christmas and this had meant changes in the routines in the kitchen. The Lindons DS0000070299.V350480.R01.S.doc Version 5.2 Page 16 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): Quality in this outcome area is poor This judgement has been made using available evidence including a visit to this service. People who used the service were able to express their concerns, and complaints and suggestions from those using the service, relatives or other visitors to the home were treated seriously. People were not protected from abuse. EVIDENCE: The homes complaints procedure was included in the Service Users guide, which was displayed in the hall. The homes complaints procedure needs to be updated to take into consideration changes in how providers of carer should proceed, when faced with a complaint that could be an abuse issue. Surveys said that people that they felt able to raise any concerns or worries with the staff or the homes manager. Surveys from relatives said that people felt able to speak to the homes manager and were made aware of any changes in people care. People were not protected from abuse as there was poor management of equipment that could be used as forms of restraint. The Lindons DS0000070299.V350480.R01.S.doc Version 5.2 Page 17 For example a reclining chair was being used to care for one person, who would be unable to get out of the chair. Details of why this chair was being used had not been included in this persons care plan and there was no record of this having been discussed with relatives, advocates or health professionals. Bed rails (also viewed a s a form of restraint) were fitted to beds. One bed rail had no bumper covering the metal frame. No risk assessment for the use of bed rails had been completed. There were no records detailing the reasons for the use of bed rails and no evidence of this having been discussed with relatives, advocates or health professionals. Bed rails used in this way are a form of restraint and the lack of protection on the bumper puts people at risk of injury. The manager is in the process of investigating serious concerns about one persons care, raised through the safeguarding adults process. This process had not been completed at the time of the inspections site visit. The Lindons DS0000070299.V350480.R01.S.doc Version 5.2 Page 18 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): Quality in this outcome area is poor This judgement has been made using available evidence including a visit to this service. People did not live in a safe, clean or well -maintained environment EVIDENCE: Large parts of the home were in need of redecoration and refurbishment. Communal rooms and corridors were dirty and there was a strong unpleasant odour on entering the home. Furniture in communal rooms and some individual rooms were dirty. Linen was worn frayed and faded. The kitchen and bathrooms were dirty. No schedules were in place for cleaning. The Lindons DS0000070299.V350480.R01.S.doc Version 5.2 Page 19 The manager said that they had been recruiting and advertising for domestic staff for some time and was continuing to pursue recruiting a cleaner. The current arrangements meant that care staff were also trying to carry out domestic and cleaning tasks. Fire safety precautions in the home were poor. An immediate requirement had been issued at a previous short visit to the home prior to the inspection site visit. The immediate requirement was in relation to a fire door being propped open. This posed a fire risk. At the time of the inspection site visit the home had not responded to the immediate requirement notice. The Lindons DS0000070299.V350480.R01.S.doc Version 5.2 Page 20 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): Quality in this outcome area is poor This judgement has been made using available evidence including a visit to this service. The people using the service, were supported by Staff, who were trained, skilled and competent. Not all Staff had been subject to rigorous recruitment checks. The numbers of staff employed in the home sometimes affected the care people received. EVIDENCE: Peoples needs were not fully or consistently met as the numbers of staff on duty sometimes fell to three staff for up to nineteen older people with a range of physical and mental frailties. Staff rotas showed that at key times of the day, such as in the morning when people were being assisted to wash and dress, three staff were on duty, with no domestic or laundry support. Members of Staff were expected to carry out a number of tasks such as cleaning, medication administration, laundry duties in addition to providing care, even on the days when the numbers of staff fell to three. The Lindons DS0000070299.V350480.R01.S.doc Version 5.2 Page 21 The staff spoken with were very positive about the people they cared for and were clearly trying hard to meet peoples needs. However due to the numbers of staff employed in the home they were unable to provide the service they wished to. The home employs and outside agency to oversee the recruitment and selection of staff. Four files containing Staff records including recruitment records were examined. Staff files holding recruitment information had been updated so that they included staff roles and responsibilities in job descriptions, interview checklists and questions, references and police checks, identity checks and photographs of staff. Staff appointed through the responsible individual and the manager of the home (not the outside agency) had not been subject to such comprehensive checks. Two staff did not have written confirmation of there work status in this country. Shortly after the inspection visit the responsible individual confirmed that action had been taken to address this. Staff had received a range of training, which was recorded and included fire safety, manual handling and care of the person with dementia. The Lindons DS0000070299.V350480.R01.S.doc Version 5.2 Page 22 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): Quality in this outcome area is poor This judgement has been made using available evidence including a visit to this service. People did not live in a well managed home. The home did not provide a stimulating or safe environment. EVIDENCE: The manager had been employed by the previous owner of the home and had now formalised and extended her role under the new home owners. The manager had successfully completed her National Vocational Award in care management. The manager was sometimes included in staff rotas as one of three care staff to care for up to nineteen older people. This meant that on those occasions the The Lindons DS0000070299.V350480.R01.S.doc Version 5.2 Page 23 manager was unable to spend a concentrated time on the management and running of the home. Many of the areas highlighted throughout this report that required a managers overview had not been monitored and addressed by the manager. For example the poor recording of care, the poor maintenance and cleanliness of the home and poor health and safety systems in the kitchen and in fire safety. In addition the monitoring of accidents had not been kept up to date, so that records were poorly completed and did not show how people had been protected from reoccurring incidents and accidents. The quality assurance system in the home had not been fully implemented under the new ownership arrangements. Survey information from previous survey questionnaires asking about the quality of the service under the previous owner overlapped into this year and had some positive comments. Shortly after the inspection site visit the responsible person, working with the manager and an outside agency began to address some of the issues raised They confirmed in a detailed action plan the action they intended to take to address the issues raised at the inspection site visit and as part of their own audit of the property and services. The Lindons DS0000070299.V350480.R01.S.doc Version 5.2 Page 24 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 2 x 2 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 2 9 1 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 2 14 2 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 x 18 1 1 x x x x x x 1 STAFFING Standard No Score 27 1 28 2 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 x x x x x x 1 The Lindons DS0000070299.V350480.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? N/A 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 OP7 Regulation 15 Requirement Care plans (the service users plan) must include full details of how the service users health and welfare are to be met. Care plans (the service users plan) must be prepared with consultation with the service user and/or their representative Call bells must be in place so that service users can call for assistance Services users needs must be consistently assessed, reviewed and updated Medication must be stored safely in clean lockable containers. This relates to the fridge kept for storing eye medication Medication administration must be consistently recorded. This relates to missing information on medication administration records. This relates to medication left on trays in a kitchen area. Medication must not be left unattended. People must receive a wholesome balanced diet of their DS0000070299.V350480.R01.S.doc Timescale for action 22/02/08 2 OP7 15 22/02/08 3 4 5 OP8 OP8 OP9 12 12 13 22/02/08 22/02/08 22/02/08 6 OP9 13 22/02/08 7 8 OP9 OP15 13 12 22/02/08 22/02/08 The Lindons Version 5.2 Page 26 choice. This relates to the lack of recording of peoples choices of menu and drink and to the poor recording and monitoring of peoples nutritional needs. 9 OP18 13 People must be safe from abuse and the use of inappropriate restraints. This relates to the use of bed rails, reclining chairs and low sofas The home must be well maintained This relates to the poor decoration and repair of parts of the home. The home must be clean and odour free This relates to the poor standard of cleanliness throughout the home and furnishings The numbers of staff employed in the home must be sufficient to meet peoples needs. This relates to the numbers of staff carrying out multiple task falling to three staff for up to nineteen older people. The catering arrangements must meet food hygiene legislation standards and ensure that people are safe from harm, through food poisoning The fire safety arrangements must safeguard people from harm. This relates to the poor practice of holding fire doors open with pedal bins. 22/02/08 10 OP19 13 22/02/08 11 OP26 13 22/02/08 12 OP27 18 22/02/08 13 OP38 13 22/02/08 14 OP38 13 22/02/08 The Lindons DS0000070299.V350480.R01.S.doc Version 5.2 Page 27 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 OP1 Good Practice Recommendations The new detailed service users guide and statement of purpose should be finalised, circulated and made available to people planning to come into the home. The assessment of peoples needs should be fully recorded including, where the assessments had been carried out, and if the person coming into the home or their relatives/ advocates had been involved in the discussion and assessment of their needs. Activities, recreational and social interests should be consistently detailed and fully explored with the people living in the home. This information should then be recorded. A choice of social and recreational activities should be available to every one living at the home. Staff recruitment should include written confirmation of work permits to work in this country. The manager should receive the support and time to carry out management tasks. A quality assurance system should be implemented 2 OP3 3 OP12 4 5 6 7 OP12 OP29 OP31 OP33 The Lindons DS0000070299.V350480.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Devon Area Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 The Lindons DS0000070299.V350480.R01.S.doc Version 5.2 Page 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!