Care Home: Claridge Nursing Homes (Lynhales Hall) Limited

Similar services:

• Maple Lodge
• Heathlands
• Aston Court Nursing Home
• Breme
• Ravenhurst
• Bank House
• Inspirations
• Westmead

What the care home does well Care is taken to get all the necessary information about new people moving in and to help them and their families to adjust to the move. Staff know what people`s care needs are and deal with these conscientiously. Medication is managed safely. The home understands about good practice in dementia care and works hard to make life as good as possible for the people who live there. Activities are provided and include ordinary daily tasks to help make life feel as normal as possible for people with dementia. The food provided is varied and nutritious and takes people`s dietary needs, wishes and preferences into account. The home is well maintained, safe, clean and attractive and any equipment needed is provided. Staff recruitment and training is well planned and organised. The owner and manager use a variety of quality assurance methods, including finding out what people think about the home. They use this information to help them improve the service they provide. What the care home could do better: Lynhales Hall continues to provide an excellent service. We are confident that the owner and manager will act on our recommendations and continue to develop and improve the service. Some records could be developed further: The records of pressure area care would be improved by including details of progress made during treatment of wounds and by making sure body maps and/or measurementsand diagrams or photographs are always used. The attentive hands on care we witnesses would be better supported if more specific details were given in some care plans where fairly generalised care statements had been used. When people have `as required` medication it is good practice to have a care plan explaining when someone should be given a dose and what staff should consider when making a decision about giving it (eg level of challenging behaviour, how long it has lasted, whether other approaches have been unsuccessful). This will help staff to be consistent in their decisions about this. The complaints records should include additional information to provide a more robust audit trail showing how the outcome has been reached. Random inspection report Care homes for older people Name: Address: Lynhales Hall Nursing Home Lynhales Hall Nursing Home Lyonshall Kington Herefordshire HR5 3LN three star excellent service The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Denise Reynolds Date: 0 6 0 4 2 0 1 0 Information about the care home Name of care home: Address: Lynhales Hall Nursing Home Lynhales Hall Nursing Home Lyonshall Kington Herefordshire HR5 3LN 01544340642 01544340644 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Lynhales Hall Nursing Home Limited care home 67 Number of places (if applicable): Under 65 Over 65 0 67 0 dementia old age, not falling within any other category physical disability Conditions of registration: 67 0 6 1. The registered person may provide the following category of service only: Care Home with Nursing (Code N) to service users of the following gender: Either Whose primary needs on admission to the home are within the following categories: Older people not falling with any other category (OP) 67 Dementia (DE) 67 Physical Disability (PD) 6 2. The maximum number of service users to be accommodated is 67. The home may accommodate two named residents who are between 60 and 64 years of age and have care needs arising from mental health disorders. Date of last inspection Care Homes for Older People Page 2 of 11 Brief description of the care home Lynhales Hall, which is located on the outskirts of the village of Lyonshall, is approached by a long drive and is in a very rural situation. Set in its own extensive grounds, it was originally built as a gentlemans residence. Now modernised and extended, it is a care home with nursing, offering services for up to 67 older men and women and specialising in dementia care. There is information literature describing the service and the front entrance to the home advertises copies of this. Each bedroom has a large print copy of this information and the home will make it available in Braille, CD disc or picture form if this helps people. Information about the homes fees and additional charges should be requested direct from the home. Please note that our last key inspection of this service was on 10th April 2007 when we rated the home as a 3 star (excellent) service. Our computer system has not entered this information into the relevent boxes above for which we apologise. Since the inspection in 2007 we have done an annual service review each year and this has confirmed our view about the 3 star rating. Care Homes for Older People Page 3 of 11 What we found: We (the Care Quality Commission) did an unannounced inspection at Lynhales Hall. This means that no-one at the home knew we would be arriving. One of our inspectors spent a day at the home and looked at a cross section of things. We wanted to get a snapshot of life at the home to make sure that things are running well and that people living there are receiving a service that meets their needs. While we were at the home we met some of the people who live there, some staff and the family of one person. We saw some parts of the building and looked at some of the most important records such as care records, medication records and staff recruitment details. During the course of the day we were able to observe staff as they dealt with people and got a picture of day to day life. We met one of the chefs and found out how food is organised and saw the meal served at lunchtime. Some weeks earlier the owner and manager sent us their annual quality assurance assessment (AQAA for short). This is a document which services are required to send to us to tell us what they do well, what they think they need to improve and what their plans are to achieve these changes. The AQAA was clear and accurate in its description of the service. We also received information from a sample of people who live in the home and from staff. We have used all of this information to help us get a picture of how the home is doing. We saw that the manager gets good information about people before they move in so that she can be sure that Lynhales is a suitable place for them to live. Information is written down as an assessment of the persons needs and then staff use this to build a detailed care plan. The manager asks people or their family to fill in a questionnaire when they have been at the home for a while and uses what these tell her to make sure staff are doing things well. We read some of the questionnaires and saw that people were very pleased with how this potentially stressful time was dealt with by staff. They had written about things like staff being caring and welcoming and everything in the room being ready for their relative. One person had answered a question about the best part of the experience for them by writing The friendly and professional staff, the beautifully prepared room including the cards to welcome the new residents, the swift arrival of the housekeeper to take an itinerary of belongings and the prompt giving of medication as required. We looked in some detail at the care that two people have. One person is looked after in bed because they have a lot of physical needs and the other is a very active person but has advanced dementia. In both cases we saw examples of them getting the right care from staff and saw that staff were gentle and respectful towards them. From checking the records and speaking to staff we could tell that staff know what care they need and that they are conscientious about the attention they give. Medication is dealt with in a safe and well organised way. There are good systems for making sure that people get the right medication and checks are done regularly (daily in some cases) to make sure that medication is being given as prescribed. The storage for medication is safe and secure and is air conditioned to make sure the storage Care Homes for Older People Page 4 of 11 temperature is stable. The manager sets high standards and expects that people will be treated with dignity and respect. Lynhales specialises in caring for people who need care because they have dementia. Staff at the home are trained to understand the best ways to help people who have problems remembering or understanding because of this and who may sometimes show behaviour that is challenging such as getting very frustrated, angry or distressed. We saw that people were mostly very calm and relaxed and that staff dealt with some brief outbursts capably and kindly. Incidents like this are written down in a persons care records to help staff monitor how things are going and to help them decide when using prescribed medication is the best thing to do if other things dont help. One of the nurses told us that they usually try distracting a person (eg by walking with them or suggesting a cup of tea) or asking a different carer to take over before they even think about using medication. This information was not included in a care plan; this would be good practice because it would help make sure the approach to giving this person medication is consistent amongst all the staff. We saw that people are free to move around the house without staff making them go and sit down. In the John Sperry Unit this is made easier due to the excellent design which means people never come to a dead end and so can walk freely. There is a full time activity organiser who arranges things for people to do. We could tell from some of the records of activities that other staff also do things like taking people outside for walks. There is a secure internal courtyard with raised flower beds and a covered fishpond which means that in good weather the doors can be open and people can go outside safely. Doors to the large open grounds are kept shut so that people are not at risk of going out unnoticed. Mr Claridge plans to phase out the use of any remaining shared rooms so that everyone moving to Lynhales Hall will be assured a single room. We looked at what activities one person had done recently and saw they had been for walks, helped make sandwiches for tea, done some cleaning, played scrabble and had their nails done. We saw some photographs of them taking part in some activities including a game of carpet skittles. We spoke to one of the two chefs and saw the lunchtime meal being served. There was a choice of beef casserole and vegetable or cheese and tomato flan followed by black cherry sponge or rice with strawberry sauce. There was plenty for everyone and the meal looked very appetising. It was served very nicely by the staff. We looked at the menus and saw that there is a choice of food at every meal and that overall the menu is varied and interesting. The manager has recently introduced protected mealtimes. This means that staff are expected to give all their attention to helping people with their food and not get involved in doing anything else. The manager is conscientious about informing us of incidents at the home which must be reported to us. This includes any concerns that need to be dealt with under local safeguarding arrangements. We are aware that she has taken the correct action when incidents have taken place including making safeguarding referrals and when necessary taking disciplinary action against staff. We saw the records kept at the home that show that safeguarding concerns and complaints are dealt with and recorded. We made some suggestions about the information recorded when a complaint has been dealt with. Staff are trained so that they understand how to recognise all types of abuse and know Care Homes for Older People Page 5 of 11 what to do if they feel a person may be at risk. The building has two self contained areas. The John Sperry Unit is a purpose built unit and has been designed to provide a good environment for people who have dementia. There is plenty of space and the rooms are arranged around a secure central courtyard. The corridor linking the rooms goes round in a circle so that people can move around freely. One part of the corridor is wider and creates a conservatory type space with comfy sofas and plenty of room for anyone who may be restless. The main house is a converted manor house with a more traditional feel but also has large rooms and lots of space so people are not confined to small areas. Throughout the home the standard of furnishings and decor is excellent. The kitchen and laundry areas are well equipped. A number of staff told us that Mr Claridge is very good about providing any equipment needed in the home and is always willing to provide the best available. There is a good staff recruitment process that makes sure the required checks are done before a person starts work. This helps to reduce the risk of someone unsuitable getting employment there. The manager and administrative staff are aware of changes in the way that staff vetting will be done in future and are keeping abreast of developments. Overseas staff are employed to work at the home and their recruitment is also dealt with correctly. Because of the good standard of their recruitment practice the home has been vetted and approved by the UK Border Agency to carry out certain parts of the immigration process themselves. This helps us to be confident that the home manages recruitment competently. We saw records to show there is a well organised approach to staff training. The manager showed us the February 2010 audits of training in each topic and a list of training booked for March. The training programme includes essential health and safety training such as moving and handling, first aid and food hygiene as well as care related subjects like palliative care, dementia, and nutrition. The emphasis placed on training was recognised in 2009 when the home won an award from the Chamber of Commerce for their practice in staff development. The home also has Investors in People status. Information in the staff surveys sent to us confirmed that staff consider they have the training they need. Some staff made comments that gave an insight into how they view the home and their role there, these included Excellent care and upholds all standards. I would be happy to place my parents here when necessary. The carers are very well trained. They work very hard for the individuals best interest maintaining the dignity and choice of residents at this same time. The home is very well resourced and managed and there is a good administrative support team to deal with all aspects of the day to day running of the home. We saw information about the quality assurance measures used by the owner and manager to help them keep the standard of the service under review and plan for improvements. In addition to achieving the Gold Standard Framework awarded for end of life care, the award from the Chamber of Commerce for training and the Investors in People award the home also uses the ISO external quality assurance monitoring system. In 2009 Meg Fallon the manager came top in a national competition for her outstanding contribution to social care. We saw some cards in the compliments file congratulating her on this. One relative described her as having Care Homes for Older People Page 6 of 11 Quiet professionalism and genuine compassion. It was clear from what we saw during the day and from other information that the owner and manager are respected for their commitment to providing a high quality service for people who live at the home. For example, one staff member wrote Lynhales is a lovely place to work where I feel that I am valued. The management lead from the top and always have time to spare, even when they are busy themselves. The manager hopes further improvements in the quality of the service will come about as a result of her being involved in a local dementia care working party looking at how life for people with dementia can be improved. What the care home does well: What they could do better: Lynhales Hall continues to provide an excellent service. We are confident that the owner and manager will act on our recommendations and continue to develop and improve the service. Some records could be developed further: The records of pressure area care would be improved by including details of progress made during treatment of wounds and by making sure body maps and/or measurements Care Homes for Older People Page 7 of 11 and diagrams or photographs are always used. The attentive hands on care we witnesses would be better supported if more specific details were given in some care plans where fairly generalised care statements had been used. When people have as required medication it is good practice to have a care plan explaining when someone should be given a dose and what staff should consider when making a decision about giving it (eg level of challenging behaviour, how long it has lasted, whether other approaches have been unsuccessful). This will help staff to be consistent in their decisions about this. The complaints records should include additional information to provide a more robust audit trail showing how the outcome has been reached. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Older People Page 8 of 11 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 9 of 11 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 2 7 8 The detail in some care plans could be developed to make them more specific. The records of pressure area care would be improved by including details of progress made during treatment of wounds and by making sure body maps and or measurements and diagrams or photographs are always used. When people have as required medication it is good practice to have a care plan guiding staff about the circumstances when someone should be given a dose and what they should consider wehn making a decision about giving it (eg level of challenging behaviour, how long it has lasted, whether other approaches have been unsuccessful). This will help staff to be consistent in their decisions about this. The complaints records should include additional information to provide a more robust audit trail showing how the outcome has been reached. 3 9 4 16 Care Homes for Older People Page 10 of 11 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for noncommercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. Care Homes for Older People Page 11 of 11 - 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!