Care Home: Lakeside Residential Home

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What the care home does well People receive good information as to what the home has to offer to help them decide if it is the right place for them. Their needs are fully assessed, with their involvement, should they decide they want to live at Lakeside. This assessment leads to a plan of how their support and care should be provided in accordance with their wishes. People receive a high standard of personal care and the home ensures that any health needs will be properly managed. There is equipment available to help people maintain their independence and ensure staff safety.Lakeside Residential HomeDS0000073143.V378437.R01.S.docVersion 5.2There is a good programme of activities at the home and people are supported to lead their lives as they choose. Where any risk exists this has been assessed and removed or reduced as necessary. The food is liked by most people. There is choice, variety and it is served to each individual. Special diets are properly catered for and the importance of a good diet understood by staff. People can feel free to talk about any concern they have and are aware how to make a formal complaint. The policies and procedures at the home ensure that people are protected from abuse. The home environment is clean, fresh, furnished to a high standard, properly maintained and meets the needs of the people who currently live there. Staff are provided in sufficient numbers and there are arrangements for this to be reviewed as necessary. Staff are safely recruited and people who use the service have the opportunity to be involved in their recruitment. Staff are encouraged to undertake training and training is provided in aspects of health and safety and conditions pertaining to people’s care needs. The manager does ‘competency checks’ to make sure staff have put training into practice. The registered manager and provider work together, listen to what people who use the service have to say, and work hard to ensure their choices and preferences are met. There is sound management practice and professionalism underlying a caring service. Health and safety are well attended to. What has improved since the last inspection? This does not apply as this is the first key inspection of the service. What the care home could do better: The home should consider the use of more open questions during people’s assessment, so that there will be more opportunity, and people may feel more comfortable, talking about what is important to them. Any medicine which is prescribed to be given ‘as necessary’ or ‘as required’ must be part of planned care. This will help ensure that its use is consistent, which ever person or staff administers it.Lakeside Residential HomeDS0000073143.V378437.R01.S.doc Version 5.2 The use of general terms of endearment by staff should be reconsidered because this gives the impression of disrespect and some people who use the service do not like it. There should be liquid soap and paper towels wherever personal care is provide so that hand washing arrangements for staff protect people from cross contamination. Key inspection report CARE HOMES FOR OLDER PEOPLE Lakeside Residential Home Lower Maddaford Southcott Okehampton Devon EX20 4NL Lead Inspector Anita Sutcliffe Key Unannounced Inspection 10th November 2009 09:00 DS0000073143.V378437.R01.S.do c Version 5.3 Page 1 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should: • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care homes for older people can be found at www.dh.gov.uk or bought 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. The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Lakeside Residential Home DS0000073143.V378437.R01.S.doc Version 5.2 Page 2 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Lakeside Residential Home DS0000073143.V378437.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Lakeside Residential Home Address Lower Maddaford Southcott Okehampton Devon EX20 4NL 01837 52078 01837 52078 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) Mr Roger Langbridge Mr Ian Langbridge, Mrs Joyce Langbridge Miss Louise Waldron Care Home 24 Category(ies) of Old age, not falling within any other category registration, with number (24) of places Lakeside Residential Home DS0000073143.V378437.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 category: 2. Old age, not falling within any other category (Code OP) The maximum number of service users who can be accommodated is 24. Not applicable as Lakeside is a new service. Date of last inspection Brief Description of the Service: Lakeside is a service providing accommodation and care to a maximum of 24 older people. Health care needs are met through local health care services, such as district nursing. The home is in a rural situated next to a golf course, four miles from the town of Okehampton. There is no public transport but the home has its own minibus. Level access is available throughout the building. All rooms are single occupancy and en suite. There are two additional bath and shower rooms available within the building. Most of the rooms are on the ground floor. There is a variety of lounge and dining space and a hairdressing room. There are views of Dartmoor, a lake and attractively laid gardens. Twenty four hour staff are available and the providers closely involved in the day to day running of the home. Fees at the time of this inspection range from £450 to £600 a week. An additional charge is made for chiropody, hairdressing, newspapers and entrance fees to outside venues. No charge is made for the normal use of the minibus. Information about the home is available at the entrance. There is also a website with information. Lakeside Residential Home DS0000073143.V378437.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 2 star. This means the people who use this service experience good quality outcomes. Had this not been a new service it would have been rated as excellent, but as yet we do not have a sustained track record of delivering good performance and managing improvement. The Commission has collected information about Lakeside since it was registered May 2009. Toward this inspection we sent surveys to people who use the service (6 were returned), and staff (5 were returned) and a community nurse with knowledge of the home. The home provided us with information about the service. This includes data, such as how many staff work there and when policies were last reviewed. It also gives the home the opportunity to tell us what they do well, any barriers to improvement and what improvements are planned. We did one unannounced visit to the home. We looked closely at the care of two people who use the service. This included meeting them, speaking with staff about their needs and examining records pertaining to their care. We also observed staff going about their work and their interaction with the people in their care. We saw most of the building and several bedrooms. We examined some policies, procedures and records. We asked questions of three staff and the manager and registered provider, who were present throughout. People who use the service may be described within this report as residents, clients, service users or patients. What the service does well: People receive good information as to what the home has to offer to help them decide if it is the right place for them. Their needs are fully assessed, with their involvement, should they decide they want to live at Lakeside. This assessment leads to a plan of how their support and care should be provided in accordance with their wishes. People receive a high standard of personal care and the home ensures that any health needs will be properly managed. There is equipment available to help people maintain their independence and ensure staff safety. Lakeside Residential Home DS0000073143.V378437.R01.S.doc Version 5.2 Page 6 There is a good programme of activities at the home and people are supported to lead their lives as they choose. Where any risk exists this has been assessed and removed or reduced as necessary. The food is liked by most people. There is choice, variety and it is served to each individual. Special diets are properly catered for and the importance of a good diet understood by staff. People can feel free to talk about any concern they have and are aware how to make a formal complaint. The policies and procedures at the home ensure that people are protected from abuse. The home environment is clean, fresh, furnished to a high standard, properly maintained and meets the needs of the people who currently live there. Staff are provided in sufficient numbers and there are arrangements for this to be reviewed as necessary. Staff are safely recruited and people who use the service have the opportunity to be involved in their recruitment. Staff are encouraged to undertake training and training is provided in aspects of health and safety and conditions pertaining to people’s care needs. The manager does ‘competency checks’ to make sure staff have put training into practice. The registered manager and provider work together, listen to what people who use the service have to say, and work hard to ensure their choices and preferences are met. There is sound management practice and professionalism underlying a caring service. Health and safety are well attended to. What has improved since the last inspection? What they could do better: The home should consider the use of more open questions during people’s assessment, so that there will be more opportunity, and people may feel more comfortable, talking about what is important to them. Any medicine which is prescribed to be given ‘as necessary’ or ‘as required’ must be part of planned care. This will help ensure that its use is consistent, which ever person or staff administers it. Lakeside Residential Home DS0000073143.V378437.R01.S.doc Version 5.2 Page 7 The use of general terms of endearment by staff should be reconsidered because this gives the impression of disrespect and some people who use the service do not like it. There should be liquid soap and paper towels wherever personal care is provide so that hand washing arrangements for staff protect people from cross contamination. 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 on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line – 0870 240 7535. Lakeside Residential Home DS0000073143.V378437.R01.S.doc Version 5.3 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 Lakeside Residential Home DS0000073143.V378437.R01.S.doc Version 5.3 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3 & 5 Standard 6 does not apply to Lakeside. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are fully informed as to what the home has to offer and their needs are understood on admission. EVIDENCE: We looked at whether people receive enough information about the home to make an informed decision as to whether it will suit their needs. The six people who completed surveys told us that they got enough information about the home to decide if it was the right place for them. The home reports that a website is also available with information. One person we met told us that they knew everything they needed to know when they moved in. In one of the sitting rooms, and at the home’s entrance, there is much information about the service and other services which might be important to Lakeside Residential Home DS0000073143.V378437.R01.S.doc Version 5.3 Page 10 people. This includes the required Statement of Purpose and Service User Guide. The six people who completed surveys told us that they had received terms and conditions (or a contract) on the service, as they should. This helps to ensure that the expectations of the person moving in and the organisation are clear and they are therefore more protected. We looked at the care of two people who use the service, each new to the home. The first told us they were very happy with the home and how their needs were being met, adding: “They were very, very good at admission. I came for a few days and chose the room. Almost 100 ”. We found that the home are supporting their independence well. The second spoke highly of the service but was having a problem adjusting to a new way of life. We looked at the records of the two people’s assessment. Each appeared sufficiently detailed and contained some very important information, such as medical history and how health conditions have been managed. The assessment was quite broad in content and included family and social history, hobbies and interests. In addition there were nutritional, falls and moving and handling risk assessments. The home has also collected important information on how people are protected in law, including whether they have made an Advanced Decision to refuse treatment and whether they have Lasting Power of Attorney arrangement in place. However, we felt that a more open approach to questions might provide the opportunity for people to express their individual needs better. We are told that the manager goes to people’s home to assess them, people are encouraged to visit for the day, that each person has a month’s trial at Lakeside during which their needs are reviewed and each person receives written confirmation that their needs can be me before they are admitted to the home. Lakeside Residential Home DS0000073143.V378437.R01.S.doc Version 5.3 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People’s care and support is provided as they would wish and to a high standard. The home’s approach to ensuring dignity needs to be reviewed. EVIDENCE: Each person living in the home must have a plan of care that accurately reflects his or her care needs and identifies the action required by staff to meet those needs. The plan of care must be reviewed a minimum of monthly in consultation with the person or their representative and updated when the person’s needs change. This is to ensure that a person’s changing needs are assessed and met. We looked at the care plans of two people who use the service and found they were a good guide to how staff were to provide care and support and how the person using the service was involved in the planning. Plans included clear Lakeside Residential Home DS0000073143.V378437.R01.S.doc Version 5.3 Page 12 information relating to people managing their own medicines. There was information on managing health problems and assessments of risks, which were specific to the person; for example, blood sugar levels of a person with diabetes. Each of the five staff who responded to survey told us they are always given up to date information, such as through care planning, about the needs of the people who they support. Those we spoke with had the necessary knowledge of people’s needs and one told us: “People’s care plans are very detailed and we update them regularly”. Each of the people who responded to survey told us that staff always listen and act on what they say. All the information we received suggests that people’s needs are fully met. What they told us, their records and staff knowledge about them was consistent. We saw records which showed lots of involvement of health care professionals where this was necessary. Each person who responded to survey told us that they always get the care, support and medical care they need. One added: “All areas of care are excellent”. A district nurse with knowledge of the home said: “As far as we are aware the staff contact us if there are concerns about residents and ask for advice when appropriate. The residents appear to be well cared for and content.” We looked at how the home helps people to manage their medicines or does so for them where necessary. Care plans describe how a person is supported to manage their medicines. Each person’s medicines are kept in their room in lockable storage. Where necessary they also have a medicines fridge. The home takes measured steps to monitor that medicines are handled properly so mistakes are avoided. The home keeps a stock of medicines. This was orderly and securely kept, including medicines which are called ‘Controlled Drugs’ and need specialist storage. We saw that records were clear; staff used codes to indicate why a medicine is not given and any variable dose is properly recorded. We discussed the need for any medicines, prescribed to be given ‘as necessary’ or ‘as required’ to be part of planned care, so there is less change of mishandling and the use of the medicine will be consistent. The home reports that people are treated with respect and it was clear that staff are attentive and working hard to provide a good service. However, people were not called by their name; instead terms of endearment, such as ‘sweetie’, were used repeatedly in the sitting room. The two people we spoke with said they felt staff treated them with respect but when we asked whether they minded being called sweetie one told us that she tolerated it, adding that Lakeside Residential Home DS0000073143.V378437.R01.S.doc Version 5.3 Page 13 she wants to “conform to the expectations of the home”. We discussed this with the manager and provider. Each person has single room occupancy and their own en suite facility so privacy should be easy to maintain regarding personal and health care. People have the option of locking their door if they wish. Lakeside Residential Home DS0000073143.V378437.R01.S.doc Version 5.3 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 People using the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have the support to lead as full a life as they choose and are able. EVIDENCE: One person who uses the service told us: “The home makes everyone feel special and goes to a lot of trouble to give each of us what we would like to eat. They welcome visitors and always offer them refreshment. They take phone messages when they are not able to visit. It makes you feel secure and happy. A real family feel”. Staff told us: • “We put the resident’s needs first. We provide activities and outings and respect their wishes.” • “It’s a lovely family run home that gives the ultimate attention to every detail of the client’s needs. We care for the individual’s needs which makes everyone, staff and clients, feel at home.” DS0000073143.V378437.R01.S.doc Version 5.3 Page 15 Lakeside Residential Home • “We have meetings where residents are encouraged join in and make suggestions and put forward ideas for their weekly trips out etc.” We saw that regular activities are listed on a notice board. People have the opportunity to go out from the home every week. Trips have included Tavistock shopping and a garden centre. People are able to bake; there are exercises to music, bingo and board games. People make their choices known through the monthly residents’ meetings. We were told that one area of the home may become a ‘cinema’. We saw people sharing company and reading newspapers in one of the very attractive lounges. Bedrooms are much personalised and interests, hobbies and information relevant to each person, for example the death of a loved one, is recorded in their care records. We were told: “There are absolutely no visiting restrictions” at Lakeside. We saw staff offering choice and being attentive to people’s needs. Five told us through survey that they always like the meals at the home and one told us they usually do. The day of our visit there was a choice of chicken curry or fish cakes each with vegetables of choice. It was good to see that the meal was not served plated, but people make their choices and staff served what they preferred. There was a choice of desert from a chilled cabinet or the option of Bread and Butter pudding. The meal was tasty, nicely presented and enjoyed by the inspector. The dining room is comfortable and very attractive. One person, who requires a special diet, said her needs were well catered for. Wine is served with meals when requested. The menu is varied and liked by most. Lakeside Residential Home DS0000073143.V378437.R01.S.doc Version 5.3 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Any complaint will be properly responded to and people are protected from abuse. EVIDENCE: Each of the six people who responded to survey told us that they know who to speak to if they are not happy and that they know how to make a complaint. We saw that the Complaints Policy was displayed on a notice board. It included the contact details for the Commission and made clear that the Commission may be contact ‘at any stage’ of a complaint should people wish to do so. The home records that they have received no complaints. We have received no complaints about the service. Staff receive training in how to safeguard vulnerable adults from abuse. We asked two staff and the registered manager what action they should take if they had reason to believe a person was subject to abuse. Each was aware of the correct way to respond. We looked at the home’s whistle blowing policy (how to alert concerns which might be abuse). It contains the contact details for the local authority safeguarding team as it should. Lakeside Residential Home DS0000073143.V378437.R01.S.doc Version 5.3 Page 17 There have been no safeguarding alerts relating to Lakeside, which might indicate abuse. Lakeside Residential Home DS0000073143.V378437.R01.S.doc Version 5.3 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23, 24, 25 & 26 People using the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefit from a comfortable, attractive, safe and well equipped home. EVIDENCE: One person said in the survey response: “Excellent accommodation”. We visited all shared areas of the home, some bedrooms, the laundry and kitchen. We found that the home was well maintained with good arrangements for this to continue. There is level access throughout and very pleasant, well tended and interesting gardens. Where necessary people have signage to help them find their way about and we were told of other methods being considered for this. Lakeside Residential Home DS0000073143.V378437.R01.S.doc Version 5.3 Page 19 All the rooms are en-suite with four rooms having had a new large en-suite shower facility purpose built. The other rooms have an en-suite bathroom; however the baths may not be accessible to anyone who needed assistance with bathing as they are fixed to one wall. We were told this will be amended in the future. All en-suite rooms have a W.C. and hand wash basin. There is a call bell system in the bedrooms and en-suite and the radiators are guarded to protect people from contact burns. The provider told us that the water is regulated so that it cannot scald people. People benefit from stunning views. There is a variety of well equipped, attractive sitting room space furnished to a high standard and a hairdressing salon. People’s rooms are very homely and personalised, containing items of their own furniture and things of importance to them. Each door is lockable, offering the option of more privacy. We were told that equipment is provided as necessary. A staff told us: “Roger is very good at providing equipment. He never quibbles.” We discussed the use of assisted technologies, for example, a hearing loop for those with poor hearing. There is lots of room for the storage of equipment so it can be kept out of the way unless needed. Each person told us through survey that the home is always fresh and clean. The laundry is well equipped to meet the needs of the home. Staff have protective clothing, such as gloves and aprons, available to them to reduce the possibility of cross contamination. Staff receive training in infection control. We found the home to be very clean, fresh and pleasant. However, bedrooms do not have liquid soap and paper towels for staff to wash their hands before and following personal care. This is strongly recommended. Lakeside Residential Home DS0000073143.V378437.R01.S.doc Version 5.3 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefit from a staff which is safely recruited, properly trained and in sufficient numbers to meet their individual needs. EVIDENCE: Five people told us through survey that staff are always available when they need them and one said they usually are. Four staff told us through survey that there are always enough staff to meet the individual needs of all the people who use the service and one said there usually are. There were nine people resident at Lakeside when we visited and we found that there were enough staff on duty to meet their individual needs. The registered manager explained how staffing numbers will increase as the number of people resident increases. We looked at whether recruitment practice protects people from staff who are unsafe or unsuitable to work with them. We found that references were received and there were checks to see if they had a criminal record. However, currently staff do not make a signed statement as to whether they have committed any criminal offence, have ‘spent’ convictions or have received a Lakeside Residential Home DS0000073143.V378437.R01.S.doc Version 5.3 Page 21 police Caution. This should be included within the recruitment process. It is commendable that people who use the service have the opportunity to interview potential staff. Each staff told us through survey that their induction covered everything they needed to know to do the job when they started. We were told that new staff spend one day with the manager looking at important information, such as the Codes of Conduct, health and safety etc. Staff told us they spend two weeks shadowing a senior staff when new; during this time they are additional to the normal number of staff on duty. The home uses a computerised system to monitor the training people receive. Each staff told us that they are being given training that is relevant to their role, helps them understand and meet people’s needs, keeps them up to date with new ways of working and gives them knowledge about health care and medication. Training records show that staff receive training in, amongst other training: The Principles of Care, first aid, food hygiene, infection control, pressure care and safeguarding adults. They have yet to be trained in the Mental Capacity Act and deprivation of liberty safeguards. Staff are encouraged to undertake National Vocational Qualifications (NVQ) in care. NVQ’s are an indicator of competence. Lakeside Residential Home DS0000073143.V378437.R01.S.doc Version 5.3 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 34, 35, 36, 37 & 38 People using the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is run in the best interest of people who use the service by a provider and manager who are setting high standards. EVIDENCE: Miss Waldron was registered to be the manager of Lakeside May 2009. She had previous experience of managing the day to day care of older people and has worked in care for some years. She was aware that as the registered manager she would be legally responsible for ensuring that the regulations and standards were upheld. She achieved her National Vocational Qualification (NVQ) level 3 in care in 2001 and her Registered Managers Award in December Lakeside Residential Home DS0000073143.V378437.R01.S.doc Version 5.3 Page 23 2004. She stated she has applied to undertake the NVQ level 4 in care now she is settled into her new post. She has also attended other relevant training courses. People told us: “The home makes everyone feel special and goes to a lot of trouble… It makes you feel secure and happy. A real family feel”. There were no negative comments from any person who has completed a survey for us. One staff said of the home: “Lakeside is by far the best residential home I have worked in. It is a pleasure to come to work. We have meetings where residents are encouraged join in and make suggestions and put forward ideas for their weekly trips out etc.” The home is developing a quality review system. This should ensure that the home is able to make continual improvement. There are regular meetings for people where they can discuss the service. The registered provider Mr. Roger Langbridge, told us: “We listen well. We deal with suggestions and ideas. We try to encourage residents. We want them to have ‘ownership’ of the home”. To this end people have been invited to be involved in interviewing new staff. The registered providers have day to day involvement in the home and also do a monthly ‘audit’ and report back to the manager. There are staff meetings and ‘competence’ checks, for example, setting off the fire alarms to check staff respond correctly. Staff receive monthly, formal supervision of their work. We discussed surveying opinion of the service and further developing the quality monitoring through a systematic cycle of planning, action and review. At the point that the home was registered the Commission was satisfied that people are safeguarded by the accounting and financial procedures of the home. This was not looked at again for this inspection. We looked at how people are supported to manage their finances. Most people keep their money and valuables with them but people are able to use secure storage at the home. We saw records for this were complete; two people sign to record any transaction. Miss Waldron checks the balance monthly to ensure it is correct. We looked at how the home have developed policies and procedures for staff to follow and found these were clear and appeared to be of a good standard. Staff were fully aware of where to find them. Personal information on people is held in accordance with the Data Protection Act 1998 in that it is only available to them and those with a need to know; care staff. We looked to see if health and safety were properly attended to. We saw no concerns during our look around the home and the standard of maintenance appeared high. Staff receive the necessary health and safety training and the Lakeside Residential Home DS0000073143.V378437.R01.S.doc Version 5.3 Page 24 manager does some ‘competence’ checks to see if the training is put into practice. We saw good health and safety signage in the home and there are emergency plans for gas leak, missing persons and failure of utilities, such as gas and electric. We saw that the manager is making arrangements for the regular servicing of equipment. We found that generic and individual risks to people are assessed so that any steps to remove or reduce risk can be taken. Lakeside Residential Home DS0000073143.V378437.R01.S.doc Version 5.3 Page 25 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 4 3 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 4 3 3 3 3 3 2 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 4 3 3 3 3 3 4 Lakeside Residential Home DS0000073143.V378437.R01.S.doc Version 5.3 Page 26 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 OP9 Regulation 13(2) Requirement Any medicine which is prescribed to be given ‘as necessary’ or ‘as required’ must be part of planned care. This will help ensure that its use is consistent, which ever person or staff is involved in its use. Timescale for action 10/12/09 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 2 Refer to Standard OP3 OP10 Good Practice Recommendations The home should consider the use of more open questions so that people have the opportunity and feel comfortable making their diverse needs known to the home. The use of general terms of endearment by staff should be reconsidered because they give the impression of disrespect and some people who use the service do not like it. There should be liquid soap and paper towels wherever personal care is provide so that hand washing arrangements for staff protect people from cross contamination. DS0000073143.V378437.R01.S.doc Version 5.3 Page 27 3 OP26 Lakeside Residential Home Lakeside Residential Home DS0000073143.V378437.R01.S.doc Version 5.3 Page 28 Care Quality Commission Care Quality Commission South West Region Citygate Gallowgate Newcastle Upon Tyne NE1 4PA National Enquiry Line: 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. Copyright © (2009) Care Quality Commission (CQC). 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