Care Home: Landona House

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What the care home does well Personal support is responsive to the varied and individual needs and preferences of the people who use services. The delivery of personal care is individual and flexible. Staff respect privacy and dignity and are sensitive to changing needs. The ethos of the home is that it welcomes complaints and suggestions about the service, uses these positively and learns from them. Service users spoke of their confidence in the staff that care for them. The service ensures that all staff receive relevant training. What has improved since the last inspection? What the care home could do better: This service has more strengths than areas for improvement. There are no significant areas for improvement needed relating to the health and safety of people using the service or issues of management. We are confident that the management will address any areas for improvement identified by the service itself i.e. to implement service audits in areas such as medication, infection control, care plans etc. The service now has measures in place to recognise its own weaknesses as they emerge and manage them well. CARE HOMES FOR OLDER PEOPLE Landona House Love Lane Wem Shrewsbury Shropshire SY4 5QP Lead Inspector Pat Scott Unannounced Inspection 26th September 2008 09:00 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 Landona House DS0000062558.V372613.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. Landona House DS0000062558.V372613.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Landona House Address Love Lane Wem Shrewsbury Shropshire SY4 5QP 01939 232620 01939 232620 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) Mrs Radhika Lakhubhai Ramlal Sisodia Mr Kamal Sisodia Post vacant Care Home 30 Category(ies) of Dementia - over 65 years of age (15), Learning registration, with number disability (2), Old age, not falling within any of places other category (13) Landona House DS0000062558.V372613.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home may provide accommodation and personal support to a maximum of 30 service users over the age of 65 years to include 15 service users with Dementia. Date of last inspection 5th July 2007 Brief Description of the Service: Landona House is registered to accommodate and provide personal care to thirty people. It is situated on the outskirts of the small town of Wem, and is within easy walking distance of various local facilities. Accommodation is provided in both single and shared bedrooms, some of which have en-suite facilities. Bedrooms are located on the ground and first floor with access to the upper floor via passenger lift. Communal areas comprise a large lounge, separate dining room, and a conservatory area. Weekly fees range from £370- £490.00 Information of the home and the provision of the service are available in the statement of purpose and service user guide, both documents are being revised. Reports for this service are available from the provider or can be obtained from www.csci.org.uk Landona House DS0000062558.V372613.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 *TWO star good service. This means the people who use this service experience good quality outcomes. We, the commission, used a range of evidence to make judgements about this service. This includes: information from the manager in the annual quality assurance assessment (AQAA), staff records kept in the home, medication audits, discussion with the owner, discussion with residents, tour of the premises, previous inspection reports, quality assurance processes, Fire Authority reports, Environmental Health Office reports, observation of care experienced by people using the service. What the service does well: What has improved since the last inspection? Refurbishment has occurred in bedrooms and communal areas with a commitment to maintain the improved décor of the home. The living environment is appropriate for the particular lifestyle and needs of the residents and is more homely, clean, safe, comfortable and well maintained. Service users spoken to feel that the home looks fresher and is more pleasant to live in. Landona House DS0000062558.V372613.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Landona House DS0000062558.V372613.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Landona House DS0000062558.V372613.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Key standard 3. 6 not applicable Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Written records for the admission of new people to the service demonstrate that the process is personalised and that consideration has been given to all aspects of care. EVIDENCE: A review of care records demonstrates that the service maintains preadmission and admission records. The Single Assessment paperwork is provided through the care management process. The assessment information forms the care plan based on the individuals needs. The manager keeps copies of the assessment summary and care plans of those carried out through care management arrangements. A resident spoken with stated that she had provided information to the manager prior to coming to live at the home. Landona House DS0000062558.V372613.R01.S.doc Version 5.2 Page 9 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): Key standards 7,8,9,10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service aims to address and meet assessed need through the continued development of plans of care, so that service users are provided with more person centre care. The manager understands the need to comply with safe medication systems and staff practice ensures that the home’s procedures are complied with and that service users health matters are always safely addressed. The actions of staff and their approach to care ensures that service users are treated with respect and their right to privacy is upheld. EVIDENCE: The care documentation was examined in detail for 3 residents. All have care plans derived from the initial assessments. Each plan has a recorded monthly Landona House DS0000062558.V372613.R01.S.doc Version 5.2 Page 10 review of the elements of care. They provide clear detail as to how care is to be delivered by staff in a way that the person prefers. Staff spoken with state that the care plans provide them with a clear picture of the person’s needs and progress. Keyworkers are also involved in care planning. The service conducts nutritional risk assessments. Daily records monitor the progress of individuals which provide clear indications of how a person has spent their day. The plans demonstrate contact with healthcare professionals such as the community psychiatric nurse or general practitioner. Residents all appeared well groomed with their hair, nails and clothes looking clean. The service accepts responsibility for administering medication to residents. The service has suitable storage facilities for prescribed drugs and for homely remedies. Written records for receipt, administration and disposal of medication are in place. The service does not audit the medication system on a monthly basis for compliance and errors but intends to do so. Landona House DS0000062558.V372613.R01.S.doc Version 5.2 Page 11 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): Key standards 12,13,14,15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff support people to keep in touch with family, friends and representatives so that they have appropriate relationships. The food in the home is of good quality so that the dietary needs of people are met. EVIDENCE: Social activities are provided. The service intends to improve resident consultation about leisure pursuits through regular meetings with staff, resident and their families. Leisure pursuits and hobbies are organised for regular dates in the home and for days out/trips etc. Residents helped organise stalls for the summer fayre held at the home. The activity co-ordinator produces a questionnaire to ascertain resident satisfaction with the activities provided. The service intends to provide a sensory garden. A computer is available for residents to use. Landona House DS0000062558.V372613.R01.S.doc Version 5.2 Page 12 All residents spoken with said they liked the food and it is always nicely cooked. One resident said she is very, very happy in the home and enjoyed going out. Relevant staff have had food hygiene training. Menus provide a choice of meal each day and staff assist service users with their choice each morning. Landona House DS0000062558.V372613.R01.S.doc Version 5.2 Page 13 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): Key standards 16,18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service has a complaint procedure which is accessible so that people who use the service have information of how to make complaints about the home. Training is provided so that residents are protected from abuse and have their legal rights protected. EVIDENCE: Residents spoken to say that they would go to the manager, owner or one of the staff if they had a problem. All expressed confidence that issues would be dealt with. Records show that concerns spoken about by service users had been promptly dealt with and a satisfied outcome reached. A suggestion box is in place or residents to use. Staff files examined had details of attendance at adult protection training. Landona House DS0000062558.V372613.R01.S.doc Version 5.2 Page 14 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): Key standards 19,26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Personalisation of the home has improved, through service user choice, so that people feel they live in a comfortable, clean home with modern furnishings and facilities which suit their individual needs and preferences EVIDENCE: The home is comfortable and clean. Furnishings and fittings are generally well presented. Vacant rooms are to be redecorated before a new resident is admitted. Assisted bathing facilities have improved. The home has a large well presented garden and a secure courtyard area which is to be upgraded to include a sensory garden. Landona House DS0000062558.V372613.R01.S.doc Version 5.2 Page 15 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): Key standards 27,28,29,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff in the home are being trained and are in sufficient numbers to fill the aims of the home and meet the changing needs of service users. EVIDENCE: Staffing rotas are in place. NVQ training is provided and the minimum ratio of 50 trained staff being at level 2 has been exceeded. Staff files kept in the home evidence the induction process provided for new starters. Initial training such as infection control, manual handling, first aid and medication are provided. After induction, candidates are assessed for suitability to move onto NVQ training. Staff turnover in the home is low so that continuity of care is provided. The residents know the staff very well and observation showed that they provide a personal but professional service. Three staff personnel files were selected for inspection. All the necessary identity checks have been carried out. Landona House DS0000062558.V372613.R01.S.doc Version 5.2 Page 16 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): Key standards 31,33,35,38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The management of the home is based on openness and respect. The service has quality assurance surveys in place so that people are assured that the overall conduct of the home is taking into account their views. People’s opinions are more central to how the home develops and reviews it’s practice, and the service is developing appropriate ways of making sure they get things right. So, people have confidence in the care home because it is run and managed well. EVIDENCE: Landona House DS0000062558.V372613.R01.S.doc Version 5.2 Page 17 The service sent us their annual quality assurance assessment (AQAA) when we asked for it. It was clear and gave us all the information we asked for. The manager was not present during this key inspection. The owner described her process of conducting surveys and the planned introduction of resident meetings. The manager and her staff have attended training events and updates to complement their roles within the home. Staff files seen record all training activity. The home has a system for managing residents’ own money. Accurate records are kept and audited. Equality and diversity for service users is promoted throughout the home within the assessments, care plans and activities. Equality for staff is promoted through the opportunities for training at all levels. Quality assurance takes place throughout the service in both a formal and informal manner. Meetings, surveys, day to day contact all provide records to show that resident satisfaction is at the heart of the service. The manager and her senior carers implement plans for improvement The provider produces a monthly report to the manager to demonstrate that the overall conduct of the service is being managed well. It covers areas such as; interviewing residents, relatives, staff, catering, complaints, health and safety. The home keeps records to show that the health and safety of residents is promoted and protected. The service conducts fire drills and has regular alarm tests. Landona House DS0000062558.V372613.R01.S.doc Version 5.2 Page 18 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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 X X X X X X 3 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 X 3 X 3 X X 3 Landona House DS0000062558.V372613.R01.S.doc Version 5.2 Page 19 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Landona House DS0000062558.V372613.R01.S.doc Version 5.2 Page 20 Commission for Social Care Inspection West Midlands West Midlands Regional Contact Team 3rd Floor 77 Paradise Circus Queensway Birmingham, B1 2DT 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 Landona House DS0000062558.V372613.R01.S.doc Version 5.2 Page 21 - 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. 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