Care Home: Lavender House

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What the care home does well The home is well-managed in the interests of people who live there and there is a strong culture of ensuring that service users are safe and comfortable and that their needs are met. The range of activities in the home is good and continues to improve. Staffing numbers were good and the staff observed on the day of the inspection visit were very competent in their roles, particularly in respect of communicating with people who live in the home. What has improved since the last inspection? There had been no requirements or recommendations from the previous inspection, but the Inspector had highlighted that the home needed to develop a quality assurance process based on seeking the views of people who used the service and people who had an interest in the service. The Manager had addressed this point. Other improvements since the previous inspection include the introduction of a formalised training package for staff and the introduction of a wider variety of activities for people living in the home. What the care home could do better: There were no requirements or recommendations made as a result of this inspection. We discussed some issues with the Manager who has told us these will be addressed. They included the chair lift being folded up when not in use, the laundry door being kept shut, individual records being kept of the activities service users were involved in and ensuring that Criminal Records Bureau checks were updated as necessary. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Lavender House Newtown Road Woolston Southampton Hampshire SO19 9HR     The quality rating for this care home is:   two star good service 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 assessment of the service. We call this a ‘key’ inspection. Lead inspector: Nick Morrison     Date: 2 8 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. 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 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 23 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 23 Information about the care home Name of care home: Address: Lavender House Newtown Road Woolston Southampton Hampshire SO19 9HR 02380444234 08712248456 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Carey Bettina Ely Type of registration: Number of places registered: Mr Richard Edward Kitchen,Mrs Elizabeth Kitchen care home 18 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users to be accommodated is 18. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Dementia (DE) Old age, not falling within any other category (OP). Date of last inspection Brief description of the care home Lavender House is a care home providing personal care and accommodation for up to 18 older service users, some of whom have dementia. It is owned by Mr and Mrs Kitchen, who have several years experience of owning care homes. The home is located in Woolston on the outskirts of Southampton, and the nearest shops and other Care Homes for Older People Page 4 of 23 Over 65 0 18 18 0 Brief description of the care home public amenities are relatively accessible. The home comprises a detached property with on street car parking for several vehicles to the side of the building and an accessible garden to the front. There are eight single bedrooms, two with an en-suite facility, and there are five double bedrooms, two with en-suite facilities. The bedrooms are situated on both ground and first floors. There is a lounge on the ground floor, which includes a dining area. The manager reported in the pre-inspection questionnaire that the fees for a place at the home range from #386 to #440 per week. Care Homes for Older People Page 5 of 23 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This report represents a review of all the evidence and information gathered about the service since the previous inspection. This included a site visit that occurred on 28th November 2008 and lasted six hours. During this time we toured the premises, looked at four service users files and met with two people living in the home. We also met with the Manager and spoke with three other members of staff and the relative of someone who lives in the home. All records and relevant documentation referred to in the report were seen on the day of inspection visit. We have also referred to the Providers Annual Quality Assurance Assessment (AQAA). Care Homes for Older People Page 6 of 23 What the care home does well: What has improved since the last inspection? What they could do better: 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 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 7 of 23 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 8 of 23 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users benefit from having their needs assessed prior to moving into the home and have the information they need about the service. Evidence: The home requires full assessment for all service users prior to deciding whether or not they can meet the persons needs in the home. Service users files showed that these assessments were in place and had been completed prior to the person moving in. Assessments were comprehensive and contained details of all needs. In addition to the above information the home spent time asking relatives to complete a short history of the person staying in the home. Care Homes for Older People Page 9 of 23 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users benefit from having their needs identified in a care plan and from having their healthcare needs met. They are protected by the homes medication policies and procedures and are treated with dignity and respect. Evidence: Each service user has a Care Plan in place. The Manager ensured that care plans were as brief as possible in order to cut down on the amount of paperwork required of care staff. The plans seen were comprehensive enough and reflected the needs of service users as described by their care management and pre-admission assessments. All care plans seen were kept under regular review and altered as necessary. The health needs of people living in the home were monitored well. Records were kept on service users files about their current health needs and records also showed that needs were responded to in a timely manner and that people were supported to access the healthcare services they needed. The service liaises with the families of service users to ensure they are kept informed about their relatives health needs. This was Care Homes for Older People Page 10 of 23 Evidence: confirmed in discussion with a relative spoken with on the day of the inspection. Observation throughout the day of our inspection visit showed that people living in the home were well presented and had support to maintain their own appearance where necessary. Medication in the home was well managed. They use a monitored dosage system and keep good records of all medication coming into and going out of the home as well as good, clear records of all medication administered to people living in the home. All staff are receiving training through Southampton City College in administering medication. The medication in the home was stored safely in a a drugs trolley secured to the wall. The Manager ensured that all service users had regular medication reviews so that people did not end up taking medication for long periods if they did not need it. Observation throughout the inspection, and discussion with service users and a relative, demonstrated that people living in the home were treated with respect and that their dignity was maintained at all times. The home also recorded service users preferred form of address. Care Homes for Older People Page 11 of 23 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users benefit from being able to exercise choice and control and have stimulating activities. They also benefit from good support in maintaining contact with friends and families and a good, balanced diet Evidence: Entertainers are brought into the home and there are also entertainment sessions led by staff. In Staff spend a lot of time interacting with service users and promoting socialisation among all the people living in the home. The home provides a range of activities to ensure that people living there receive stimulation and are able to interact with others. We discussed with the Manager the need to keep individual records for service users about the activities they were involved in. The new Manager had a system for doing this. The home did not encourage service users to watch the television during the mornings, but encouraged them to be involved in activities and to socialise with each other. We observed a good level of interaction between service users and staff were skilled in encouraging and supporting this. Some new activities such as card making and jewelery making had recently been introduced into the home and they had also planned to take people to a local nativity play and a pantomime. Care Homes for Older People Page 12 of 23 Evidence: People living in the home were supported to maintain contact with their families and friends. Records showed there were regular visits and that staff kept in touch with families to ensure they were kept up-to-date with what was happening with their relative. The relative we spoke with during the inspection told us that the home kept her well-informed about issues. The Provider has given her mobile telephone number to all relatives of people living in the home so that they are able to contact her at any time with any concerns or questions. Families were encouraged to visit the home at any time that was convenient to them and their relative. On the day of the inspection visit we observed how hospitable and welcoming were towards visitors. The home is aware of the need for people to maintain relationships and makes every effort to support them in doing so. Observation during the inspection visit showed that staff were aware of the need to interact with people living in the home throughout the day. They were skilled in communicating with people. The food in the home was of good quality. The food storage area showed that only good quality food was purchased for the home and menus showed that a range of nutritious meals were made available. This was supplemented by fresh fruit, crisps and sweets being available to all service users throughout the day. Service users and staff spoken with were very complimentary about the cook and the standard of the food produced. The cook spent time with service users getting to know the kinds of foods they preferred and also read peoples care plans to ensure that their individual dietary requirements were met. The kitchen area was well managed and kept very clean. During the day there were opportunities for service users to eat and drink according to their preferences. Tea, coffee, squash and sherry were made available to people throughout the inspection and biscuits were offered to people if staff thought they were hungry. On Saturdays the home organises a take away fish and chip meal for service users who want it and they were also able to have their friends and family visit to join in with th meal. Care Homes for Older People Page 13 of 23 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users benefit from a clear and effective complaints procedure and are protected by the homes adult protection procedures and practices Evidence: The home has a Complaints Policy in place and this has been made available to all service users and their families. A copy of the policy was also kept in the Service User Guide in each service users room. People told us they were aware of how to complain if they thought they needed to. A relative of a person who had recently moved into the home told us they had been given good information about the home, including the complaints procedure. There was a system in place to ensure that all complaints were recorded and responded to in line with the Complaints Policy. There had been no complaints. Systems were in place through policies and staff training to ensure that people were protected from abuse. Staff were aware of their role within this and the Manager was aware of the local reporting procedures for any suspected incidents of abuse of any kind. No such issues had been identified in the home and all he feedback we got from people suggested that they felt that people living there were safe. Care Homes for Older People Page 14 of 23 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users benefit from living in clean, safe, well-maintained environment. Evidence: All parts of the building were kept very clean, but the home retained a homely and comfortable appearance. The Provider ensured that items in the building were replaced as and when necessary. There was also a programme of routine maintenance and records were kept to demonstrate that maintenance issues were responded to swiftly. There were comprehensive cleaning rotas in place, including one for cleaning the kitchen. Infection control procedures were in place and were posted in places throughout the building to ensure that staff were able to refer to them throughout their work. Feedback from service users and their families confirmed that they thought the home was always kept clean and tidy. We discussed two issues with the Manager. One was the fact that the chair lift on the stairs was not always folded away after use and we observed one person struggling to get past it. The other issue was that the laundry door had a sign that stated that it must be kept shut at all times. It was open throughout the time of the inspection visit. In discussion with the Manager we were informed that there was no need for it to be kept locked at all times as it was not a risk to anyone in the home. We agreed with the Manager that the door should be kept shut or the sign should be Care Homes for Older People Page 15 of 23 Evidence: removed. The Manager also told us she would attend to the issue of the chair lift. Care Homes for Older People Page 16 of 23 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users benefit from being supported by adequate numbers of sufficiently trained staff and are protected by the homes recruitment policies and practices. Evidence: Staffing levels during the day reflected the needs of people living in the home and, from observation, it was clear that there were sufficient staff to meet the needs of people living in the home. There is always telephone support available twenty-four hours a day from the Manager of the home or the Provider, either of whom would attend the home if necessary. Records showed that support and supervision for all staff is being introduced and staff meetings have recently begun. Staff spoken with on the day of the inspection visit confirmed that they received good support and direction from the Manager. The recruitment records showed that all necessary pre-employment checks are undertaken prior to staff working in the home. In discussion the Manager demonstrated an awareness of ensuring the safety of people in the home by implementing a rigorous recruitment process. We discussed with the Manager the need to ensure that Criminal Records Bureau checks for staff were updated regularly. Care Homes for Older People Page 17 of 23 Evidence: There was a training system in place in the home and records showed that all staff training was up-to-date. Staff spoken with confirmed that they received regular training and that their training needs were met. Observation of staff working in the home on the day of the inspection visit showed that they were skilled and competent, particularly in communicating with people living in the home. Feedback from service users and relatives was very complimentary about the staff. Care Homes for Older People Page 18 of 23 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users are protected by the homes financial procedures and by the management of health and safety issues. Evidence: The current Manager of the home is registered and has demonstrated that she has the skills, knowledge, experience and qualifications to manage the home. During the inspection we also met the new Manager who had recently been employed. It is planned that she will take over from the existing Manager when she moves on to another role within the company. The new Manager will be making an application to become the Registered Manager. The home produces six monthly satisfaction questionnaires for staff, service users and their relatives. These are used in planning the development of the service. The current Manager will be moving to a different position in the company which will include managing quality across all the homes owned by the Provider. Care Homes for Older People Page 19 of 23 Evidence: Service users and their families are encouraged to manage their own financial affairs, although the home does hold some small amounts of money for some service suers where necessary. Receipts are kept of all transactions along with clear records. No outstanding Health and Safety issues were identified throughout the course of the inspection process. Feedback from staff and relatives of people living in the home was very complimentary about the management of the home. The relative of someone who had recently moved into the home told us the home was very well managed and that the Manager went out of her way to ensure that her relatives move into the home had been a positive experience. Care Homes for Older People Page 20 of 23 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, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 21 of 23 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, Care Homes 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 Care Homes for Older People Page 22 of 23 Helpline: 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 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 © (2008) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 23 of 23 - 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!