Care Home: Lea House Residential Care Home

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What the care home does well Everyone was given an information pack to help them make decisions about Lea House. The documents were available in large print, or could be translated into another language and would be provided within a few days of the request. It was normal practice for the manager to visit people in their home or in hospital so that they could make an assessment of the persons needs. This Lea House Residential Care Home DS0000073262.V376058.R01.S.doc Version 5.2 helped them to measure the levels of risk and dependency in order to make sure that their needs could be met. People were also encouraged to visit the home before they made any decisions. However if they were unable to visit, they would be shown a photograph album during the home/hospital assessment visit to give them some idea of what the home looked like and what was offered. Following the assessment, the person was informed in writing if a place would be offered depending on not whether his or her needs could be met. The home had a key worker system which meant that each resident was allocated a care worker to help them settle into the home quickly and to have someone to go to with any problems. The people who completed a survey form said that always/usually they received the care and support they needed and that the staff listened and acted on what they said. A care plan was in place which had been put together from the assessment and talking with residents and relatives. The care plan told the care staff what the needs of the people were and how these needs were to be met. Everyone`s health and personal care needs were met through GP visits, district nurse, opticians and chiropodists. There was a letter from one of the GP`s confirming that there was a good level of service from the new staff at Lea House and that they were always helpful and professional. Letters were also on file from the district nurse saying that communication between them and the staff team was good. The surveys said that always/usually the home made sure that they got the medical care they needed. The owners of the home had introduced a residents `Charter of Rights` to respect peoples right to have their privacy and dignity respected. During our visit we saw no practice which did not respect the person`s privacy, dignity and choice. People said that they could go to bed and get up when they wished, and they could have an alternate meal if they did not like what was on the menu. Menus rotated over a four week period. Local produce was used by the cook such as the butcher and fish supplier. The owners of the home had employed an activities co-ordinator who kept a record of what had taken place. A mini bus was available for day trips or short outings. Again people who completed a survey said that always/usually the home arranged activities that they could take part in. One of the people we saw said that the entertainer who had visited on the day of our visit was funny and that they liked him. The home was for the most part reasonably decorated and furnished. As stated in the next section the new owners were in the process of upgrading the property. Lea House Residential Care Home DS0000073262.V376058.R01.S.doc Version 5.2 Page 8All staff had received a Protection of Vulnerable Adults (POVA) `First Check` before they commenced work and they also had a Criminal Record Bureau (CRB) check. New staff had to complete an application form, have an interview, provide the names of two people for reference purposes and complete and induction programme. They were also given a staff handbook which contained information about work practices and disciplinary procedures etc. New staff had to complete the induction programme. The majority of the surveys we received said that the induction covered everything they needed to know to do the job very well Staff had received training in core skills such as moving and handling, safe handling of medicines, safe guarding adults, health and safety, infection control and first aid. Seven of the staff team had also completed a National Vocational Qualification (NVQ) level 2 or above in care. Senior staff had received training in the Mental Capacity Act and Deprivation of Liberty Safeguards. This training was being passed down to all the staff team. A supervision plan had been put in place and had started. We were able to see the forms that had been completed after each supervision session. These forms recorded what had been discussed such as working practice, skills and knowledge, and how any gaps could be filled with training either `in house` or through outside training organisations. Staff meetings had also taken place. The information we received from the managers said that they encouraged and listened carefully to the views of the people who used the service and their relatives and friends. Over the last few months five service user surveys had been completed on the following; medication; hairdressing; meals and meal times; birthday celebrations. Action had been taken on these areas to improve the service. Resident meetings had taken place there was a suggestion box and individual day to day contact. Those that completed a survey said that always/usually staff listened and acted on what they said and they received the care and support they needed. All of them said that there was someone they could speak to informally if they were not happy. The owner visited the home regularly and completed each month a report about the home which was required under the Care Homes Regulations. We saw copies of the reports during our visit; they were comprehensive and made reference to items that needed improving or attending to as well as the good things that had taken place. During these visits the owner made sure that a range of peoples views were sought and followed up where necessary.Lea House Residential Care HomeDS0000073262.V376058.R01.S.docVersion 5.2Page 9The information we received before our visit and the practice we saw led us to believe that the owners and managers were aware of safe working practices and had in place policies and procedures to make sure that both the people who used the service and the staff team were kept safe. What has improved since the last inspection? This is a new service however the new owners since taking over on the 23rd February 2009 had started a programme of re-decoration both inside and out side of the home. All the radiators had been covered to protect people from burns and the fire alarm control panel had been replaced. They had also introduced new care plans and care files for recording information about the people who used the service, an induction programme for new staff and a training and development plan. The organisation had the Investors in People award. The owner said that they were bringing the investors in people documentation that was used in the other homes into Lea House. What the care home could do better: Any mistakes in the controlled drugs book need to be crossed out with a single line and the correct entry made at the side. The application form should be amended to replace the `ten year employment history` to `full employment history from leaving school or full time education and explain any gaps.` This is to make sure that as much as can be is done, so that only suitable people are employed. The personnel files should clearly show where applicable that a person has permission to work. Key inspection report CARE HOMES FOR OLDER PEOPLE Lea House Residential Care Home 37-39 Lea Road Heaton Moor Stockport Cheshire SK4 4JT Lead Inspector Mrs Jackie Kelly Key Unannounced Inspection 12th August 2009 10:40 DS0000073262.V376058.R01.S.do c Version 5.2 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. Lea House Residential Care Home DS0000073262.V376058.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 Lea House Residential Care Home DS0000073262.V376058.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Lea House Residential Care Home Address 37-39 Lea Road Heaton Moor Stockport Cheshire SK4 4JT 0161 443 1049 0161 432 6313 leahouse@btconnect.com 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) Willowbank Rest Home Limited Care Home 27 Category(ies) of Dementia (10), Old age, not falling within any registration, with number other category (27) of places Lea House Residential Care Home DS0000073262.V376058.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following categories of service only: Care home only- Code PC To people of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category- Code OP (maximum number 27) Dementia- Code DE (maximum number 10) The maximum number of people who can be accommodated is: 27 Date of last inspection New service – first inspection Brief Description of the Service: Lea House was registered with new owners on the 23 February 2009. The home is one of three owned by the organisation. Lea House was originally two semi-detached houses which have been converted into one and an extension and conservatory added. The home is set over four floors; there is a full passenger lift to all floors. Three of the twenty-four bedrooms are double rooms; these rooms have screens to give people privacy. Thirteen of the rooms have an en-suite which consists of a toilet and wash basin. There are gardens to the front and rear of the building which are well kept. There is car parking space and a raised decked area leading from the conservatory at the back of the house. Ramped access is in place to the front door. The home is close to local shops, a post office, churches, restaurants, cafes and motorway networks. The fees range from £384.00 to £442.00. However the actual amount payable will depend on the persons financial circumstances. There was a statement of purpose and service user guide available. There is no previous inspection report as the home has new owners. Lea House Residential Care Home DS0000073262.V376058.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. This means that the people who use the service experience good quality outcomes. The home has new owners and this is the first inspection the home has had under them. The report was written on behalf of the Care Quality Commission therefore throughout the report the terms ‘we’ and ‘us’ are used. This was a key inspection which the managers did not know we were going to make. We spent five and half hours over two days at the home. During this time we looked at the records of four people who used the service, the personnel and training files of those people who had been newly appointed, policies and procedures and the service user guide. We also spoke with the operations manager, the owner, senior care workers, care workers and the people who used the service. Before the inspection we asked the managers of the home to complete a form called an Annual Quality Assurance Assessment, AQAA, to tell us what they did well and what they needed to do better. We felt time had been given to filling in the form, that it had been completed honestly and that it showed us the manager saw the service being provided the same way that we did. Also before our visit to the home we sent out surveys to staff and the people who used the service. We had returned to us five completed staff surveys and three service user surveys. The responses we received were positive. The following were some of the general comments we received from both groups to the question ‘what does the home do well?’ ‘Sociable staff; some friends here, like sitting in the garden;’ ‘look after me – help me get dressed and ready – take me to the hospital – keep my room nice;’ ‘the staff welcomed me – helpful – care for your welfare and daily needs – are there for reassurance when needed’. ‘Provide good staff room facility - beautiful garden with great seating and dining patio area - lovely bright conservatory - comfortable and ample seating for all residents - attractive dining room - good security alarm system on all external doors - liaise with outside professional agencies - good rapport, also working alongside the district nurse team - have the character of a personal, private home - not a purpose built, clinical environment - has an established, long serving team of great staff’; ‘takes extremely good care of the residents - staff are encouraged to bounce ideas off each other which would enhance the quality of life of the resident. Staff are supported extremely well by the management’. Lea House Residential Care Home DS0000073262.V376058.R01.S.doc Version 5.2 Page 6 To the question what could the home do better the people who used the service did not give us any suggestions. However the staff team did say; ‘provide reading matter in both communal areas i.e. newspaper and magazines on a daily basis (enough for more than one client at a time to read) and a library of books - large print - possibly from library old stock. In my opinion Lea House is a very well run home and would be hard pressed to do any better;’ ‘More staff on rather than 3/4 daily (need more staff on) so we could get entertainment daily going for residents and we could have more quality time for residents as we only have 3/4 staff a day we cant spend time with our residents. Residents to have choice at mealtimes (not all residents like same meals as others)’. We did ask the owner about the staffing levels and the meals. We found that that the rotas showed five staff on duty including a manager from the hours of 8am to 8pm. Both the owner and the senior care worker we spoke with felt that this was sufficient staff to meet the needs of the people. With regard to the meal it is a set menu but people could have an alternative if they wished. The surveys and the people we spoke with during our visit said that they always or usually liked the meals and that they could have something different if they wanted it. The lounge on the day of the inspection had an offensive odour as did one of the bedrooms we looked at. This was discussed with the owners and the senior manager. The owner said that every effort was being made to make the rooms more pleasant and that the lounge would be looked at. A programme of redecoration was in place. Neither the managers of the home nor we had received any complaints or safeguarding adult referrals or investigations. None of the people who completed a survey form or those we had contact with on the day of our visit had any complaints. The home did not provide an intermediate care service that required them to offer rehabilitation services including treatment and recovery programmes to enable the person to return home after a short stay. The registered manager had left the company just before our inspection visit to the home. The owner said that they were actively seeking a replacement and hoped that they could do this soon. What the service does well: Everyone was given an information pack to help them make decisions about Lea House. The documents were available in large print, or could be translated into another language and would be provided within a few days of the request. It was normal practice for the manager to visit people in their home or in hospital so that they could make an assessment of the persons needs. This Lea House Residential Care Home DS0000073262.V376058.R01.S.doc Version 5.2 Page 7 helped them to measure the levels of risk and dependency in order to make sure that their needs could be met. People were also encouraged to visit the home before they made any decisions. However if they were unable to visit, they would be shown a photograph album during the home/hospital assessment visit to give them some idea of what the home looked like and what was offered. Following the assessment, the person was informed in writing if a place would be offered depending on not whether his or her needs could be met. The home had a key worker system which meant that each resident was allocated a care worker to help them settle into the home quickly and to have someone to go to with any problems. The people who completed a survey form said that always/usually they received the care and support they needed and that the staff listened and acted on what they said. A care plan was in place which had been put together from the assessment and talking with residents and relatives. The care plan told the care staff what the needs of the people were and how these needs were to be met. Everyone’s health and personal care needs were met through GP visits, district nurse, opticians and chiropodists. There was a letter from one of the GP’s confirming that there was a good level of service from the new staff at Lea House and that they were always helpful and professional. Letters were also on file from the district nurse saying that communication between them and the staff team was good. The surveys said that always/usually the home made sure that they got the medical care they needed. The owners of the home had introduced a residents ‘Charter of Rights’ to respect peoples right to have their privacy and dignity respected. During our visit we saw no practice which did not respect the person’s privacy, dignity and choice. People said that they could go to bed and get up when they wished, and they could have an alternate meal if they did not like what was on the menu. Menus rotated over a four week period. Local produce was used by the cook such as the butcher and fish supplier. The owners of the home had employed an activities co-ordinator who kept a record of what had taken place. A mini bus was available for day trips or short outings. Again people who completed a survey said that always/usually the home arranged activities that they could take part in. One of the people we saw said that the entertainer who had visited on the day of our visit was funny and that they liked him. The home was for the most part reasonably decorated and furnished. As stated in the next section the new owners were in the process of upgrading the property. Lea House Residential Care Home DS0000073262.V376058.R01.S.doc Version 5.2 Page 8 All staff had received a Protection of Vulnerable Adults (POVA) ‘First Check’ before they commenced work and they also had a Criminal Record Bureau (CRB) check. New staff had to complete an application form, have an interview, provide the names of two people for reference purposes and complete and induction programme. They were also given a staff handbook which contained information about work practices and disciplinary procedures etc. New staff had to complete the induction programme. The majority of the surveys we received said that the induction covered everything they needed to know to do the job very well Staff had received training in core skills such as moving and handling, safe handling of medicines, safe guarding adults, health and safety, infection control and first aid. Seven of the staff team had also completed a National Vocational Qualification (NVQ) level 2 or above in care. Senior staff had received training in the Mental Capacity Act and Deprivation of Liberty Safeguards. This training was being passed down to all the staff team. A supervision plan had been put in place and had started. We were able to see the forms that had been completed after each supervision session. These forms recorded what had been discussed such as working practice, skills and knowledge, and how any gaps could be filled with training either ‘in house’ or through outside training organisations. Staff meetings had also taken place. The information we received from the managers said that they encouraged and listened carefully to the views of the people who used the service and their relatives and friends. Over the last few months five service user surveys had been completed on the following; medication; hairdressing; meals and meal times; birthday celebrations. Action had been taken on these areas to improve the service. Resident meetings had taken place there was a suggestion box and individual day to day contact. Those that completed a survey said that always/usually staff listened and acted on what they said and they received the care and support they needed. All of them said that there was someone they could speak to informally if they were not happy. The owner visited the home regularly and completed each month a report about the home which was required under the Care Homes Regulations. We saw copies of the reports during our visit; they were comprehensive and made reference to items that needed improving or attending to as well as the good things that had taken place. During these visits the owner made sure that a range of peoples views were sought and followed up where necessary. Lea House Residential Care Home DS0000073262.V376058.R01.S.doc Version 5.2 Page 9 The information we received before our visit and the practice we saw led us to believe that the owners and managers were aware of safe working practices and had in place policies and procedures to make sure that both the people who used the service and the staff team were kept safe. 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 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. Lea House Residential Care Home DS0000073262.V376058.R01.S.doc Version 5.2 Page 10 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 Lea House Residential Care Home DS0000073262.V376058.R01.S.doc Version 5.2 Page 11 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): 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 thinking of moving into Lea House received enough information to help them make a decision. They also have their health and personal care needs assessed to make sure that the staff group have the knowledge and skills to meet their needs. EVIDENCE: The managers of the home welcomed all enquiries and encouraged visitors to look around the home, with or without an appointment. An information pack was given to everyone to help them make decisions about Lea House. The pack told people all about the home and what they could Lea House Residential Care Home DS0000073262.V376058.R01.S.doc Version 5.2 Page 12 expect from the managers and care staff. Any of these documents can be requested in large print, or translated into another language within a few days. Everyone who expressed further interest was visited in their home or hospital in order for the managers to make an assessment of the persons needs. Forms had been introduced by the new owners which were now part of day to day practice. This helped the senior staff to measure the levels of risk and dependency of the prospective service user in order to make sure that their needs could be met. If the prospective service user was unable to visit Lea House, they would be shown a photograph album during the home/hospital assessment visit to give them some idea of what the home looked like and what was offered. Where a local authority assessment had also occurred, a copy of the assessment and care plan was required by the home. Following the assessment, the person was informed in writing whether or not his or her needs could be met. When people were admitted to the home in an emergency the policy of the company said that the person would have their needs fully assessed within 72 hours of their admission. On admission they were given a written contract/statement of terms and conditions of the home which everyone had to sign and confirmation of fees/funding rate of Local Authority. The care workers that were employed at Lea House had the experience, knowledge and skills to meet the needs of the people who lived there. The home did not provide an intermediate care service that required them to offer rehabilitation services including treatment and recovery programmes to enable the person to return home after a short stay. Lea House Residential Care Home DS0000073262.V376058.R01.S.doc Version 5.2 Page 13 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): 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. The healthcare needs of people living at Lea House are well managed to make sure that they receive the care and attention they require. EVIDENCE: The care files for the most recently admitted people were better as the information was more easily accessible. Everyone had a care plan which had been put together from the assessment and talking with residents and relatives. The care plan told the care staff what the needs of the people were and how these needs were to be met. The new owners had introduced new forms and eventually all the people would have the same care plan and care file. The home had a key worker system which meant that each resident was allocated a care worker to help them settle into the home quickly and to have someone to go to with any problems. Lea House Residential Care Home DS0000073262.V376058.R01.S.doc Version 5.2 Page 14 Any changes to a person’s health care needs were regularly updated on the care plan and were discussed at each handover session before the commencement of each shift. Everyone’s health and personal care needs were met through GP visits, district nurse, opticians and chiropodists. There was a letter from one of the GP’s confirming that there was a good level of service from the new staff at Lea House and that they were always helpful and professional. Letters were also on file from the district nurse who said that there had been an improvement in communication between them and the staff team. Each service user had access to a GP of their choice, many continuing with their original GP. The senior staff was responsible for the management and supervision of medicines in the home. Records were looked at and were satisfactory apart from the practice on a small number of occasions when an error had been made in the controlled drugs record and it had been scribbled out. This should not happen a single line should be put through and the mistake and the correct amount written at the side. All medication was reviewed by the GPs as required. Regular medication audits were undertaken by the Manager and Senior in Charge and any errors that were identified were investigated immediately. A new system for storage and administration of medication had recently been implemented with the assistance of the pharmacist. Any resident who may wish to administer his or her own medication would be able to do so providing it was felt that there would be no risk to themselves or others. This would be recorded in the individual’s care plan. A lockable facility to keep the medication would also be made available. The information we received before the inspection took place said:- ‘Our ethos to delivering care, and our charter to respect the rights of our service users, is clearly contained in our staff handbook, which forms part of each employee’s terms and conditions of service’. The residents ‘Charter of Rights’ was also in the service user’s guide that was given to all prospective residents. During our visit we saw no practice which did not respect the person’s privacy and dignity. Lea House Residential Care Home DS0000073262.V376058.R01.S.doc Version 5.2 Page 15 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): 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 provided with activities and a variety of home cooked food, which they enjoy. EVIDENCE: There was an activities organiser who kept a record of what had taken place. The record also contained the minutes of resident meetings; six people attended the one in July. Suggestions were made as to what people wanted for activities. Everyone said they liked the food. A clothing sale had been organised for August, and entertainers visited regularly. One attended on the day of the inspection to sing for the resident one of whom said they liked him as he was ‘funny’. The owners said that they hoped to further develop the role of the activities co-ordinator and build relationships with external organisations who may be able to extend and enhance the social activities programme. Lea House Residential Care Home DS0000073262.V376058.R01.S.doc Version 5.2 Page 16 Families, staff and residents were being encouraged where possible to take part in the planning of activities and social events such as selling of raffle tickets, providing items for the summer fayre and making decorations. A rolling programme of social events e.g. a summer fayre, Christmas party, pantomime and seasonal raffles had been put in place. There was a mini-bus available for day trips out and shorter outings. The new owners had obtained a new hairdresser who was the preferred choice of the people who were living at Lea House. The newly appointed hairdresser visited weekly rather than monthly and was also less expensive. We asked the people during our visit if they could get up or go to bed when they wanted; all said yes. With regard to the food available it was a set menu but people could have an alternative if they did not like what was available. People could eat in the dining room or could eat in their bedroom if they wished to. We looked at the menus which rotate over a four week period. No one had any complaints about the food. To celebrate birthdays, a home-baked cake and a present was given to the person. Many had brought items with them from home to make their bedrooms more personal. The new providers said that they would work to build strong relationships with families and friends to encourage contact with their relatives. Lea House Residential Care Home DS0000073262.V376058.R01.S.doc Version 5.2 Page 17 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): 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 using the service were protected by the complaints and safeguarding policies together with staff training and supervision. EVIDENCE: Everyone was given a service users’ guide, which had a copy of the complaints procedure. The complaints procedure required updating with our new address and telephone number. At the time of our inspection there had been no complaints. The owner in the information they gave to us said that staff received training and supervision that stressed the importance of making sure residents’ views were listened to and acted on. Senior staff had received training in the ‘Mental Capacity Act’, and all other staff had received awareness training through supervision. The company was also to provide awareness training to all key staff regarding the ‘Deprivation of Liberty Safeguards’. Lea House Residential Care Home DS0000073262.V376058.R01.S.doc Version 5.2 Page 18 The staff recruitment system made sure that all new members of staff had a Protection of Vulnerable Adults (POVA) ‘First Check’ before they commenced work and they also had a Criminal Record Bureau (CRB) check. The company had a policy to guide staff in reporting any concerns they may have. Training for staff about abuse of vulnerable adults included how to recognise it, how to report it and the consequences of ignoring it. All staff had received POVA training in the last 12 months. There had been no safeguarding referrals or investigations. None of the people who completed a survey form or those we had contact with on the day of our visit had any complaints. Lea House Residential Care Home DS0000073262.V376058.R01.S.doc Version 5.2 Page 19 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): People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Lea House provides a safe and reasonably comfortable, decorated and furnished home. EVIDENCE: Lea House was originally two semi-detached houses which have been converted into one. An extension and conservatory was added some years ago. The home is set over four floors (lower ground, ground and two upper floors. There are twenty-four bedrooms three of which are double rooms. The shared rooms have screens to give people privacy. Thirteen of the rooms have an ensuite which consists of a toilet and wash basin. There is a bath and shower room on all floors as well as toilets. The lounge, dining room, conservatory, Lea House Residential Care Home DS0000073262.V376058.R01.S.doc Version 5.2 Page 20 and patio area are all on the ground floor. There is also a quite lounge on the lower ground floor which also contains the kitchen, laundry, staff room and office. There is a full passenger lift to all floors. The house is suitable to meet the needs of the people who live there. There are gardens to the front and rear of the building which are well kept. There is car parking space and a raised decked area leading from the conservatory at the back of the house. Ramped access is in place for those people who may use a wheelchair or have difficulty walking. The home has good access to local shops, a post office, churches, restaurants, cafes and motorway networks. The new owners have introduced a programme of decorating and maintenance throughout the home. Senior managers conduct weekly inspections of the building and also carry out monthly recorded visits to highlight any repairs that require attention. There were infection control procedures in place that followed the Department of Health Guidance ‘Essential Steps’. Protective clothing was provided for staff. There was a full domestic and laundry service within the home with equipment and supplies available to the team to enable the home to be kept fresh, clean and odour free. However the lounge on the day of the inspection had an offensive odour as did one of the bedrooms we looked at. This was discussed with the owners and the senior manager. The owner said that every effort was being made to make the rooms more pleasant. All the radiators had been covered to protect people from burns and the fire alarm control panel had been replaced. Lea House Residential Care Home DS0000073262.V376058.R01.S.doc Version 5.2 Page 21 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): 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. Staffing arrangements, recruitment and training make sure that people are cared for and supported safely. EVIDENCE: We looked at the rotas for the previous week and the week we were visiting. They showed that for the majority of the time there were never less than 5 care workers plus a senior on duty during the hours of 8am to 8pm. There were two care workers for the late evening/night shift from 8pm to 8am; senior managers were also available ‘on call’. A domestic and laundry assistant plus a maintenance person who worked four days a week were also employed. A cook was present seven days a week. The senior care worker, who was spoken with on the day of our visit, said that staff supported each other for sickness and holidays. The home did have their own ‘bank staff’ that they could call upon. Nine of the staff team had completed a National Vocational Qualification (NVQ) level 2 or above. Other staff would also be taking this qualification. Lea House Residential Care Home DS0000073262.V376058.R01.S.doc Version 5.2 Page 22 There was a recruitment and selection system in place to make sure that all new members of staff had a POVA First Check before they commenced employment and had a Criminal Record Bureau (CRB) check carried out. The process also included the person completing an application form, providing names for references and an interview. On commencement of employment they were given job descriptions and a statement of terms and conditions of employment. All staff had personnel files which contained all the information required and were well organized. It is recommended that the application form be changed from ten years previous employment history to ‘employment history from leaving school or full time education and explain any gaps’. This is to make sure that as much as can be is done, so that only suitable people are employed. The personnel files should have information that clearly shows that people (where applicable) have permission to work. All new members of staff had to complete an induction period for which the senior care worker was responsible for implementing. Each person had an induction training file which contained a check list for each area of work for example; fire safety, infection control, moving and handling, health and safety. Handouts were given to people to keep in their files such as hand cleaning techniques. Observation sheets had been completed when the senior carer had worked with the person. The senior care worker was also responsible for ongoing staff training. A plan of training and development had been produced on the computer and was available for people to see. The managers said that they regularly reviewed the training plan and updated staff records to make sure that training needs were being met. Lea House Residential Care Home DS0000073262.V376058.R01.S.doc Version 5.2 Page 23 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): 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. Lea House is well managed so that it is run in the best interests of the people who live there. EVIDENCE: We had been informed by the owner Margaret Hill that the manager had left the organisation. This was just a few days before we made our visit to the home. Letters had been sent to relatives and staff to tell them of the manager’s departure. The owner was actively seeking a replacement manager and hoped that it would not take too long. Lea House Residential Care Home DS0000073262.V376058.R01.S.doc Version 5.2 Page 24 Whilst the process was taking place the home was being managed by the operations manager and the senior care worker with support from the owners and other senior staff. The information we received from the managers said that they encouraged and listened carefully to the views of the people who used the service and their relatives and friends. They did this through the resident meetings that had taken place, a suggestion box and individual day to day contact. They also said that they ‘respected the self determination and choice of individuals, their right to express their views and make decisions themselves’. Over the last few months five service user surveys had been completed on the following; medication; hairdressing; meals and meal times; birthday celebrations. Action had been taken on these areas to improve the service. The staff team also had regular meetings so that they too could express their views and be kept informed of any changes. The owner visited the home regularly and completed each month a report about the home which was required under the Care Homes Regulations. We saw copies of the reports during our visit; they were comprehensive and made reference to items that needed improving or attending to as well as the good things that had taken place. During these visits the owner made sure that a range of peoples views were sought and followed up where necessary. We saw letters that had been sent to the home from the District Nurse and GP who both said that they had seen improvements in the home and the staff team. The new hairdresser also said that she had found the staff very kind and caring to everybody. The staff group were patient with all the residents and treated them lovely; Lea House was clean and comfortable and visitors were made welcome. The organisation had the Investors in People award. The owner said that they were bringing the investors in people documentation that was used in the other homes into Lea House. There were a set of polices and procedures on the table in the quiet lounge for everyone to look at; they were well organised and easily accessible. All the records seen were also well organised and information was easily available. A staff handbook was given to all employees. The people who used the service were encouraged to manage their own finances. A record was kept for small amounts of money that was left with the managers. All members of staff had regular formal supervision and appraisals which gave them the opportunity to look at their working practice, talk about their skills Lea House Residential Care Home DS0000073262.V376058.R01.S.doc Version 5.2 Page 25 and knowledge, and how any gaps could be filled with training either ‘in house’ or through outside training organisations. The information we received before our visit and the practice we saw led us to believe that the owners and managers were aware of safe working practices and had in place policies and procedures to make sure that both the people who used the service and the staff team were kept safe. Lea House Residential Care Home DS0000073262.V376058.R01.S.doc Version 5.2 Page 26 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 3 3 3 3 3 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 3 18 3 3 3 3 x x 2 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 3 3 x 3 3 3 3 Lea House Residential Care Home DS0000073262.V376058.R01.S.doc Version 5.2 Page 27 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. 1. 2. Refer to Standard OP9 Good Practice Recommendations Any mistakes in the controlled drugs book should be crossed out with a single line and the correct entry made at the side. The application form should be amended to replace the ‘ten year employment history’ to ‘full employment history from leaving school or full time education and explain any gaps.’ This is to make sure that as much as can be is done, so that only suitable people are employed. The personnel files should have information that clearly shows that people (where applicable) have permission to work. OP29 3. OP29 Lea House Residential Care Home DS0000073262.V376058.R01.S.doc Version 5.2 Page 28 Care Quality Commission North 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). 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. 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