Care Home: Legh House

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What the care home does well Residents health needs are properly met by the home and by visiting community health professionals. The activities arranged within the home meet the expectations of the residents living there. The programme of recreational and social activities comprises small group and one-to-one activities designed to suit the differing preferences of each resident. Residents are encouraged to maintain their links with friends and family and all visitors are made welcome. Residents are encouraged and supported to exercise choice and control over their lives as far as possible. Meals are wholesome and nutritious and planned around the likes and dislikes of residents; there is a choice of food available at every meal. Residents are encouraged to personalise their bedrooms with small items of furniture, pictures and other possessions. A satisfactory recruitment process is followed when employing staff and there is an ongoing training programme to provide staff with the skills they need to properly care for the residents. What has improved since the last inspection? The registered manager and staff have worked hard to meet the requirements of the report of the key inspection of December 2009. In particular, pre admission assessment of prospective residents, care planning processes and documentation, staff recruitment and supervision, and standards for infection control have received appropriate attention. What the care home could do better: This report contains no requirements for improvement; the National Minimum Standards are met. This report contains some recommendations for improvement to aspects of record keeping. Key inspection report Care homes for older people Name: Address: Legh House 117 Rylands Lane Wyke Regis Weymouth Dorset DT4 9QB     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Gloria Ashwell     Date: 1 8 0 6 2 0 1 0 This is a review of 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. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. that people have said are important to them: They reflect the things 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. Care Homes for Older People Page 2 of 22 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. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 22 Information about the care home Name of care home: Address: Legh House 117 Rylands Lane Wyke Regis Weymouth Dorset DT4 9QB 01305773663 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): annburt@btconnect.com The Abbeyfield (Weymouth) Society Limited Name of registered manager (if applicable) Mrs Ann Burt Type of registration: Number of places registered: care home 17 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Seventeen (17) in Fifteen (15) single rooms and a suite of two rooms registered as one double. Date of last inspection Brief description of the care home Legh House is registered to provide care and accommodation for a maximum of 17 people age sixty five and over. The registration is for old age, not falling within any other category. Legh House is a single storey building located in an elevated position, with views of the sea and Portland. There are nearby local amenities, including shops, post office, church, GP surgeries and schools. Care Homes for Older People Page 4 of 22 Over 65 17 0 Brief description of the care home Legh House is operated by the Abbeyfield Society, a registered charity, established for many years. The home has a House Committee involving residents of the home. The Executive Committee of the local branch of the Abbeyfield Society holds overall responsibility for the management of this care home. Mrs Ann Burt is the registered manager of the home. The fees for the home are £68 per day/night for all single rooms; there is usually a higher charge for the care suite. Additional charges include hairdressing, chiropody privately arranged, toiletries and newspapers. Care Homes for Older People Page 5 of 22 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: The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This was a statutory inspection required in accordance with the Care Standards Act 2000. This inspection was unannounced and was carried out by two inspectors. Throughout the report the term we is used, to show that the report is the view of the Care Quality Commission. The inspectors and the registered manager discussed and examined documents regarding care provision and management of the home, and toured the premises and spoke to residents, staff, observed staff interaction with residents and the carrying out Care Homes for Older People Page 6 of 22 of routine tasks. During the inspection, particular residents were case tracked; for example, for evidence regarding Standards 7, 8 and 9, records relating to the same residents were examined and the residents spoken with or with regard to those who due to mental and physical frailty were unable to converse, were observed. In advance of the inspection we received from service users and staff a number of completed survey forms; all comments indicated unreserved satisfaction with the home. During this inspection compliance with all key standards of the National Minimum Standards was assessed. Care Homes for Older People Page 7 of 22 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 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. Care Homes for Older People Page 8 of 22 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 9 of 22 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. Prior to admission, the needs of each proposed resident are assessed to ensure the home will be properly able to meet them. Evidence: The records of a resident admitted since the last inspection included details of pre admission assessment carried out by a senior staff member of the home while visiting the prospective resident at their previous address. In advance of making the decision to enter the home the prospective residents or their representatives are encouraged to visit the home to view the premises and meet residents and staff. Following pre admission assessment of each prospective residents needs and circumstances the home writes to them confirming the agreement and ability to provide accommodation and care. Care Homes for Older People Page 10 of 22 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. The health and social care needs of residents are met by suitably trained staff; doctors and other professionals visit as necessary and residents receive the medicines they have been prescribed. Evidence: We combined the information we obtained from the documents we read, with the things we saw taking place in the home during our inspection, and what we were told by residents, staff and visitors. We examined the care records of 4 residents and found them to be of very good standard, based on up to date and relevant risk assessments, highly individual and reflective of the changing conditions of residents. For medicine handling the home uses a monitored dosage system, whereby most of the medications are stored in blister packs, to simplify the process of administration. Staff trained in this work carry out all medicine handling. Medication records were properly kept indicating that residents receive prescribed medicines at the correct Care Homes for Older People Page 11 of 22 Evidence: times and in correct amounts. This report contains two recommendations for the further improvement of medicine handling processes. In the presence of staff residents appeared relaxed, confident and at ease; staff interactions with residents were of a friendly and polite manner and the atmosphere throughout the home was calm and unhurried. Residents are treated with respect and those we spoke to felt that staff are always kind and considerate of their needs. Care Homes for Older People Page 12 of 22 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. Residents have opportunities to engage in social and recreational activities and are encouraged and supported to pass the time according to individual preference. A choice of menu is provided and meals are nutritional and appetising. Evidence: Residents are supported to spend their time according to their wishes. There is a programme of recreational and social activities and residents we spoke to told us they are satisfeid with the frequency and variety of activities. Visitors are welcome at any time and those spoken to during the inspection said they are always made to feel welcome and placed at ease by the staff. Most residents take meals in the dining room on the ground floor while those who wish to receive them in their bedrooms. Residents receive a choice for all main meals and those spoken with said the food is well presented, plentiful and appetizing and was seen to be enjoyed by the residents. Care Homes for Older People Page 13 of 22 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. People know how to complain and are confident their complaints would be listened to. Residents are safeguarded against risks of abuse in its various forms. Evidence: The home has a complaints policy and procedure. From discussion with staff and examination of records there was evidence that there is a reliable process ensuring that any complaints received would be competently managed to ensure that if weaknesses in service were identified they would be unlikely to recur. All staff receive training on the safeguarding of vulnerable persons and the home has a written policy and procedure for the protection of vulnerable adults. Care Homes for Older People Page 14 of 22 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. The home is comfortable, clean, and suited to the needs of residents. Evidence: The home is well maintained and there is a continuous programme of repair, renewal and refurbishment to ensure the premises and furnishings remain comfortable, well maintained and safe. Work is currently ongoing to enlarge a number of bedrooms and to provide each bedroom with en suite hygieine facilities containing a toilet and wash hand basin. The premises are being enlarged to provide two additional bedrooms and a Quiet Room. The bedrooms we saw had been personalised with pictures, furniture and photographs to reflect the taste of the particular residents currently accommodated in these rooms. All areas of the home were clean and there were no unpleasant odours. There are bathrooms equipped for the use of residents who need assistance. The laundry room has equipment compliant with hygiene requirements, including a sluice cycle washing machine. Adequate supplies of clean linen were seen to be available. Care Homes for Older People Page 15 of 22 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. The home employs enough staff to meet the needs of residents and to ensure their safety and comfort and maintenance of the good condition of the premises. Staff receive training for their work and are properly supervised. Evidence: Staffing levels are provided in accordance with the assessed needs of residents to ensure that at all times sufficient staff are available to properly meet their needs. The records of three recently employed staff members were examined and found to contain essential information including written references and evidence of identity. Staff we spoke with told us they had received comprehensive induction, and training in core subjects including safe moving and handling and the home meets the standard for at least 50 of care staff to hold a National Vocational Qualification in care. Records of staff training were poorly kept; during the inspection we were given a copy of the training matrix and noted that the document indicated that a number of staff did not appear to have received appropriate and recent training. We brought this to the attention of the manager and were given another version of the matrix but later we were informed that it was also inaccurate. The manager told us that to obtain Care Homes for Older People Page 16 of 22 Evidence: accurate and full written details of training received by staff it would be necessary for her to check each persons certificates and records. This was expected to take a considerable amount of time so the manager agreed to send to us accurate information about staff training after the inspection. This report contains a related recommendation. Care Homes for Older People Page 17 of 22 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. The home is properly managed and maintained to promote the safety and well being of service users but this inspection has identified some areas where aspects of record keeping should be improved. Evidence: The registered manager of the home is Mrs Ann Burt, who is supported by a deputy manager employed since the last inspection. The home has processes for quality assurance, satisfaction surveys are periodically issued and the audited results of the most recent survey, during May 2010, show that people living in and visiting the home are very satisfied with it. Records are kept of accidents and there is evidence of subsequent investigation, review of the care plan and periodic audit to identify any trends e.g. time, place, person, and activity. Care Homes for Older People Page 18 of 22 Evidence: The home manages the finances of some residents with regard to the safekeeping of monies for personal expenditure and discussion of the associated processes indicated that a robust and reliable system is operated. We noted that a resident has placed an item of jewellery in the safekeeping of the home, but the home had made no record of this and had not provided the resident with a receipt. This report contains an associated recommendation. There are good processes for staff recruitment and induction, and staff we spoke to during the inspection told us they receive training in essential subjects although we were unable to verify this from the documentation available during our visit. Records indicated that fire safety equipment has been checked and tested at the required frequencies. A sample of records relating to the maintenance and safety of the premises and equipment were examined and provided evidence that routine checks and tests are carried out to ensure the safety of the various items and installations. Care Homes for Older People Page 19 of 22 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 20 of 22 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 1 9 Handwritten medicine administration instructions should be signed and dated by the writer, and countersigned by another person to confirm that the instructions have been correctly recorded. Each medicine administration record (MAR) should make reference to the allergy status of the resident, and when no allergy to any medicine is known to be present, this should be recorded on the MAR. Records of staff interview should be signed and dated. Records of staff training should be properly kept to ensure there is robust evidence of the training each staff member has undertaken, and that any aspects of omission can be readily identified. A record should be kept and a receipt should be given with regard to any item given by a resident to the home for safekeeping. 2 9 3 4 29 30 5 35 Care Homes for Older People Page 21 of 22 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. Care Homes for Older People Page 22 of 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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