Care Home: Leybourne House

What the care home does well We saw that the people living at the home were well cared for by competent staff with a good understanding of dementia care. Care was person centred. Residents were supported to maintain contact with family and friends, enabling them to continue to enjoy relationships that were meaningful. We saw that people enjoyed the variety of activities provided. Where people did not want to join in any group activity staff were available to give one to one support. The food provided was varied and nutritious and enjoyed by the residents. Financial procedures within the home also ensure that residents interests are protected. There is an ongoing programme of maintenance, which ensures the home is comfortable and safe. What has improved since the last inspection? The Registered Manager told us that she and her staff are always looking at ways to improve the service given to the people living at Leybourne House. Since the last inspection the standard of care documentation has improved so that staff have a good level of information to enable them to give individualised care appropriately. The shift patterns for staff have been altered so that they are no longer working very long hours. There have been environmental improvements made, which include the refurbishment to two bathrooms. The garden has also been improved to make access much easier. What the care home could do better: This home is providing a good service to those who live there. The Registered Manager confirmed that she and her staff were continuing to improve care documentation. However a requirement has been made that a risk assessment is undertaken with any resident when considering the use of bedrails. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Leybourne House Western Avenue Bournemouth Dorset BH10 6HH     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: Amanda Bell     Date: 0 2 0 3 2 0 0 9 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. 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. 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 22 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) 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 22 Information about the care home Name of care home: Address: Leybourne House Western Avenue Bournemouth Dorset BH10 6HH 01202574426 01202590382 leybourne@care-south.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Care South care home 41 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia Additional conditions: Four service users in the age range 18-65 years (in the categories DE or MD) may be accommodated to receive personal care. Date of last inspection Brief description of the care home Leybourne House is part of the Care South (formerly The Dorset Trust) group of homes and is managed by Mrs GiChristine Trinder. The Dorset Trust was established in 1991 having leased several homes across Dorset from the local authority, the Trust has since expanded and now provides care in Devon and Somerset resulting in the name change to Care South. Care South is a non-profit making organisation. Leybourne House provides accommodation for up to 41 older people who have dementia or other mental health needs and who require assistance with personal care. The premises were purpose built by the local authority, and provides 39 single rooms, one with an enCare Homes for Older People Page 4 of 22 Over 65 41 41 0 0 Brief description of the care home suite shower, and one shared room, over two floors. The first floor is reached by a passenger lift and stairways. Residents are able to benefit from the three lounge/dining room areas and conservatory on the ground floor and the mature, accessible gardens. There is off road parking to the front of the home. Current fees are £630 per week. See the following website for further guidance on fees and contracts: /www.csci.org.uk/about_csci/press_releases/better_advice_for_people_choos.aspx 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 unannounced inspection took place on the 2nd March 2009 and took approximately four hours. The purpose of the inspection was to assess all of the key standards and improvements made since the last key inspection in March 2007. The inspection was carried out by one inspector however the term we is used throughout the report to reflect the findings of the Commission for Social Inspection, CSCI. The Registered Manager, Mrs Christine Trinder was on hand throughout to aid the inspection process. We gathered information in a variety of ways, which included reports made to CSCI by the home; the annual quality assurance assessment completed by the Registered Manager; a tour of the premises ; observation of the daily Care Homes for Older People Page 6 of 22 life in the home and discussion with those people living and working at the home. We also reviewed a number of care records, recruitment and training records and maintenance documentation. 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 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. New residents move into the home having had their needs assessed and been assured that these needs will be met fully. Evidence: We reviewed the care files for some residents who had recently come to live at the home. These showed that the home had a good procedure in place. Prior to anyone moving into the home a full assessment of needs was undertaken with the prospective resident. Sufficient information was obtained so that a care plan could be drawn up and made available to staff. The Registered Manager said that she encouraged prospective residents and their families to visit the home before admission. She said that she gave them all the information they needed to make an informed decision about admission. 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. Robust systems are in place to provide staff with the information they need to meet the health and personal care needs of residents. The principles of respect, dignity and privacy are put into practice. Evidence: The home continues to provide a good standard of care to the people living at the home. We reviewed the care files for four residents and found they contained most of the relevant assessments and care plans needed so that staff had the information to be able to give a very good standard of care. Where the need for specialist equipment was identified it was provided. However there was no system in place to assess the use of bedrails and some beds were fitted with them. It was required that the home have a written policy about this type of restraint so that staff can formerly assess the use of the bedrails. It was clear from discussions with staff that residents have access to the health services they need. There was evidence to show that residents get support from Care Homes for Older People Page 11 of 22 Evidence: General Practitioners, district nursing services, community psychiatric nurses and chiropodists. The home has a good medicines policy and procedure in place. Examination of records indicated that medicines were properly administered so that residents were assured that they would get the correct medication they needed in accordance with their GPs instructions. We looked at the medication administration records and found that these were being completed correctly with no gaps within the records. We observed that people living at the home were well cared for by the staff. The staffs approach was person-centred, kind, caring and respectful. They had a clear understanding of how to care for people with dementia. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use this service are supported to maintain their life skills and are encouraged to make choices as far as possible. Social, spiritual and recreational activities meet the needs of the residents well. Evidence: The home employed two activities co-ordinators. There was a varied programme of activities in place, which was subject to change depending on the needs of the residents. This included arts and crafts, reminiscence, gardening, visits from outside entertainers, PAT dogs. It was evident during the inspection that staff had the time to spend on a one to one basis with people. Those living at the home were able to make choices about their daily routine. The home ensured that there were a variety of items available to residents, which included books, magazines, soft toys, hats and coats and a number of household items. One resident enjoyed playing a set of drums, others liked to walk around the home. We saw residents enjoying individual manicure sessions during the morning and a group making Easter decorations in the afternoon. Throughout people appeared engaged and were cared for by considerate, cheerful staff. Lunch time was a social affair and the food was well presented and enjoyed by the Care Homes for Older People Page 13 of 22 Evidence: residents in the dining room. When people needed further assistance with their meals this was given in an appropriate manner. The menu offered choice. Staff told us that extra snacks were always available throughout the day and night in case anyone was hungry. Care Homes for Older People Page 14 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 who use the service are able to express their concerns, and have access to a robust, effective complaints procedure. Protection from abuse is promoted. Evidence: We saw that the home had a robust complaints policy in place. There had been one complaint during the last year, which had been thoroughly investigated following the homes procedures. There were also policies in place to protect the vulnerable adults living at Leybourne House. Staff confirmed that they had received safeguarding training and showed us that they would know what to do if an allegation of abuse arose. Care Homes for Older People Page 15 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 standard of the environment at the home is good and provides residents with homely and safe place to live. Evidence: The home continued to provide a safe and comfortable place for people to live. There was a routine maintenance programme in place to ensure that the facilities at Leybourne House were kept in a good state of repair. Since the last inspection some of the bathrooms had been upgraded. The garden had safe, easy access and was a very pleasant place for people to spend time. All areas were clean and free from any unpleasant odours. The laundry continued to be well managed in the home and we saw sufficient amounts of clean linen throughout the home. Care Homes for Older People Page 16 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. Sufficient care staff are employed to meet the needs of residents. Robust recruitment procedures are in place to protect residents from the risk of unsuitable staff working at the home.Staff are given the training and support so that they can give a good standard of care to the residents living at the home. Evidence: At the time of inspection staff rosters demonstrated that there were sufficient staff on duty at that time. During the inspection staff were on hand to meet the needs of the residents. The home had an ongoing training programme, which included NVQ level 2 and 3 in care. We reviewed the recruitment files for four new members of staff. The files were well ordered and contained all the information required by law. POVA first and enhanced Criminal Record Bureau checks had been obtained for all new staff. Training files showed us that staff were receiving induction training and staff confirmed this. They also told us that they were encouraged to take up training opportunities provided and had received specific training in caring for people with dementia. 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 well organised and the daily management and running of the home centres around the care of residents. Good management practice, systems in place, and records kept, confirm the health and safety of all in the home. Evidence: The Registered Manager, Mrs Trinder, was suitably qualified and experienced to manage Leybourne House. She demonstrated throughout the inspection that she ran the home well. Mrs Trinder followed robust procedures to ensure that she had a welltrained and competent staff to care for those people living at the home. There were quality assurance and quality monitoring systems in place. The home took steps to review its performance regularly and residents views were sought and suggestions put forward were acted upon. Records showed us that staff had received recent training in fire safety and manual handling updates. Substances hazardous to health were seen to be stored securely. Records showed that equipment had been serviced regularly. Accidents were recorded Care Homes for Older People Page 18 of 22 Evidence: and appropriate action was taken as necessary. 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 1 7 13 A risk assessment must be undertaken with any person living at the home who may need bedrails to be put in place. This will ensure that bedrails are appropriately used and people living at the home are safe. 29/04/2009 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 7 It is recommended that written risk assessments are completed for each resident where the home is considering the use of bedrails. Care Homes for Older People Page 21 of 22 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 © (2009) 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 22 of 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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