Care Home: Lindisfarne House

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What the care home does well The service has a new and well designed building. It is suitably equipped and has most aids and adaptations that it needs. The home is kept clean and odour free. One relative said that, "It is always clean. There is never any smell." The staff are knowledgeable about service users needs and treat them with respect. Comments such as, "The care is absolutely great," and "It`s lovely," were typical of those made to the inspector. Staff value service users and help them maintain their dignity and individuality. One service user commented, in their survey form, that, "I feel valuable here and I am listened to." Another commented, in their survey form, that, "We have residents meetings where we can say what we need and want." Service users have good access to local health services and there health care needs are met. One service user commented in a survey form that, "My physical health and mental well being have improved dramatically since I came to Lindisfarne House." Lindisfarne House DS0000072643.V377311.R01.S.doc Version 5.2 Service users have a good social programme and are able to interact well with each other and with staff. One visitor, who had moved her relative from another home, said, "In here they have things to do. I`d recommend it to anyone." Another with a similar experience said, "it`s absolutely amazing." The home provides appetizing food and drinks are freely available. One service users said, "I think it`s brilliant, the food is good and everyone`s friendly." The home provide free transport to visitors who need this or who experience difficulties in travelling. The home provides a good induction and training to staff. The home is well managed by an experienced home manager that service user`s find approachable. One service users said, of the manager, "This lady is a gem." What has improved since the last inspection? The home is newly registered and this is the homes first key inspection. What the care home could do better: The home would benefit from having a loop induction system to help hearing aid users. The home has plans for a number of improvements including providing a "Sensory Room" and developing a sensory area in the gardens Key inspection report CARE HOMES FOR OLDER PEOPLE Lindisfarne House Silverdale Place Newton Aycliffe County Durham DL5 7DZ Lead Inspector Tom Moody Key Unannounced Inspection 15th May 2009 09:00 DS0000072643.V377311.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. Lindisfarne House DS0000072643.V377311.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 Lindisfarne House DS0000072643.V377311.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Lindisfarne House Address Silverdale Place Newton Aycliffe County Durham DL5 7DZ 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) 01325 320227 gainford.aycliffe@btconnect.com CLS@gainfordcarehomes.co.uk Gainsford Care Homes Ltd Mrs Margaret Roe Care Home 56 Category(ies) of Dementia (56), Mental disorder, excluding registration, with number learning disability or dementia (56), Old age, of places not falling within any other category (56) Lindisfarne House DS0000072643.V377311.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home with nursing - Code N To service users 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 of places 56 Dementia - Code De, maximum number of places 56 Mental Disorder, excluding learning disability or dementia - Code MD, maximum number of places, 56 The maximum number of users who can be accommodated is: 56 2. Date of last inspection New Service Brief Description of the Service: Lindisfarne House is a care home owned by the Gainsford company. It provides accommodation, over three floors, for older persons or older persons who have dementia. The building is purpose built and has generous accommodation and circulation space. It is of traditional brick and tile construction and it is located in a residential area. It is close to bus and rail routes and there are shops nearby. All floors are accessible by lift and the home is well equipped, providing all necessary aids and adaptations. It has pleasantly landscaped grounds and parking space is available. Tea and Coffee are provided free of charge to visitors and the home provides a free transport service if it is needed. At the time of this inspection the fees charged to live at the home were from £449.71p to £471.44p per week. Additional charges include hairdressing, chiropody and personal toiletries. Up to date information about fees should be sought from the manager. Lindisfarne House DS0000072643.V377311.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Lindisfarne house is a newly built and registered care home and this was it’s first key inspection. Information sent from he home, including a Self Assessment was used, together with other information on file. Surveys, returned by service users and relatives were also read, however there were few of these returned. This included the results of a random inspection, carried out in February, and other notifications sent by the home. A site visit was carried out on 15 May and this lasted 6 hours. During this a tour of the premises was carried out. Documents relating to 6 service users, including care plans, were examined and these service users were spoken to by the inspector. We call this case tracking. The inspector spoke with the manager and other staff in the home. A number of visitors and service users were interviewed. Other records and documents were also examined at this time. As a result of this inspection the quality rating for this service was assessed as 2 stars. This means that the people who use this service experience good quality outcomes. What the service does well: The service has a new and well designed building. It is suitably equipped and has most aids and adaptations that it needs. The home is kept clean and odour free. One relative said that, “It is always clean. There is never any smell.” The staff are knowledgeable about service users needs and treat them with respect. Comments such as, “The care is absolutely great,” and “It’s lovely,” were typical of those made to the inspector. Staff value service users and help them maintain their dignity and individuality. One service user commented, in their survey form, that, “I feel valuable here and I am listened to.” Another commented, in their survey form, that, “We have residents meetings where we can say what we need and want.” Service users have good access to local health services and there health care needs are met. One service user commented in a survey form that, “My physical health and mental well being have improved dramatically since I came to Lindisfarne House.” Lindisfarne House DS0000072643.V377311.R01.S.doc Version 5.2 Page 6 Service users have a good social programme and are able to interact well with each other and with staff. One visitor, who had moved her relative from another home, said, “In here they have things to do. I’d recommend it to anyone.” Another with a similar experience said, “it’s absolutely amazing.” The home provides appetizing food and drinks are freely available. One service users said, “I think it’s brilliant, the food is good and everyone’s friendly.” The home provide free transport to visitors who need this or who experience difficulties in travelling. The home provides a good induction and training to staff. The home is well managed by an experienced home manager that service user’s find approachable. One service users said, of the manager, “This lady is a gem.” 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. Lindisfarne House DS0000072643.V377311.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Lindisfarne House DS0000072643.V377311.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. 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 service users needs are accurately assessed and the home can meet those needs Service users have information they need to make choices and a service users guide is available containing all the necessary information. Service users can make a trial visit and are able to make an informed choice about coming into the home. EVIDENCE: The home has a comprehensive service user’s guide with pictures to aid understanding. The manager said that the home provides all necessary information to people who are considering coming into the home. Surveys and relatives comments confirmed this. The home’s self assessment says that Lindisfarne House DS0000072643.V377311.R01.S.doc Version 5.2 Page 9 people’s needs are assessed before they come in to be cared for. Care plans and records confirm this. Contracts were also seen and these were suitable. The manager said that relatives and service users are able to visit before deciding if the home is suitable. Several relatives commented that they had looked at alternatives and this home was better than others they had seen. Lindisfarne House DS0000072643.V377311.R01.S.doc Version 5.2 Page 10 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Each person has a detailed plan, which explains how their care they will be given and people’s health care needs are met. The homes policies, procedures and practice, for dealing with medication, protect service users. Service users feel that they are treated with respect by the staff. EVIDENCE: The service home’s self-assessment says that, the health and personal care which a service user receives is based upon individual needs. What is identified during the assessment process is put into the service users plans of care and is agreed by the service user or their advocates. The care plans seen during the site visit confirmed this. They also show that the service users have good access to all health services, such as GP’s, Dentists and Opticians, as well as other specialist practitioners. Lindisfarne House DS0000072643.V377311.R01.S.doc Version 5.2 Page 11 One service user commented in a survey form that, “My physical health and mental well being have improved dramatically since I came to Lindisfarne House.” Medication is stored, given out and recorded appropriately and safely. The homes self-assessment also says that, care is delivered in accordance with care plans ensuring privacy and dignity. This was seen during the sight visit. Service users were addressed respectfully by staff and allowed time to respond. They were clean and well dressed and staff always knocked before entering their rooms. Staff also asked permission, or explained what they were going to do, before carrying out care. One service user commented, in their survey form, that, “I feel valuable here and I am listened to.” Lindisfarne House DS0000072643.V377311.R01.S.doc Version 5.2 Page 12 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The homes provision matches service user’s recreational, social and cultural needs, and helps them maintain contact with the surrounding community. They are able to exercise choice and control over most aspects of their lives and they enjoy nutritious and appetizing food. EVIDENCE: The service providers self-assessment says that, they have a comprehensive activity programme based on individual and group needs. Service users life stories, interests and hobbies are recorded and opportunities for stimulation given daily. The environment reflects this. This was seen during the site visit, with service users taking place in small scale activities supported by staff. All corridors have a decorative theme to help people know where they are and promote stimulation and communication. There are decorative panels with interesting textures that service users can handle and “rummage” boxes containing items of interest that service users can sort through. The manager Lindisfarne House DS0000072643.V377311.R01.S.doc Version 5.2 Page 13 states that the themes corridors are used for diversion and distraction and are effective in preventing challenging behaviour. A calm atmosphere was there all through the time of the site visit. The service users have outings in the homes mini bus and photographs of these trips are on display. The manager said that the home maintains contacts with local churches and opportunities for worship are available to service users. Activities are planned a month ahead and weekly activity programmes are displayed in each lounge and on the relative’s notice board. One visitor, who had moved her relative from another home, said, “In here they have things to do. I’d recommend it to anyone.” Nutritional assessments are recorded in care plans and weights are monitored. The dining rooms are pleasant and service users enjoyed an appetizing meal. There was further evidence of “home baking” in the kitchen. Service users were supported well by staff who had time to assist those who needed help. The kitchens are well stocked and menu choices are given to service users by staff. The kitchen staff are knowledgeable about service user’s needs and preferences. The cook confirmed that the catering budget is unrestricted and service user’s preferences can be easily met because of this. Drinks are freely available in sitting rooms. Service users said, “Everything’s run perfectly” and “I think it’s brilliant, the food is good and everyone’s friendly.” Lindisfarne House DS0000072643.V377311.R01.S.doc Version 5.2 Page 14 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. The service users and relatives know how to raise issues and they are confident staff and managers will act on their concerns. Training and procedures ensure service users are protected and that their rights are upheld. EVIDENCE: The service user’s guide contains information on how to make complaints or raise concerns. This information is also displayed on notice boards. Management strategies for dealing with challenging behaviour are recorded in care plans. Relatives and service users said they would be happy to approach the manager or staff if they had any concerns. One service user commented in their survey form that, “We have residents meetings where we can say what we need and want.” Staff said they had received training in Protecting Vulnerable Adults (POVA) and they had a good awareness of these issues. This was confirmed by training records. Recruitment records indicate all pre employment checks are carried out including Criminal Records Bureau, POVA list and previous employers references. Lindisfarne House DS0000072643.V377311.R01.S.doc Version 5.2 Page 15 Lindisfarne House DS0000072643.V377311.R01.S.doc Version 5.2 Page 16 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a comfortable environment that is safe and well maintained. The home is very well equipped, with a wide range of aids and adaptations. It is spacious, clean and meets the service users needs EVIDENCE: The service has a new and well designed building. The home is a new build and is specifically designed for persons suffering from dementia. It is suitably equipped and has most aids and adaptations that it needs. The home does not have a “loop induction” system to help hearing aid users and this would be a useful improvement. Lindisfarne House DS0000072643.V377311.R01.S.doc Version 5.2 Page 17 A programme of maintenance is ongoing and supported by the handyman on a daily basis. The gardens are well kept and secure and easily accessed by service users. The home has plans to establish a sensory garden to enable relatives, staff and service users to have a quiet place for reflection. There is a smoking room but the manager confirmed that service users never smoked without staff supervision and smoking materials were not left in service user’s possession. Picture signage is used throughout the home to help service users to find their way around. The bedrooms are individual, have en-suite facilities and are personalised to individual tastes. Each individual’s bedroom is marked by a memory box to help service users to identify their room, and each door has a picture of the service user. Keys are made available for relatives and service users. The home has private visiting areas for relatives. Relatives were very pleased with the home. One said, “We looked around a few before deciding. It’s champion.” Another commented that, “We decided it was better to travel a little distance to get this quality.” Good hand washing facilities are available and staff are trained in infection control. Clinical waste is disposed of professionally and safely. The laundry is well equipped. The home is kept clean and odour free. One relative said that, “It is always clean. There is never any smell.” Lindisfarne House DS0000072643.V377311.R01.S.doc Version 5.2 Page 18 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The staffing of the home meets service user’s needs. They are supported in a safe manner, by staff who are properly recruited, and have the appropriate training. EVIDENCE: There were a suitable amount of staff on duty at the time of the site visit. Service user’s needs were met, call buzzers were answered within a reasonable time and care was given in an unhurried manner. The home’s self assessment stated that, over 70 of care staff have NVQ qualifications and the remainder are currently working towards the same. Staff who were spoken to confirmed they held NVQ qualifications. Staff also said they received an induction, and training, and records confirmed this. There was a training “matrix” to show the amount of training each member of staff had received. There was also a list of training available to staff displayed in the staff rest room. Staff records indicate all pre employment checks are carried out including Criminal Records Bureau, Protection Of Vulnerable Adults list and previous employer references. Records also show that staff are interviewed and they receive terms and conditions. Lindisfarne House DS0000072643.V377311.R01.S.doc Version 5.2 Page 19 Lindisfarne House DS0000072643.V377311.R01.S.doc Version 5.2 Page 20 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is managed by an experienced person who has service user’s interests at heart. The home is run in the best interests of service users. They are kept safe and their welfare and rights are protected by good record keeping and the promotion of good practice EVIDENCE: The manager has 28 years experience as a Registered Mental Nurse. She has achieved the Registered Managers award and has a Degree in Person Centred Counselling. She has been a home manager for 9 years and is registered with the Care Quality Commission. The manager states that an annual plan for quality assurance is in place. Lindisfarne House DS0000072643.V377311.R01.S.doc Version 5.2 Page 21 Meetings with relatives and staff are held monthly and recorded. Information from these sources are included in the quality monitoring plans. The proprietor completes a Regulation 26 visit, monthly. Medication audits are completed monthly. Relative and service user satisfaction surveys are completed 6 monthly and examples of these were seen. Information received from these will be used to plan quality improvements. Written and electronic records of service user’s personal allowance are maintained. Individual pocket money accounts are maintained with two signatures. Secure facilities are provided for the safe keeping of money and valuables. Records and receipts are kept of money and valuables. Records indicate that all staff receive training in health and safety and they have a good awareness of this. Water temperatures are recorded. Accurate risk assessments are recorded in care plans. Lindisfarne House DS0000072643.V377311.R01.S.doc Version 5.2 Page 22 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 3 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 x 4 4 4 2 4 4 4 4 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 Lindisfarne House DS0000072643.V377311.R01.S.doc Version 5.2 Page 23 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. Refer to Standard OP22 Good Practice Recommendations The home should provide a loop induction system to help hearing aid users. Lindisfarne House DS0000072643.V377311.R01.S.doc Version 5.2 Page 24 Care Quality Commission North East Region Citygate Gallowgate Newcastle upon Tyne NE1 4PA National Enquiry Line: Telephone: 03000 616161 Email: enquiriesnortheastern@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). 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