Care Home: Lindley Grange Nursing Home

What the care home does well As a tribute to the standard of food provided the home has received a five stars, "excellent" award in association with Kirklees Council`s Health Choice Award. "Scores on the doors". The award is a five star rating scheme providing information about the standards of hygiene and compliance with legislation in food premises within Kirklees.The relatives spoken with were complementary about the staff and the care that their relatives are receiving. Comments include, "My mum is well cared for." "Staff are very observant, so if anything is wrong the doctor is call." "Any issues that arise are dealt with straight away." "My mum is always well dressed." What has improved since the last inspection? Records showed that all staff have had safeguarding (adult protection) training, which provides information on how to protect people from abuse. All staff have had movement and handling training, which will ensure that they know how to move and handle people correctly and safely. Staff are encouraged to have an NVQ level 2 in care, and the manager confirmed that fifty percent of care staff have the qualification. Since the last inspection a small lounge has been changed into a Sensory room where people can go and relax. What the care home could do better: Staff could be clearer when writing care plans relating to wound care. This would make sure that all staff knows the procedure to follow, and ensure the continuity of care. To show people`s involvement and enjoyment of activities a record should be made of all activities undertaken by the person. All staff should have regular supervision to ensure that they are supported and competent to do their job. There were no requirements made at this inspection. CARE HOMES FOR OLDER PEOPLE Lindley Grange Nursing Home Acre Street Lindley Huddersfield West Yorkshire HD3 3EJ Lead Inspector Karen Summers Key Unannounced Inspection 09:30 2 & 5 September 2008 nd th X10015.doc Version 1.40 Page 1 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 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Lindley Grange Nursing Home DS0000001118.V371136.R02.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Lindley Grange Nursing Home DS0000001118.V371136.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Lindley Grange Nursing Home Address Acre Street Lindley Huddersfield West Yorkshire HD3 3EJ 01484 460557 01484 659336 bottrillc@bupa.com www.bupa.co.uk BUPA Care Homes (GL) Ltd 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) Manager post vacant Care Home 45 Category(ies) of Dementia - over 65 years of age (45) registration, with number of places Lindley Grange Nursing Home DS0000001118.V371136.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Can provide accommodation and care for four named service users under 65 years of age. 5th September 2007 Date of last inspection Brief Description of the Service: Lindley Grange provides nursing care and accommodation for up to 45 older people with dementia type illnesses. The accommodation is on two floors and all the bedrooms have en-suite facilities. Each floor also has lounge and dining room facilities. The home is a stone, purpose built nursing home set in its own grounds. It is approximately two miles from Huddersfield and is on a main bus route. Lindley village, with all its amenities, is located within a short walk. There is a safe garden for people using the service, and ample parking to the front and side of the building. The Commission was informed on 2 September 2008, that the home’s weekly fees ranged from £362.54 to £650. Additional charges are made for chiropody and hairdressing. Information about the home and the latest Commission for Social Care Inspection report are available from the home. Lindley Grange Nursing Home DS0000001118.V371136.R02.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 the people who use this service experience good quality outcomes. This report refers to an inspection, part of which included an unannounced visit to the home on the 2nd and 5th September 2008, and the length of the inspection was 10 hours. There were 43 people living at Lindley Grange on the day of the visit. As part of the inspection, and in order to provide information to help us form judgments about how the service is run, the manager was asked to complete an annual quality assessment document. This she did, and the document provided the Commission for Social Care Inspection (CSCI) with a lot of information about the way the home is run, and what they hope to achieve in the future. During the visit we spoke with members of staff and people who receive care to obtain their views. We also looked at a sample of care records, staff recruitment, and training records, quality assurance audits and looked around the home. To enable people who use the service to comment on the care it provides, we sent surveys to people living at the home, their next of kin, and people’s doctors and health care workers (social workers, community nurses). At the time of writing this report none of the surveys were returned. As no one responded to the surveys, with the consent of people’s relatives we contacted several of them and they kindly commented on the care the home provides. We would like to thank all the people who gave feedback about this home, and would like to thank the Manager and staff for their co-operation throughout the inspection process. What the service does well: As a tribute to the standard of food provided the home has received a five stars, “excellent” award in association with Kirklees Council’s Health Choice Award. “Scores on the doors”. The award is a five star rating scheme providing information about the standards of hygiene and compliance with legislation in food premises within Kirklees. Lindley Grange Nursing Home DS0000001118.V371136.R02.S.doc Version 5.2 Page 6 The relatives spoken with were complementary about the staff and the care that their relatives are receiving. Comments include, “My mum is well cared for.” “Staff are very observant, so if anything is wrong the doctor is call.” “Any issues that arise are dealt with straight away.” “My mum is always well dressed.” What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Lindley Grange Nursing Home DS0000001118.V371136.R02.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 Lindley Grange Nursing Home DS0000001118.V371136.R02.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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People are assessed prior to them moving into the home and are able to visit the home to establish whether or not it is the right place for them. EVIDENCE: The information received from the home prior to inspection said that people are only admitted after a full assessment to ensure that their needs can be met. The care records of three people who use the service were examined, all of which contained a pre-admission assessment carried out by the funding Local Authority. Each assessment contained detailed information about the person’s current needs. In addition to this, there was evidence that the home had also carried out an assessment of the person’s needs. Lindley Grange Nursing Home DS0000001118.V371136.R02.S.doc Version 5.2 Page 9 The Manager also said that people are encouraged to visit and look round the home to see if it is the right place for them, and this was also confirmed by relatives visiting the home. Relatives of people living in the home also said that they received enough information about the home before deciding that it was the right place for their relative to live. Lindley Grange Nursing Home DS0000001118.V371136.R02.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. JUDGEMENT – we looked at outcomes for the following standard(s): 7 - 10 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People’s care plans outline the level of support and care each person requires in ensuring their health and welfare needs will be met. People are treated with respect. The recording and administration of medication is satisfactory. EVIDENCE: Three people’s care records were looked at in detail and the documentation identified the care needs, and the level of support the person requires. Risk assessments had also been completed and included the risk of falls. There were also movement and handling assessments, nutritional assessment, skin integrity, social interests, religious and cultural needs, and people’s likes and dislikes recorded. Lindley Grange Nursing Home DS0000001118.V371136.R02.S.doc Version 5.2 Page 11 There was evidence that the care plans are updated monthly or as the needs of the person change. Evidence was seen of involvement from people’s doctors, physiotherapists, opticians, dentists and other healthcare professionals where needed. Relatives said that they were kept up to date with important issues affecting their friend/ relative, and that the staff were kind and helpful. Relatives also said that their relative received medical support when needed. Care records in relation to the recording and treatment of pressure sores need to be written more clearly so that staff are aware of the procedures to follow. The care plan documentation and records were discussed with the Manager in detail, and although the records in some areas need to be more detailed, staff are committed in supporting individuals to lead purposeful and fulfilling lives. The Manager assured us that the short falls in the care plan recording would be addressed. On the day of this inspection, a sample of four people’s medication was checked, and the storage, administration and recording of the medication were done correctly. However, staff are advised to date and sign the medication that has been brought forward from the previous supply to ensure that the amounts can be easily balanced when the audits are carried out. There was evidence that audits are carried out regularly to ensure that the medication is being given correctly. Lindley Grange Nursing Home DS0000001118.V371136.R02.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 People who use this service experience adequate outcomes in this area. This judgement has been made using available evidence including a visit to this service. People who use the service are able to maintain contact with their family and friends, and staff assist people in having a choice in most things they do. Meals are varied and nutritious. There was a lack of evidence to suggest that people take part in regular activities. EVIDENCE: At the time of the visit, people were seen having their breakfast, and staff assisted those who needed assistance, in a dignified manner. Visitors were offered hospitality, and people said that they were always made welcome. A dedicated activities co-ordinator continues to be employed for thirty-two hours per week, Monday to Friday. When speaking with the activities person, and listening to her speak with people using the service, it was evident that she knew the people well. Within the care records, staff had recorded the individual person’s likes, dislikes and abilities and how they like to spend their time. A record of the person’s previous hobbies and interests were also documented. The daily social records of people were recorded separately to Lindley Grange Nursing Home DS0000001118.V371136.R02.S.doc Version 5.2 Page 13 the care records and, although the activities person had recorded when she had carried out an activity, this had not been done on a regular basis. It was also evident that staff were not recording when they had carried out an activity with a person. This was discussed with the manager and she said that she would ensure that the record was completed. The manager also said that the company were holding an activities conference later in the month that the activities person would be attending, and it was where staff would share good practice, which then would be brought back to the home and put into practice. The activities recorded, included; painting of nails, hairdressing, sherry afternoon, garden party, gently exercise, fish and chips etc. The list of activities displayed in the corridor was of a small print and not easy to read. The manager said that she would ensure that these issues would be addressed. An outside entertainer also visits the home every two weeks. The hairdresser visits weekly and the chiropodist every six weeks, and there was documented evidence to suggest that this takes place. It was said that, ministers visit the home monthly and carry out communion, and also a Catholic priest visits those people who request a visit. A regular visitor to the home brings in a local church newsletter. The records in the visitors’ book confirmed that people visit the home at various times throughout the day, and comments from visitors suggested that they are usually kept up to date with important issues affecting their relative or friend. The menus offered a variety of food, and the food preferences and diets of people were also taken into consideration. The manager said that should someone wish to have a diet specific to his or her culture then one would be provided. As a tribute to the standard of food provided the home has received a five stars, “excellent” award in association with Kirklees Council’s Health Choice Award. “Scores on the doors”. The award is a five star rating scheme providing information about the standards of hygiene and compliance with legislation in food premises within Kirklees. Lindley Grange Nursing Home DS0000001118.V371136.R02.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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 &18 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People who use the service can be confident that their complaints will be listened to and taken seriously. People are protected from abuse. EVIDENCE: The complaints procedure identified the procedure to follow should someone wish to complain. Relatives of people, who use the service, said that they knew how to make a complaint and knew who to speak with if they were not happy. The manager keeps a log of any complaints received and there was evidence that people’s concerns had been taken seriously and the appropriate action had been taken to resolve the matter wherever possible. According to the information received from the home prior to the inspection, and the information seen on the day, they had received three complaints in the last twelve months, and between three and five compliments each month. The home has a whistle blowing procedure, and staff that were spoken with were aware of the procedure to follow. Records showed that all staff have had safeguarding (adult protection) training, which provides information on how to protect people from abuse. Lindley Grange Nursing Home DS0000001118.V371136.R02.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home offers people a homely and comfortable environment. EVIDENCE: As part of the inspection a tour of the home was conducted which included the communal areas, and a number of people’s bedrooms. The home continues to be decorated to a good standard, and since the last inspection a small lounge has been changed into a Sensory room where people can go and relax. The home was clean and free from unpleasant odours during this visit. Relatives also confirmed that the home is clean when they visit. Another relative commented that some of the seats on the chairs in the first floor dining room were stained and showing signs of wear. Lindley Grange Nursing Home DS0000001118.V371136.R02.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27 – 30 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People are supported by qualified, competent and experienced staff in sufficient numbers and that has had all the necessary checks before working with people so that they are kept safe. EVIDENCE: The information received from the home stated they are staffed efficiently to meet the needs of the people in their care, and evidence confirmed this when we looked at the duty rotas and spoke with staff. Relatives of people who use the service also said that there were staff around when they need them and this was evident on the day of inspection. Evidence was seen to suggest that care staff are encouraged to have an NVQ level 2 in care, and the manager confirmed that fifty percent of care staff have the qualification. Staff recruitment files of three members of staff were looked at in detail and they contained the required information and employment checks. These checks are necessary to help protect people from potentially unsuitable staff. Lindley Grange Nursing Home DS0000001118.V371136.R02.S.doc Version 5.2 Page 17 The staff that were spoken with confirmed that they had received induction training when they came to work at the home, which provides them with knowledge and skill to look after people in their care. There was also evidence that staff had dementia care training and a number of staff confirmed this. Lindley Grange Nursing Home DS0000001118.V371136.R02.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People benefit from the management approach of the home and the manager ensures so far as is practicable that the health, safety and welfare of people and staff are protected. The home is run in the best interest of people who live there. EVIDENCE: The home is currently advertising for a manager and in the interim period an experienced manager from another BUPA homes is covering the vacancy. The Operations Manager, on behalf of the company, visits the home monthly and one of the purposes of the visit is to ensure that the home is meeting its Lindley Grange Nursing Home DS0000001118.V371136.R02.S.doc Version 5.2 Page 19 objectives. Records were also seen of quality monitoring systems for each area of the home. To ensure that the home is run in the best interest of people who live there, satisfaction surveys are sent out each year, and the most recent surveys were displayed on the notice board in the entrance of the home. The results from the last report were positive. Comments included “They keep me well informed.” “The nursing staff are so good at keeping me informed of any changes.” “Every time I go there I feel welcome.” “My mum is well cared for.” There are no personal monies held in the home for people who use the service. A number of staff said that they had not received supervision for a number of months. Records showed that not all staff had received regular supervision. This was discussed with the manager and she said that she would ensure that all staff have regular supervision to ensure that they are competent to do their work. Staff also confirmed that they were aware that the manager was in the process of arranging supervision sessions for all the care staff. At the last inspection not all staff had up to date movement and handling training. At this inspection records showed and staff confirmed that with the exception of one member of staff all staff had received annual up date training. The member of staff who had not received the training, had failed to turn up for the sessions and the manager was addressing this issue. Evidence showed that not all staff had received the recommended two fire lectures this year however, the manager confirmed that further lectures had been book for those staff to attend. Lindley Grange Nursing Home DS0000001118.V371136.R02.S.doc Version 5.2 Page 20 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 X X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 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 X 3 X 3 X X 3 Lindley Grange Nursing Home DS0000001118.V371136.R02.S.doc Version 5.2 Page 21 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 OP7 OP12 Good Practice Recommendations Wound care plans need to be written more clearly so that staff know the procedures to follow. To show people’s involvement and enjoyment of activities a better record should be made of activities undertaken. Lindley Grange Nursing Home DS0000001118.V371136.R02.S.doc Version 5.2 Page 22 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB National Enquiry Line: 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 © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Lindley Grange Nursing Home DS0000001118.V371136.R02.S.doc Version 5.2 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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