Care Home: Locharwoods

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What the care home does well There are processes used at Locharwoods to help make sure that people`s needs can be met at the home. We found that people`s health and personal care needs were being met by staff in a way which respected their privacy and dignity. People`s personal and healthcare needs are well documented and include their personal wishes and preferences. This makes sure that staff have the information they need to make sure they meet people`s needs in the way they prefer. People who live in Locharwoods told us the care is good and they had no complaints about the way they are supported. They told us they were satisfied with the lifestyle in Locharwoods and they said the food is very good with plenty of choice and variety. This helps to make sure they receive a nourishing diet to keep them as healthy as possible. We have not received any complaints or safeguarding alerts about Locharwoods since our last visit to the home. We found that there are good safeguarding procedures in place to ensure that people remain safe in this home. The complaints procedure is clear and accessible meaning that people who live in Locharwoods feel listened to and taken seriously. What has improved since the last inspection? Staff training is continuing and some new staff are being recruited to cover holidays and absences as they occur, to give continuity to the service. We found that staff have the skills to support people`s needs and residents told us they have no concerns about the staff`s abilities in care giving. This means that people`s needs are being met in the way they prefer. Residents` comfort and needs have been made the top priority in the improvement programme. A lot of work has been carried out in communal areas and bedrooms which have been refurbished to a good standard and to residents` satisfaction. There are plans to refurbish the kitchen and laundry next, to improve the layout and efficiency of these areas. What the care home could do better: To avoid the risk of error when giving out medication, we recommend that handwritten medication administration records be signed by the writer, checked against pharmacy containers and signed by a colleague to confirm that they have been copied accurately. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Locharwoods 23 Carrs Crescent Formby Liverpool Merseyside L37 2EU     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: Patricia Thomas     Date: 0 6 0 2 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 25 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.cqc.org.uk Internet address Care Homes for Older People Page 3 of 25 Information about the care home Name of care home: Address: Locharwoods 23 Carrs Crescent Formby Liverpool Merseyside L37 2EU 01704832047 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : locharwoods@hotmail.com Mr Stuart Gordon Pearson,Mrs Charlie Pearson care home 18 Number of places (if applicable): Under 65 Over 65 18 old age, not falling within any other category Additional conditions: 0 The registered person may provide the following category/ies of service only: Care home only - Code PC 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 The maximum number of service users who can be accommodated is: 18 Date of last inspection Brief description of the care home Locharwoods is a care home for 18 older people. The home is owned by Mr. S. and Mrs. C. Pearson. Mrs. Linda Anderton is the registered manager. Locharwoods is a large converted house in pleasant and secluded gardens. Situated in a quiet residential area of Formby, the home is close to shops and local amenities. Locharwoods is staffed throughout the day and night and provides personal care, single accommodation, meals, laundry and in-house social activities. The weekly charge for Locharwoods is #398.00. Care Homes for Older People Page 4 of 25 Care Homes for Older People Page 5 of 25 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: We (the commission) made this unannounced visit to Locharwoods on 6 February 2009. It took five hours and was done by one inspector. The report will say we when referring to what we did, because it is written on behalf of the Commission. During our visit, we walked around the home and we checked various records to see what care people living there receive. We spoke with people who live at Locharwoods and they told us what they thought about their home. We also spoke with the manager and staff who gave us their views about working in Locharwoods. We have included their views throughout the report. During our visit to the home, we used a system we call case tracking. This is a way of Care Homes for Older People Page 6 of 25 inspecting that helps us to look at services from the point of view of some of the people who use them. During the visit, we tracked peoples care to see whether the service meets peoples individual needs properly and safely. The visit was just one part of the inspection, as we also reviewed information we have received about the home since our last visit. This included the Annual Quality Assurance Assessment (AQAA), which had been filled in by the manager and returned to us. This document provides information about Locharwoods including plans for future development and some numerical information about the service. We sent out surveys to people who live in Locharwoods and their views are included in the report. 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.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 25 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 25 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. There is plenty of good information available about Locharwoods and staff from the home check what peoples needs are before they move in, so people know their needs can be met at the home. Evidence: There is a good system to introduce people to Locharwoods, with information provided and checks done before people move in to find out what their needs are. The booklet that tells people what the home does is on display in the home and given to people who are interested in moving in. It gives a lot of information about the home, the accommodation, the staff and their experience. A person who lives at the home told us that she had received very good information about Locharwoods before she moved in. The manager told us that she visits people before they move into Locharwoods, to check what their care needs are. These checks cover peoples health and personal care Care Homes for Older People Page 10 of 25 Evidence: needs. In this way people hoping to move in know that their needs can be met at Locharwoods. We looked at care files of three people who live at the home and these showed us that the staff there had plenty of information on which to base each persons care plan when they moved in. This helps to make sure that each persons needs could be met correctly as soon as they move into the home. Care Homes for Older People Page 11 of 25 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. People who live in Locharwoods have their needs met and their care is provided in a manner that makes sure their privacy and dignity is respected. Evidence: We looked at care files of three people who live at Locharwoods, to check on what care they were receiving. We found that the care plans on personal care tasks focused on what people are able to do for themselves, which helps them to stay as independent as possible. Where risks to the persons safety had been identified, staff had written guidance about how to promote the persons safety, for example when helping them to bathe or move around the home. Care plans had been regularly reviewed to make sure that any change in each persons condition had been recorded and the care plan changed to make sure the persons needs would continue to be met. The files we saw showed clearly that peoples health care needs had been well recorded along with the action taken by staff to refer them to GPs and health care services. This helps to make sure that people living at Locharwoods stay as healthy as possible. People who live there told us in surveys that they receive medical attention when needed and five Care Homes for Older People Page 12 of 25 Evidence: people we spoke with during our visit to the home told us the care and support they receive is good. Another person told us that staff listen to what she wants and respect her wishes in the way care is given. There is a system used at Locharwoods for staff to follow in managing peoples prescribed medication. We looked at the medicine storage arrangements and record keeping and these were satisfactory. We checked one persons medicines and found that all the prescribed medicines she needed were in stock. There is a system in place for ordering drugs every twenty-eight days and returning unwanted medication to the pharmacy to avoid a build-up of unused stock. This helps to make sure that people always receive their medicines correctly. To avoid errors when handwritten entries have to be made on medicine administration sheets, it is recommended that they are signed by the person making the entry, then checked and countersigned by a colleague. This will help to make sure that instructions that have to be handwritten on MAR sheets are accurate so that people receive their medicines as prescribed. There was good evidence that peoples dignity is respected in Locharwoods. They told us their clothing is always returned from the laundry in good condition and that a hairdresser visits every week. During the visit we saw staff asking people what they would like to eat or drink and knocking on bedroom doors before entering. People living in the home appeared relaxed and they told us they like living in Locharwoods. Care Homes for Older People Page 13 of 25 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. Social activities and meals are both well managed to make sure that people living at Locharwoods can stay active, socialise and enjoy a varied diet to help keep them healthy. Evidence: There is an activities diary for the home displayed in the hallway so people who live there and their visitors can see what is going on. All activities are recorded and those on record included bingo games, hairdresser visits, film shows, manicure sessions, social gatherings, a quiz, exercise sessions and meals out at local restaurants. This shows that there was a good range of activities for people living at Locharwoods to take part in, to keep them active and give them the chance to socialise. People living there told us they were happy with the activities on offer. One person said he likes to do his crossword and read the paper. Another person said she likes a quiz and just chatting with people in the lounge. Peoples spiritual needs are recorded so they can be given the opportunity and any help they need to continue to follow their faith when they move into Locharwoods, if they wish. Staff have obtained information about the social, cultural and leisure needs Care Homes for Older People Page 14 of 25 Evidence: of people living in the home. This means that they have the information they need to make sure the support provided is right for that person. People we spoke with and those who returned surveys told us they are happy with their lifestyle in Locharwoods. They said their visitors are made welcome and they are left in private to entertain them. In one persons care file that we looked at, we saw a care plan for him going to stay with his family. We could also see from the files that peoples families were involved in planning their care and attending medical appointments with them. This helps to make sure that people living at the home keep good contact with their families and they and their relatives have a say in how their care and support are provided. Two people who returned surveys to us said they always like their meals. Two others said they do like the food usually and that an alternative is offered when they do not want what is on the menu. We went to see the dining room, which is bright and comfortable with enough seating for everybody in the home. The tables were laid with clean cloths, cutlery and condiments. There is a qualified chef employed at the home who told us menus are seasonally reviewed in consultation with the people who live at Locharwoods, to ensure variety and choice. The food stores were well stocked and the catering records had been well maintained. This showed us that the people who live at Locharwoods have a healthy and varied diet to help make sure that they receive the nourishment they need to keep them well. Care Homes for Older People Page 15 of 25 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. There are good procedures to make sure that peoples concerns and complaints are taken seriously. The procedures for safeguarding are clear and staff have received training so they know what to do to make sure that people living there are protected from harm. Evidence: We looked at the records and procedures about managing complaints and procedures for protecting people who live in the home. We found that good safeguarding procedures were in place and staff had received training to make sure they knew what to do to protect the people living at Locharwoods from harm. The complaints procedure we saw was clear and everybody living at the home had been given a copy when they moved in. This means that people who use the service and their representatives could be confident that their concerns would be listened to and taken seriously. Care Homes for Older People Page 16 of 25 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. Locharwoods is well looked after so that people living there live in suitably adapted, clean, safe, comfortable and very pleasant surroundings. Evidence: People living at Locharwoods told us they think it is a comfortable and welcoming place. The home is a converted dwelling house which remains domestic in style and provides some aids and adaptations for people who have difficulty getting around. The gardens are very well maintained and attractive, giving a very good first impression of the home. Bedrooms are single rooms and residents told us they were pleased with their rooms. There are two lounges, a spacious dining room and a conservatory. We saw people who live at the home moving freely between these rooms. Some people spend time during the day in their bedrooms, and those bedrooms which we saw were highly personalised, with good views of the garden. There is a passenger lift providing access to all floors and there are assisted bathing facilities for people who have poor mobility. During our visit, the home was very clean and odour free. Domestic staff are employed and the person on duty during our visit confirmed that there are policies and procedures for control of substances hazardous to health and infection control. We were also told that relevant training in these areas is provided. This means that people Care Homes for Older People Page 17 of 25 Evidence: were protected from infection, toxic conditions and the spread of infection at the home. Care Homes for Older People Page 18 of 25 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 staffing arrangements, recruitment procedures and training in place help to make sure that people living at Locharwoods are cared for and supported safely. Evidence: At the time of our visit, the manager, two care assistants, one cook and one housekeeper were on duty to meet the needs of the people living at Locharwoods. The rotas we saw gave a true record of the people on duty during our visit. They were providing the support for the seventeen people living in the home at the time. Staff told us they did not feel rushed, meaning there is time to support people properly in a relaxed atmosphere. The home employs a training agency and accesses some mandatory staff training from the local authority. Records we saw showed that newly appointed staff are given induction training and that mandatory training is regularly updated to ensure their knowledge and skills are up to date. Over fifty percent of staff of care staff have a nationally recognised vocational qualification in care (NVQ). This gives staff a broad knowledge of care giving within the principles of promoting peoples rights and choices. We looked at the staff files for the two most recently employed staff in Locharwoods. These showed the recruitment procedures which are being followed. We saw that satisfactory criminal records bureau checks and employers references had been taken Care Homes for Older People Page 19 of 25 Evidence: up before the staff members started working in the home. This helps to make sure that only staff who are suitable to work in Locharwoods will be employed and people living there would be protected from poor practice and harm. Care Homes for Older People Page 20 of 25 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. Locharwoods is well managed so that it is run in the best interests of people who live there. Evidence: The manager of Locharwoods, Linda Anderton, holds a management qualification and has several years of experience in managing the home. We found good proof during our visit that the management of the service is based on openness and consultation with the people who live in Locharwoods. This helps to ensure that the home is run in the best interests of the people who live there. To help ensure that peoples opinions on Locharwoods influence the way the service is run, there is a quality assurance system in place. This is based on asking for comments through distributing annual questionnaires to people who live at the home and their families. The responses are analysed and where shortfalls are identified, improvements to the service will be made. We could see from the care files that we Care Homes for Older People Page 21 of 25 Evidence: looked at that peoples care plans are regularly reviewed and action plans amended accordingly, in consultation with the person. This means that people will receive the care they need in the way they prefer. The manager confirmed that staff do not become involved in residents personal finances. On occasions when money is held in safekeeping for people who live at the home, records are kept of the accounts and transactions are signed to make sure that accurate records are kept that can be money spent can be checked against any balances held. We saw that a series of safety checks had been carried out on the building and equipment to make sure the home was safe for people to live and work in. We looked at the records and certificates and found them to be satisfactory and in date. A record is kept of accidents to people living and working in the home and risk assessments are carried out as necessary to make sure that people remain safe in the home. Care Homes for Older People Page 22 of 25 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 23 of 25 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 entries on medication administration records should be signed by the person making the entry, checked against pharmacy containers and signed by a colleague to make sure that errors do not occur and people receive their medicines as prescribed. Care Homes for Older People Page 24 of 25 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) 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. 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