Care Home: Lowfield House

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What the care home does well Residents had written care plans and risk assessments, which supported them to ensure their health and personal care needs being met in a consistent way. They had access tohealth professional support when required. Health care professionals considered the home was very well managed by the manager who was described as `competent, kind and professional.` Residents spoken to during inspection said they were very happy with their care. Staff who gave written comments for the Annual Service Review said they were trained well. They had good support and knew how to keep residents and themselves safe. They considered they had up to date information about residents and were described by residents as being very good and helpful. Care plans showed residents rights were considered such as the right to be treated with dignity and respect. Staff also considered they were trained well and there was good evidence to show residents rights were respected. Staff were clearly expected to treat residents with dignity and respect in the course of their duties. Care plans instructed staff to maintain privacy and dignity and medication was managed safely. The complaints procedure and the way the home was managed made it very easy for residents and other people to raise any issues or concerns they had. Staff who provided written comments for the Annual Service Review said they knew what to do if a resident had any concerns or was unhappy. The person in charge during inspection said staff had been trained and were regularly informed of their responsibility in adult protection issues and was confident staff would follow the protection procedures should the need arise. What the care home could do better: This random visit found that the service has continued to provide good outcomes for residents in the home. There were no requirements made. However there were a number of recommendations made to improve current practice. These included: Where risk assessments show special measures are needed to reduce an identified high risk scenario, instructions for staff to manage the risk should be clearer and more definite. This will provide accountability to ensure nothing is overlooked. Whilst care plans identified need and responsive action required by staff, more should be written to identify exactly what staff must do rather than use terms such as `if conditions allow`. This will provide a consistent approach to resident care. More care should be taken to record a risk assessment for `not` using footrests on wheelchairs. This will ensure all residents are made fully aware of the danger of this to make an informed choice. Consent for medication should be recorded better, and demonstrate peoples wishes and capabilities to self medicate, as not all options had been considered. The homes application form should ensure applicants will complete a full work history and references should only be sought from employers rather than work colleagues. Random inspection report Care homes for older people Name: Address: Lowfield House Railway View Road Clitheroe Lancashire BB7 2HA two star good service The quality rating for this care home is: The rating was made on: 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 review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Marie Dickinson Date: 1 0 0 6 2 0 1 0 Information about the care home Name of care home: Address: Lowfield House Railway View Road Clitheroe Lancashire BB7 2HA 01200428514 01200444365 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Ms Julie Dean Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mr Peter John Hitchen care home 24 Number of places (if applicable): Under 65 Over 65 24 old age, not falling within any other category Conditions of registration: 0 The registered person may provide the following category 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 category: Old age, not falling within any other category - Code OP. The maximum number of service users who can be accommodated is:24. Date of last inspection Brief description of the care home Lowfield House is registered with the Commission for Social Care Inspection to provide care and accommodation to 24 older people. The home is situated in the centre of Clitheroe giving the people who use the service Care Homes for Older People Page 2 of 10 2 0 1 1 2 0 0 8 Brief description of the care home good access to community facilities. Sainsburys supermarket, public transport and the train station are within easy access of the home. The property is detached and set in its own grounds. All bedrooms are single and have a door lock. Most are en-suite and some are situated on the ground floor of the home. There are a number of shared and communal areas throughout the home including the dining room and lounge. Access to the first floor is via a passenger lift. There is ample parking to the front of the building and this overlooks a well-maintained garden. The people who use the service and their relatives receive a copy of the homes information guide and have access to the Statement of Purpose that includes the level of fees charged. Care Homes for Older People Page 3 of 10 What we found: This random inspection was carried out on the 10th June 2010. The focus of the inspection was to look at resident health and personal care and resident protection. The inspection involved a visit to the home. Consideration was also given to the outcome of an Annual service review (ASR) completed March 2010. Comments had been received from relatives, residents and professional visitors to the home. A relative said, Mum feels at home and is happy and content. She would not want to be anywhere else. Health care professionals said, Lowfield House is very well managed by Julie the manager who is competent, kind and professional. And Homely, pleasant environment with home cooked meals and friendly atmosphere. The majority of residents, who provided written comments and those spoken to during inspection, indicated that they always receive the care and support they needed at Lowfield House. Positive comments about the care and attention they receive were made. For example they said, Staff are very good and help me. And They are always available when I call them. Staff were also described as being helpful. Staff who provided written comments considered training was very good and they were given up to date information about the needs of residents. They had good support and said they knew how to keep themselves and residents safe. They said, The staff at Lowfield are trained well. They provide the best care anyone could receive. It really addresses the needs of residents and endeavors to make their lives happy and meaningful. Information received at the Commission for this inspection was brief. However records seen during this inspection showed care was based on residents assessments to ensure that personal and health care needs are fully considered. Potential risks were looked at and included for example, risk of developing pressure sores, nutrition, continence, moving and handling, and risk of falling. There was evidence risk was being managed. However, where risk assessments show special measures are needed to reduce an identified high risk, instructions should be clearer and more definite, for example times for activities and person responsible such as carer, or health professional and therefore provide accountability to ensure nothing is overlooked. Two care plans were looked at in detail. Information recorded included reference to peoples past history and lifestyle, and what they liked and disliked. Needs identified for personal care, mobility, communication, personal safety, medication, medical, and social were also listed. How identified needs were to be supported was generally clear, for example, the support they required with getting dressed and when having a bath. Whilst care plans identified need and responsive action required by staff, more should be written to identify exactly what staff must do rather than use terms such as if conditions allow. The plans were supported by daily records of personal care, which provided information about changing needs and any recurring difficulties and provided staff with ongoing details about the residents well being. The right of residents to be treated with dignity and respect was included in staff training. Care plans showed how staff were instructed to maintain privacy, dignity, and independence. For example, Desired outcome. Maintain hygiene standards and maintain Care Homes for Older People Page 4 of 10 choice dignity and ensure privacy. This is clearly very good practice. All residents were registered with a GP and had access to health care services both within the home and in the local community. This included for example visits from the district nursing team for nursing intervention as required, and continence care appeared to be managed very well. Pressure care was promoted and pressure-relieving aids were used where need was identified. Records seen showed risk assessments had been completed for moving and handling and were used as guidance for staff to help care for residents safely, for example Two carers to assist with transfers, hoist to be used. More care however should be taken to record a risk assessment for not using footrests on wheelchairs. This will ensure all residents are made fully aware of the danger of this to make an informed choice. The home operated a monitored dosage system for the administration of medication, which was dispensed into blister packs by the supplying pharmacist. An appropriate recording system was in place to record the receipt, administration and disposal of medication. Consent for medication should be recorded better, and demonstrate peoples wishes and capabilities to self medicate, as not all options had been evidenced as being considered. Medication given as when necessary was sufficient in detail as to when this would be given. A clear audit of medication received was kept. The record of medication administration was signed and storage of medication was secure. Staff responsible for administering medication had been trained. The complaints procedure was given to residents when they were admitted to the home. The procedure gave clear directions on whom to make a complaint to and the timescales for the process. The person in charge during inspection said any issue raised was quickly dealt and people are very open and would say if they had any concern. There had been no complaints received at the Commission and no complaints dealt with by the home. Residents and relatives, who completed surveys about the service, showed they knew who to talk to if they were not happy, and were confident to use the complaints procedure. Staff also indicated they knew what to do if someone was not happy or had any concerns. The person in charge during inspection said staff working at the home were trained in adult protection and were aware of the written abuse policies and procedures, which included whistle blowing. They knew their responsibility in this area and were confident they would report bad practice if ever the need arose. There were established arrangements in place to safeguard the residents financial affairs and staff contracts precluded them from financial reward. Records showed recruitment involved police character checks to ensure the residents were protected from unsuitable people. The application form however needed to improve to make sure a good sound employment history was recorded. Care should also be taken to request a reference from a past employer rather than a work colleague. What the care home does well: Residents had written care plans and risk assessments, which supported them to ensure their health and personal care needs being met in a consistent way. They had access to Care Homes for Older People Page 5 of 10 health professional support when required. Health care professionals considered the home was very well managed by the manager who was described as competent, kind and professional. Residents spoken to during inspection said they were very happy with their care. Staff who gave written comments for the Annual Service Review said they were trained well. They had good support and knew how to keep residents and themselves safe. They considered they had up to date information about residents and were described by residents as being very good and helpful. Care plans showed residents rights were considered such as the right to be treated with dignity and respect. Staff also considered they were trained well and there was good evidence to show residents rights were respected. Staff were clearly expected to treat residents with dignity and respect in the course of their duties. Care plans instructed staff to maintain privacy and dignity and medication was managed safely. The complaints procedure and the way the home was managed made it very easy for residents and other people to raise any issues or concerns they had. Staff who provided written comments for the Annual Service Review said they knew what to do if a resident had any concerns or was unhappy. The person in charge during inspection said staff had been trained and were regularly informed of their responsibility in adult protection issues and was confident staff would follow the protection procedures should the need arise. What they could do better: This random visit found that the service has continued to provide good outcomes for residents in the home. There were no requirements made. However there were a number of recommendations made to improve current practice. These included: Where risk assessments show special measures are needed to reduce an identified high risk scenario, instructions for staff to manage the risk should be clearer and more definite. This will provide accountability to ensure nothing is overlooked. Whilst care plans identified need and responsive action required by staff, more should be written to identify exactly what staff must do rather than use terms such as if conditions allow. This will provide a consistent approach to resident care. More care should be taken to record a risk assessment for not using footrests on wheelchairs. This will ensure all residents are made fully aware of the danger of this to make an informed choice. Consent for medication should be recorded better, and demonstrate peoples wishes and capabilities to self medicate, as not all options had been considered. The homes application form should ensure applicants will complete a full work history and references should only be sought from employers rather than work colleagues. Care Homes for Older People Page 6 of 10 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 2. Care Homes for Older People Page 7 of 10 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 8 of 10 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, 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 7 Where risk assessments show special measures are needed to reduce an identified high risk scenario, instructions for staff to manage the risk should be clearer and more definite. This will provide accountability to ensure nothing is overlooked. A risk assessment for not using footrests on wheelchairs should be completed to ensure residents are made fully aware of the danger of this. Care plans should be written to identify exactly what staff must do rather than use terms such as if conditions allow. This will provide a consistent approach to resident care. Consent to medication should be recorded better with evidence all options has been discussed and agreed. The homes application form should ensure applicants will complete a full work history and references should only be sought from employers rather than work colleagues. 2 7 3 7 4 5 8 29 Care Homes for Older People Page 9 of 10 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got 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 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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