Care Home: Lymehurst

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What the care home does well All of the people consulted during the inspection were happy with the care they receive. People told us carers look after them well. Peoples` health needs are well monitored and we saw evidence of the home engaging the support of health care professionals where necessary. Lymehurst provides people with a clean and comfortable place to live with the opportunity to personalise their own bedrooms. There is a relaxed and homely atmosphere. What has improved since the last inspection? People who live at the home can enjoy weekly exercise classes if they wish to join in. Externally the grounds have been improved with decking. What the care home could do better: There were no requirements made at this inspection. Two recommendations were made, which were to retain copies of assessments on individual files and to ensure care plans are reviewed on a monthly basis. Key inspection report Care homes for older people Name: Address: Lymehurst 112 Ellesmere Road Shrewsbury Shropshire SY1 2QT     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home 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 full review a ‘key’ inspection. Lead inspector: Karen Powell     Date: 2 1 0 9 2 0 0 9 This is a review of 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. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. Care Homes for Older People Page 2 of 23 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. 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 Care Homes for Older People Page 3 of 23 Information about the care home Name of care home: Address: Lymehurst 112 Ellesmere Road Shrewsbury Shropshire SY1 2QT 01743351615 01743351615 lymehurst@aol.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mr Tay Sivri, Mrs Goulsen Ibrahim, Ms Narin Ibrahim care home 35 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users to be accommodated is 35. 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 categories: Older People (OP) 35 Dementia (DE) 8 Date of last inspection Brief description of the care home Lymehurst is a private care home registered which provides residential care for up to thirty-five older people. The home is situated on Ellesmere Road close to the centre of Shrewsbury. The homes owners Mrs Ibrahim and her family operate the business with Tay Sivri having day-to-day management responsibilities. The property has been converted from a large double fronted Victorian family style residence and extended at ground floor level to provide comprehensive and spacious accommodation. The Home stands in its own grounds entered from the road onto a large forecourt. There is an Care Homes for Older People Page 4 of 23 Over 65 0 35 8 0 Brief description of the care home established staff group providing people who live at the service with consistency in a homely atmosphere. Weekly fees range from £430.00 to £500.00 per week. Anyone wishng to know more about the fees should contact the service directly. Information about the home and the provision of the service are available in the statement of purpose and service user guide, both documents have recently been revised and are readily available. Care Quality Commission Inspection reports for this service are available from the provider or can be obtained from www.cqc.org.uk Care Homes for Older People Page 5 of 23 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The inspection of the service was unannounced and was carried out by one inspector over a period of approximately five hours. A range of evidence was used to make judgements about this service to include discussions with people using the service, the registered manager, and staff. We also examined a number of records to include care records of people living at the home, staff training, staff recruitment and health and safety records. We looked at what the home has told us about what has happened since our last visit. These are called notifications and are a legal requirement. Two people who live in the home were case tracked this involves establishing individuals experience of living in the care home by meeting them, discussing their care with staff, looking at care files and focusing on outcomes. Tracking peoples care helps us understand the experiences of people who use the service. Care Homes for Older People Page 6 of 23 An Annual Quality Assurance Assessment AQAA document was posted to Lymehurst for completion. The AQAA is a self-assessment and a dataset that is filled in once a year by all providers. It informs us about how providers are meeting outcomes for people using their service and is an opportunity for them to share with us areas that they believe they are doing well. By law they must complete this and return it to us within a given timescale. The administrator who is also a partner in the business completed this, and some of the information is included in the report. The purpose of the inspection was to assess all 22 Key National Minimum Standards for Care Homes for older people and any further standards necessary. We carried out a random unannounced inspection on 7th May 2008 following concerns about the installation of CCTV at the home. It was agreed that cameras in use around the home would be taken out immediately, and that CCTV cameras at the front entrance to the building could remain in place. An annual service review was carried out on 30th October 2008. This did not involve a visit to the service but is a summary of new information given to us, or collected by us, since the last key inspection. The report is available at the service. Information to produce this report was gathered from the findings on the day and also by review of information received by CQC prior to the inspection date. A quality rating is provided throughout the report based on each outcome area for the people who use the service. These ratings are described as excellent/good/adequate or poor based on findings of the inspection. Fees are published in information given to prospective clients. The weekly fee range is 430.00 to 450.00 for residential placements and 450.00 to 500.00 for EMI placements. Readers wishing to know more about this information should contact the service directly. Care Homes for Older People Page 7 of 23 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 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 23 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 23 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. People are provided with information and encouraged to make informed decisions about the home before moving in. Pre placement assessments ensure that individual needs are met. Evidence: The home has clear information in the service user guide and statement of purpose to help people understand what services the home can provide. People are only admitted to the home following an assessment of their needs carried out by the registered manager or a suitably qualified health care professional. This is to ensure the home can meet their assessed needs. We looked at one individuals file who was recently admitted to the home. We talked to them about their experience of the admission, they told us that their next of kin had assisted them with finding a place at Lymehurst. Care Homes for Older People Page 10 of 23 Evidence: We did not see the written assessment on their file but were assured by the registered manager that an assessment had been undertaken. Wherever possible, people who choose to live at the home or their relatives are included in discussions about their care, so that their admission assessments and care plans reflect their individuality. Most of the people who move into the Service do so with the intention of making it their longer term home. However, there is provision for people to stay for shorter periods, this is sometimes known as respite care. This might be so that someone who cares for them at home can have some time to themselves. Or, someone might move in on a short term basis because they are trying to decide if they want to stay living at home. Care Homes for Older People Page 11 of 23 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. Staff have the information they need and have a clear understanding of how to offer care to each person, which ensures peoples health and personal care needs are met in a way that they prefer. Evidence: Care plans we looked at for three people explained to staff how people preferred their care to be given. The service has begun to look at how the new depravation of liberty legislation impacts on the people they care for. A mental health professional care worker has reviewed several of the care plans and offered advice and guidance as to how the home should address this within individual care plans. It was stated by the registered manager that this has been carried out by the home to ensure that people are not deprived of their liberties without full assessment and supporting care plan documentation being put in place. The manager has attended a deprivation of liberties briefing session. Care plans contained a record of input from other health care professionals involved in Care Homes for Older People Page 12 of 23 Evidence: individuals care. For example the involvement of a district nurse. Care plans we sampled had not been reviewed on a monthly basis. Although this did not appear to affect the outcomes for people receiving care or support that we could see. Evaluation of care plans needs to be developed to provide meaningful feedback of the effectiveness of the care plan over the previous month. We discussed this with the manager who acknowledged that the home needs to address this. Individuals preferred social activities were documented and when we spoke to the people they were able to confirm they were able to carry out the choices they had made. One person told us they like to take a daily walk around the grounds. We saw them do this during our visit. We observed people choosing how they wanted to spend their day during our visit. The home has policies and procedures in place for the safe handling of medication. We looked at the medication administration records (MAR) and storage of medication. MARs had been signed when medication had been given indicating that medication had been given as prescribed. Only trained carers administer medication at the home. We spoke to a carer who was able to competently explain all procedures and practices relating to the safe handling of medication. Medication receipt and disposal was satisfactory and in line with good practice. We observed people to be treated with respect during the visit with their dignity and privacy being maintained. Staff were seen to be knocking on toilet doors before entering to support individuals. The staff group were patient, kind and caring throughout the day. People we spoke to confirmed this is the case at all times. People are helped to keep in touch with members of their families, if this is necessary and if this is what they want. Family members and friends are welcome to call to the Service at any reasonable time. Care Homes for Older People Page 13 of 23 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Lymehurst are provided with opportunities to experience a meaningful lifestyle that ensures self esteem and well being. People are provided with healthy, well presented meals according to their dietary requirements and choice. Evidence: All three care plans we looked at identified peoples likes and dislikes. People we spoke to during our visit told us that their daily routines are flexible and they are able to choose how they wish to spend their day. People told us they can rise and retire at the times they prefer. We saw an activities plan on the notice board and people told us they enjoy the activities on offer. On the day of our visit one person we spoke to was enjoying listening to music while playing along on the xylophone. We saw photographs around the home of people taking part in activities. One person has a cat, the manager told us they will consider taking pets if this is requested. People we spoke to told us they were happy with the food provided at the home. We spoke to the chef about the menu which is designed on a two week rolling programme. The daily menu was seen on display and offered choices to people. The menu reflected what was being served on the day of our visit. Care Homes for Older People Page 14 of 23 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Lymehurst have access to a complaints procedure, which is accessible and ensures the views of people are listened to. Staff receive training so that they have an understanding in adult protection to ensure people they support are protected from abuse, ensuring their well being. Evidence: People we spoke with told us they knew what to do if they were unhappy with the service they receive and reported that they have no concerns of complaints about the home. People have access to a complaints procedure, which we saw during our inspection. There have been three complaints since the last inspection that were dealt with through the homes complaints procedure appropriately. All complaints were substantiated. There have been no complaints to the Care Quality Commission. Staff are trained in adult protection. We discussed with staff what action they would take if they suspected an incident of abuse. All were confident in their response and demonstrated they were aware of the correct procedure to follow. Care Homes for Older People Page 15 of 23 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. People living at Lymehurst are provided with a clean and homely place to live, which is equipped to meet their individual needs and makes them feel safe and secure. Evidence: We took a tour of the home and found it to be clean and tidy. Ongoing renewal and maintenance of the home ensures that the service provides an environment that is well maintained for people who live at the home. People who use the service are encouraged to personalise their rooms according to their choice, and this was evident when we viewed the home. The home is set in pleasant grounds and in nice weather can be accessed by people if they wish to sit and walk around the garden. The laundry was well equipped. It was well organised and clean. People told us that the standard of the laundry is good and they always wear their own clothes because their clothes are labeled and dont get mixed up. Clothing looked well cared for on the day of our visit. Care Homes for Older People Page 16 of 23 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 arrangement for staffing, their support and development ensures that the needs of the people living at the home are met. People have confidence in the staff at the home because checks are done to make sure that they are able to care for them. Evidence: We looked at the files of two staff employed since our last inspection to make sure that pre employment checks are undertaken so that staff are checked as being suitable to work with vulnerable adults. Files were well organised and contained all the checks required under regulation. All people consulted as part of the inspection told us that the staff treat them well and that they are happy with the care and support they receive. We observed staff supporting people throughout the day, they did this with respect and were professional at all times. Staff told us that they are given regular updates about people living at the home during handover on each shift, and supported through updated care plans. Staff we spoke to demonstrated a clear understanding of the peoples needs. We were told by people living at the home that they felt there is sufficient staff on each shift. Staff shortages are covered by staff already working at the home. This means that the people who live at the home benefit from the people who know their Care Homes for Older People Page 17 of 23 Evidence: needs, caring for them. Training for the staff is good. We looked at training completed by staff and saw the relevant training certificates on staff files. Training included dementia, moving and handling, protection of vulnerable adults, health and safety, and fire safety. The completed AQAA did not state how many staff have a nationally recognised qualification NVQ but all staff spoken to on the day of our visit were NVQ qualified. All staff are formally supervised and appraised, we saw records to support this. Staff spoken to told us they felt well supported by the manager of the home. The homes induction process, consistent with Skills for Care expectations, is thorough and conducted over a period of time. Care Homes for Older People Page 18 of 23 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. People have confidence in Lymehurst because it is effectively managed in the best interests of the people living and working there. Evidence: The registered manager is suitably qualified to manage the care home and has a number of years experience in the care sector. The staff receive clear guidance on how to perform their role and there is a clear understanding from staff of what is expected of them. This ensures that people living at the home receive consistent care and support of a good standard. The care workers we spoke to told us that there is good team work between them. There are handover meetings at the beginning and end of each shift. These are held so that they can be kept up to date with developments. People living at the home are regularly consulted in what they think about the service and any improvements that could be made. We saw evidence of feedback from Care Homes for Older People Page 19 of 23 Evidence: questionnaires given to people to seek their views. We saw a number of thank you cards from people who had contact with the home. Comments we saw included I want to thank you for providing a home with competent and caring staff for the ten and a half years of my mothers residence with you. She always said the food was very good and everyone was well looked after. Thank you so much for looking after X over the years, once she gets called she was very happy that always telling us how well she was looked after, and how good the food was. It was such a comfort to know how well looked after she was. People who are unable to manage their finances are supported through the home. Policies and procedures are in place, which give clear guidance on managing peoples money, valuables and financial affairs. All checks required such as of the fire safety systems; hot water systems, lifting equipment and electricity are in place. People are protected through regular maintenance of systems and equipment and records to show this are well organised. Care Homes for Older People Page 20 of 23 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 21 of 23 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 3 Copies of pre admission assessments should be available on a persons file. This is to demonstrate that an assessment has taken place before the admission and that the home can determine from the assessment that they can meet the persons needs. Care plans should be reviewed monthly in order to evaluate the care/support is still effective and meeting the needs of the person using the service. 2 7 Care Homes for Older People Page 22 of 23 Helpline: Telephone: 03000 616161 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) 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. Care Homes for Older People Page 23 of 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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