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Care Home: Lymewood Nursing Home

  • Woodhouse Lymewood Nursing Home Uplyme Lyme Regis Devon DT7 3SQ
  • Tel: 01297445444
  • Fax:

The home provides accommodation, personal and nursing care for up to 37 older people who have needs related to dementia or a mental disorder. 0 4 0 2 2 0 0 9 Mr Paul Stratton is the Responsible Individual acting for the registered provider, Lymewood Care Ltd. In a beautiful rural location about 2 miles from Lyme Regis, access to the home is from the centre of the village of Uplyme. The Woodhouse Road entrance is not used. The home has plenty of parking space, and its own transport, used to take people for health appointments, etc. Accommodation is on 3 floors, with stair lifts to all floors, and a passenger lift between some areas. The manager assesses the suitability of bedrooms for prospective residents, considering the room`s location and the person`s level of mobility. Some double rooms are available. Several single rooms have ensuite facilities. There are two lounge-diners and a dining room off the entrance hall to the home, a small lounge in the newer extension, and a hairdressing room. In certain circumstances, people can bring existing pets with them when they first move into the home. Fees vary according to whether people need nursing care or not. Current information on fee levels can be obtained from the home. The weekly fees do not include newspapers, hairdressing, and chiropody, which are charged at cost price. There is also a weekly charge for personal requirements such as toiletries. Our previous inspection reports are available from the home, or our website.

  • Latitude: 50.736999511719
    Longitude: -2.9679999351501
  • Manager: Mrs Helen Mary Gray
  • Price p/w: £625
  • UK
  • Total Capacity: 37
  • Type: Care home with nursing
  • Provider: Lymewood Care Ltd
  • Ownership: Private
  • Care Home ID: 10054
Residents Needs:
Dementia, mental health, excluding learning disability or dementia

Previous Inspections

This may not be the latest inspection for this service as we are having techinical problems updating from CQC - please check directly on the regulators website for the most recent report; bestcarehome hopes to be back to regular updates shortly.

For extracts, read the latest CQC inspection for Lymewood Nursing Home.

Random inspection report Care homes for older people Name: Address: Lymewood Nursing Home Lymewood Nursing Home Woodhouse Uplyme Lyme Regis Devon DT7 3SQ two star good service 04/02/2009 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: Rachel Fleet Date: 1 6 0 9 2 0 1 0 Information about the care home Name of care home: Address: Lymewood Nursing Home Lymewood Nursing Home Woodhouse Uplyme Lyme Regis Devon DT7 3SQ 01297445444 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Helen Mary Gray Type of registration: Number of places registered: Conditions of registration: Category(ies) : Lymewood Care Ltd care home 37 Number of places (if applicable): Under 65 Over 65 37 37 dementia mental disorder, excluding learning disability or dementia Conditions of registration: 0 0 You may admit up to five service users with Dementia (DE) aged over 55 years, subject to individual assessment by local care management teams. Date of last inspection Brief description of the care home The home provides accommodation, personal and nursing care for up to 37 older people who have needs related to dementia or a mental disorder. 0 4 0 2 2 0 0 9 Care Homes for Older People Page 2 of 12 Brief description of the care home Mr Paul Stratton is the Responsible Individual acting for the registered provider, Lymewood Care Ltd. In a beautiful rural location about 2 miles from Lyme Regis, access to the home is from the centre of the village of Uplyme. The Woodhouse Road entrance is not used. The home has plenty of parking space, and its own transport, used to take people for health appointments, etc. Accommodation is on 3 floors, with stair lifts to all floors, and a passenger lift between some areas. The manager assesses the suitability of bedrooms for prospective residents, considering the rooms location and the persons level of mobility. Some double rooms are available. Several single rooms have ensuite facilities. There are two lounge-diners and a dining room off the entrance hall to the home, a small lounge in the newer extension, and a hairdressing room. In certain circumstances, people can bring existing pets with them when they first move into the home. Fees vary according to whether people need nursing care or not. Current information on fee levels can be obtained from the home. The weekly fees do not include newspapers, hairdressing, and chiropody, which are charged at cost price. There is also a weekly charge for personal requirements such as toiletries. Our previous inspection reports are available from the home, or our website. Care Homes for Older People Page 3 of 12 What we found: This Random Inspection was carried out as a result of concerning information we received about the service. We made an unannounced visit to the home to find out more about how people who lived there were treated and how staff communicated with them, particularly with regard to promotion of the dignity, general health and welfare of people living at the home. We visited for just over 6 hours, on a week day. Mrs Helen Gray, Registered Manager, was in charge when we arrived at 10.15am. She and her staff assisted us fully. There were 34 people living at the home that day, with 5 care staff and a nurse looking after them (in addition to Mrs Gray) when we arrived. The care team were supported by a cook and 2 housekeeping staff that day. During our visit, there was a calm, friendly atmosphere, with staff taking time to engage with people. A small number of people in the lounge spent time dozing. Those who were awake appeared content. We met with people living at the home, we looked at certain peoples care records, and we observed care and support that people received. Many people living at the home are not able to comment directly on the service itself, so we spent time in communal areas to observe the type of care they received and their response to the world around them. We carried out a Short Observational Framework for Inspection (SOFI). This helps us measure the well-being of people who are unable to comment directly on the care they receive. It also enables us to make judgements about how people occupy themselves during the day and the skills of the staff who support them. As a result of this observation, we then looked further into the care and support of 3 people. We spoke with some of the care staff about the support certain people needed, and how staff ensured peoples dignity was maintained. During our time in the main lounge, when we were observing how people were supported in their daily lives, we saw staff spent much time there speaking with different individuals. We noted the conversations they had gently reminded people of the day, time and season. Though conversations were not often more personalised, reading materials were offered to individuals in line with their interests as noted in their care records. Staff also told us that they sometimes looked at photographs people had, discussing the family members shown or the occasions with the individual. Staff we spoke with knew something about the life stories of people they supported, as well as some of their interests and preferences. They told us they had spoken with peoples families or talked with some people about photos, books, etc. they had, to gain this information. The care plans we read, relating to 3 people living at the home, provided only minimal person centred information. There was little about individuals daily routines, personal history, occupation, what makes them sad or happy, or general likes and dislikes. The manager told us details of some peoples lives and important events were currently with the Activities Coordinator, who was not on duty the day of our visit. Care Homes for Older People Page 4 of 12 She confirmed that such information had not been gathered about everyone living at the home, although the home was intending to approach peoples families again to try to get additional information. We discussed with the manager that we observed staff spent longer with those people who had an empty chair to sit in beside them. She hopes that the new conservatory (to be built next year) will enable better seating arrangements, rather than most chairs being in a line around the edge of the lounge as is presently the case. The care records that we read showed that peoples physical needs were better planned for than their social or psychological needs. One person who was very active (as reflected in their care notes and seen during our visit) was gaining weight despite their activity. There was evidence that GP visits were requested regularly - to see people who had fallen, or when staff thought someone had an infection developing, for example. There were risk assessments and related care plans to reduce the risk of individuals falling. When we asked staff how they prevented falls they spoke about ensuring people used their walking aids, use of the lift rather than stairs, knowing peoples whereabouts, and keeping areas tidy to reduce tripping hazards. They described behaviours of certain individuals that put them at risk, such as not stepping over peoples feet when walking past seated people. One said some people wore hip protectors, although this was not in the care plans we read. The care plans included ensuring appropriate footwear was worn, something staff did not mention when we asked how they prevent falls. Some of the information we received before our visit was that someone known to be at risk of falling had not been wearing footwear, and they had a fall. We noted in one persons care records that monthly evaluations reflected the number of falls the person had. However, the care plan had not been changed when it was noted more recently that they were falling more frequently. No evaluation had been carried out since, but from the records we looked at, it appeared they had only fallen once in the 2 months since that last evaluation. We looked at the homes system of auditing falls within the home. Such monitoring can inform any plans aimed at preventing falls generally. We discussed with the manager that falls and other accidents were monitored over a month at a time only, so patterns or causes might be missed. The records we were shown did not include any conclusions reached or other action taken as a result of the audit. People we met throughout our visit generally looked well groomed, with regard to their clothing and personal appearance. Their hair was brushed, they were wearing clean clothing, and had footwear on. A hairdresser was at the home during our visit, attending to various people over the morning. We saw that staff assisted individuals to attend to their personal needs when necessary during the day. However, we noted some peoples teeth were much in need of cleaning, and brought this to the managers attention. Staff told us some people were resistive to assistance at times, and this was reflected in some care plans and daily care notes that we read. But there was little guidance included for staff in care plans on how to meet individuals personal hygiene needs, mouth care, etc. in these specific circumstances. Peoples preferences were not well recorded (such as about their daily routine, and whether they preferred or responded better to male or female carers), although some staff described these when we spoke with them about particular individuals. Care Homes for Older People Page 5 of 12 There was little information to guide staff on how to respond to specific behaviours of the individuals (such as agitation or aggression), or on triggers for that behaviour in order that staff might try to minimise such behaviours. For example, one persons care plan suggested staff try to distract them in certain situations, without more person centred guidance on what particular distractions to try with them. We did not see any associated risk assessments. One persons daily notes had references to their increased activity and agitation at twilight, but this was not reflected in their care plan. Community Psychiatric Nurses had visited 2 of the 3 people we were following up. The outcome of one of these visits was not recorded, so it is not clear if the person received any additional support they might have needed. There was indication that behaviour charts were kept for some people, but these were not with their care plan nor were they part of the persons written care plan. We did not see clear evidence of how the information gained from them was used. Although evaluations for one person recorded they were becoming more agitated over time, no changes had been made to their written care plan. Monthly evaluations we read in peoples care plan often lacked detail, with comments such as No changes used. This meant the persons state of mental and physical wellbeing was unclear, as was the outcome of the care planned to meet their various needs. Two of the 3 care plans we looked at did not have a care plan for meeting the persons social or recreational needs. Our observations and conversations with staff did not reflect that the care planned for the third person was given. One person spent much of the morning sat at a table in a corner of the lounge, facing a wall, with their back to the room and other people. We were told that this person shares no interest in others or their surroundings but the person responded readily to us, when they were later sat at another table with a view of events around them. A care plan stated the person was to be sat at a table to stop them falling, because they moved to the edge of their seat, sometimes sliding off. Staff told us the person was not restless or agitated during the day now (and daily care notes reflected this), although this was indicated in their care plan. A magazine was on the table, but staff spent little time with them, to chat or look at the magazine with them as indicated in their care plan. A staff member told us that sometimes the table was in the window bay and the person could then look at the garden on such occasions. Dates in the persons care plan and associated records indicated these had not been evaluated or reviewed since 2009. We looked at the separate Activity folder where records relating to organised recreational activities were kept by the Activities coordinator. For 2 of the 3 people we were following up, there were 3 or less entries in the previous month of activity records. Records for the third person had 6 entries, suggesting people were not given the same opportunities for recreation or meaningful use of their time. It was positive to see, however, there was some detail in these records to show the persons level of involvement and enjoyment (or otherwise). Care assistants had spoken with us about time they spent individually with people, as we also observed during our visit. These occasions were not being recorded in care notes to show how people were and could be supported to enjoy positive and meaningful use of their time. When we asked staff how they promoted peoples dignity, they appropriately spoke about Care Homes for Older People Page 6 of 12 using screens in shared rooms, talking to people even when the individual themselves didnt speak much (when assisting them at meals, before moving someone in a wheelchair, when giving personal care, etc.), and finding out their preferred name or form of address on admission. One toilet/bathroom we found without a privacy lock or Occupied sign was brought to the managers attention. Some staff spoke about the importance of acknowledging individuality as part of promoting peoples dignity. They said they observed peoples body language to help get information about them - such as the cause of their agitation, or what was important to them, and their preferences. We noted some staff were more skilled than other staff at communicating. We observed one carer manage an aggressive outburst by someone and remain with them afterwards, maintaining a positive relationship with them. Another carer was particularly mindful of the language they used, telling us they had learnt from training at the home not to use certain words or language that would be infantile or inappropriate to use when supporting an adult. We heard them use reassuring and positive comments or tones, particularly when first speaking with individuals and before leaving them, which would promote peoples general sense of wellbeing. Staff also told us they had received guidance and advice on their actual practise, from the manager. One example was being told that before moving someone in a wheelchair, the carer should have spoken with the person about their intentions. We observed during our visit that the carer concerned communicated appropriately with such a person. Other staff were more assertive or directing in their communication. Or spoke about people in their presence without involving the individual in the conversation, which is treating individuals as an object rather than as a person. Of 15 care assistants, 10 have achieved a Certificate in Dementia Awareness through accredited long distance learning provided by a Further Education college. We spoke with the manager about her own updating on dementia care, especially as she supports staff to undertake in-house training on challenging behaviour. She had attended the half-day update that takes place annually for all care staff at the home. This includes some modules from Yesterday, today, tomorrow, an Alzheimers Society training programme for those working with people with dementia. The Responsible Individual wrote to us after our visit, detailing action that had been taken or that will be taken to address the issues raised in this report. The bathroom door lock had been repaired, action is being taken to improve written records and their subsequent use, and additional staff training is planned, for example. What the care home does well: What they could do better: Care Homes for Older People Page 7 of 12 People living at the home would benefit if there was a more person centred and individualised approach to the care and support each person receives. To help to achieve this, care and support must be planned on the basis of an up to date assessment of each persons wishes, needs and preferences. The care and support that individuals receive must be properly evaluated, with review and revision of planned care done in a timely way and using information gained through such evaluations. All staff responsible for ensuring people receive person centred, individualised care would benefit from further learning on how to achieve this. The homes audit of accidents within the home could be more robust, to prevent falls and other accidents as much as possible. 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 8 of 12 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 9 of 12 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 1 7 15 You must ensure you share 30/10/2010 each persons care plan with them or their representative, & keep it under review, revising it in a timely way when their health & welfare needs change So that staff know how to ensure each person receives the appropriate care & support to meet that persons various & diverse needs. 2 7 15 You must ensure that you 30/10/2010 write a care plan for each person living at the home, after consulting with the individual or their representative whenever possible, which is sufficiently detailed and comprehensive to show how their various and diverse health & welfare needs are to be met So that each person has their physical, psychological, health & social needs met in a person centred, Care Homes for Older People Page 10 of 12 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 individualised way. 3 7 14 You must ensure that the 30/10/2010 needs assessment of each person who lives at the home is kept under review, being revised as necessary as their needs change So that the care and support planned for people is based on their current physical, psychological, health & social needs, wishes and preferences. 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 30 It is recommended that all staff responsible for ensuring people who live at the home receive person centred, individualised care undertake further learning on how to achieve this, to ensure staff can fulfil the aims of the home and meet the changing needs of the people who live there. It is recommended that the homes auditing of accidents within the home is made more robust, to promote and protect the health, safety and welfare of people at the home by preventing falls and other accidents as much as possible. 2 38 Care Homes for Older People Page 11 of 12 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. If you would like a summary in a different format or language please contact our helpline or go to our website. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for noncommercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. Care Homes for Older People Page 12 of 12 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!

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