Care Home: Lyndale

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What the care home does well Residents, relatives and staff were very complimentary about Lyndale. Feedback through discussions and the Commission surveys confirmed that residents were happy and well cared for. Residents interviewed stated, "They have been very good to me". Relatives comments with regard to the care provided at Lyndale include, "All staff seem to have excellent people skills", "the home is very supportive, nursing care is excellent, .... has shown a huge improvement since her arrival", "Very impressed" and "Very pleased with the quality of life they help her to enjoy". The service provide an effective pre admission process to identify prospective residents needs. This ensures that all residents health and welfare needs are known prior to admission so that the service can be sure they will be able to meet the individual residents needs. Following discussion with residents it is apparent that the admission process was a positive experience. A relative interviewed about the admission process stated, "The manager came to see...in the hospital, you couldn`t have asked for better with regard to the admission". Residents needs have been identified and are reflected in the care plans. This ensures that they receive the healthcare and support they need. A visiting health professional interviewed stated, "This is one of the better homes, they are very caring. Residents are very happy, it`s very nice, it`s clean and has no smells". Residents who live in Lyndale are happy with how they live their lives. They are able to express their wishes and choices within their abilities with staff supporting them where needed. Residents interviewed stated, "I am very happy here, I like to get up at 7.30 and stay up until 11pm, I do have a choice" and "You can please yourself, I like to get up early, they are very good, I go to bed at 10.45, it`s my choice". The service ensure residents and their families are able to voice any concerns they may have and residents are confident that they will be listened to. Lyndale has a clear complaints procedure and records evidence investigations and outcomes are logged. Residents live in a well maintained and comfortable environment. Lyndale is pleasantly decorated and ongoing improvements ensure residents live in surroundings suitable for them. Lyndale is cleaned to a very high standard. Residents approve of their bedrooms with one resident stating, "I like my bedroom, it`s very nice". A relative interviewed stated, "It`s the best in Southport, It`s just great, no smells, I looked at four or five homes". Residents and relatives were very complimentary about the staff employed. Relatives commented, "I have not seen or heard of any situation where the member of staff was not fully up to the task", "the home is very supportive, nursing care is excellent", "Very impressed" and "Very pleased with the quality of life they help her to enjoy". One relative interviewed stated, "You couldn`t find more dedicated staff anywhere". Staff canvassed for their views about the training at Lyndale commented, "Courses are always available for staff in house or at various venues, all the staff find these very helpful" and "We have schedules of training in our home, I regularly attend training inour home, it is very helpful, it enhances my skills and updates my knowledge". Staff were complimentary about the support they received from the management and commented, "Our Matron is very approachable and supportive to the staff as well as very good in handling the residents". One staff interviewed confirmed that they enjoyed working at Lyndale and was complimentary about how the service was run and stated, "Richard (owner) is very nice, Nyree also (administrator) and Linda is great". A relative interviewed stated, "Mr Burdett tours the whole place and says `Good afternoon` he`s quite a nice chappy, keeps an eye on everything Residents are protected by the good management systems in place. Residents, their relatives and staff are listened to. Residents are regularly canvassed for their views and minutes of meetings with staff and residents are published. All health and safety checks are in place and up to date. What has improved since the last inspection? Senior care staff now record in the residents daily record with the nurse in charge counter signing. This ensure the daily log is completed by the carers who support the residents. Healthcare needs are well documented in care files. Residents are regularly weighed with records kept. Staff have attended the adult protection training and this ensures that they have a clearer understanding of the new local procedures in place. Risk assessments have commenced with regard to the radiators that have no protective cover. There is documented evidence of a skills for care induction in one of the staff files. Residents monies now have a home representative signature for each financial transaction. Lyndale has improved it`s recruitment procedures and this ensures that residents are better protected. All police checks are other pre employment checks are in place prior to staff being employed. The training programme has improved and first aid, infection control and food hygiene training has been implemented. Staff commented, "We have schedules of training in our home, I regularly attend training, it is very helpful, it enhances my skills and updates my knowledge". Seven staff have been enrolled on the NVQ in care training programme, which will give staff further qualifications in this area. What the care home could do better: Further monitoring of medication records need to be carried out to ensure residents aregiven their prescribed medication. There are one or two areas that need attention. In particular some signatures were noted to be missing for one or two of the prescribed medication therefore it was not known if the resident had received their medication that day. Another concern is that one of the residents is prescribed a dietary supplement but insufficient stock is delivered for the month. The manager was advised to resolve this as the resident is not getting their prescribed supplement and this may be detrimental to his health. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Lyndale 9 Rawlinson Road Southport Merseyside PR9 9LU     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: Margaret VanSchaick     Date: 0 9 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 30 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.csci.org.uk Internet address Care Homes for Older People Page 3 of 30 Information about the care home Name of care home: Address: Lyndale 9 Rawlinson Road Southport Merseyside PR9 9LU 01704543304 01704539226 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mr Richard Thomas Burdett Name of registered manager (if applicable) Linda Mitchell Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The registered person may provide the following category/ies of service only: Care home with nursing - Code N 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: 25 Date of last inspection Brief description of the care home Lyndale is a privately owned Care Home providing twenty five registered places for nursing older people. The registered provider/owner is Mr Richard Burdett and the registered manager Linda Mitchell. Lyndale is a large detached converted house situated in a quiet residential area of Southport close to the town centre and Hesketh Park. Local amenities can be accessed by the local transport services, which are close to the home. The home has twenty three single rooms, eight with an ensuite facility and one double room. All areas of the home are accessible by the use of a passenger lift, stairs and a chairlift to the mezzanine levels (no lift access) on the first and second Care Homes for Older People Page 4 of 30 care home 25 Over 65 25 0 Brief description of the care home floor. There is a spacious attractively decorated lounge and this room is also used as a dining area. Bedrooms are of a good size and colour schemes are very pleasant. Bathrooms are well equipped to assist those who are less independent and there are handrails and a ramp to the main front door. A call system operates with an alarm facility throughout all areas. Residents are able to enjoy the homes large enclosed garden during the warmer months. The weekly fee rate from 1st April 2009 is between 510 and 560 pounds a week for accommodation. Care Homes for Older People Page 5 of 30 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: A site visit took place as part of the unannounced key inspection. It was conducted over one day by one inspector and lasted 8 hours. 25 residents were accommodated at this time including two who were in hospital. As part of the inspection process most of the areas of Lyndale were viewed including some of the residents bedrooms. Care records and other documentation was also viewed. Discussion took place with residents, a relative, a visitor, a health professional and staff. The inspection was conducted with the registered manager, registered provider and administrator. During the inspection two of the residents were case tracked (their care files were looked at and their views of the service obtained). All of the key standards for older people were inspected. Previous requirements and recommendations form the last Care Homes for Older People Page 6 of 30 inspection in February 2007 were discussed. Satisfaction forms Have your say about....were distributed to residents, their relatives, health professionals and staff. A number of comments included in this report are taken from surveys and interviews. An AQAA (Annual Quality Assurance Assessment) has been completed. The AQAA comprises of two self assessment questionnaires that focus on the outcomes for people. The self assessment provides information as to how the manager and staff are meeting the needs of the current residents and a data set that gives basic facts and figures about the service including numbers and training. What the care home does well: Residents, relatives and staff were very complimentary about Lyndale. Feedback through discussions and the Commission surveys confirmed that residents were happy and well cared for. Residents interviewed stated, They have been very good to me. Relatives comments with regard to the care provided at Lyndale include, All staff seem to have excellent people skills, the home is very supportive, nursing care is excellent, .... has shown a huge improvement since her arrival, Very impressed and Very pleased with the quality of life they help her to enjoy. The service provide an effective pre admission process to identify prospective residents needs. This ensures that all residents health and welfare needs are known prior to admission so that the service can be sure they will be able to meet the individual residents needs. Following discussion with residents it is apparent that the admission process was a positive experience. A relative interviewed about the admission process stated, The manager came to see...in the hospital, you couldnt have asked for better with regard to the admission. Residents needs have been identified and are reflected in the care plans. This ensures that they receive the healthcare and support they need. A visiting health professional interviewed stated, This is one of the better homes, they are very caring. Residents are very happy, its very nice, its clean and has no smells. Residents who live in Lyndale are happy with how they live their lives. They are able to express their wishes and choices within their abilities with staff supporting them where needed. Residents interviewed stated, I am very happy here, I like to get up at 7.30 and stay up until 11pm, I do have a choice and You can please yourself, I like to get up early, they are very good, I go to bed at 10.45, its my choice. The service ensure residents and their families are able to voice any concerns they may have and residents are confident that they will be listened to. Lyndale has a clear complaints procedure and records evidence investigations and outcomes are logged. Residents live in a well maintained and comfortable environment. Lyndale is pleasantly decorated and ongoing improvements ensure residents live in surroundings suitable for them. Lyndale is cleaned to a very high standard. Residents approve of their bedrooms with one resident stating, I like my bedroom, its very nice. A relative interviewed stated, Its the best in Southport, Its just great, no smells, I looked at four or five homes. Residents and relatives were very complimentary about the staff employed. Relatives commented, I have not seen or heard of any situation where the member of staff was not fully up to the task, the home is very supportive, nursing care is excellent, Very impressed and Very pleased with the quality of life they help her to enjoy. One relative interviewed stated, You couldnt find more dedicated staff anywhere. Staff canvassed for their views about the training at Lyndale commented, Courses are always available for staff in house or at various venues, all the staff find these very helpful and We have schedules of training in our home, I regularly attend training in Care Homes for Older People Page 8 of 30 our home, it is very helpful, it enhances my skills and updates my knowledge. Staff were complimentary about the support they received from the management and commented, Our Matron is very approachable and supportive to the staff as well as very good in handling the residents. One staff interviewed confirmed that they enjoyed working at Lyndale and was complimentary about how the service was run and stated, Richard (owner) is very nice, Nyree also (administrator) and Linda is great. A relative interviewed stated, Mr Burdett tours the whole place and says Good afternoon hes quite a nice chappy, keeps an eye on everything Residents are protected by the good management systems in place. Residents, their relatives and staff are listened to. Residents are regularly canvassed for their views and minutes of meetings with staff and residents are published. All health and safety checks are in place and up to date. What has improved since the last inspection? What they could do better: Further monitoring of medication records need to be carried out to ensure residents are Care Homes for Older People Page 9 of 30 given their prescribed medication. There are one or two areas that need attention. In particular some signatures were noted to be missing for one or two of the prescribed medication therefore it was not known if the resident had received their medication that day. Another concern is that one of the residents is prescribed a dietary supplement but insufficient stock is delivered for the month. The manager was advised to resolve this as the resident is not getting their prescribed supplement and this may be detrimental to his health. 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.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 10 of 30 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 11 of 30 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. The service provide an effective pre admission process to identify prospective residents needs. This ensures that all residents health and welfare needs are known prior to admission so that the service can be sure they will be able to meet the individual residents needs. Evidence: When any prospective resident or their advocate approaches the service with regard to possible admission an enquiry form is set up to record initial details. Following this enquiry there is clear documented evidence that pre admission assessments are carried out by the registered manager prior to prospective residents coming in. The manager told us that she visits the prospective resident where they are and this includes residents homes. The assessment documentation is fairly detailed and includes all areas that we would Care Homes for Older People Page 12 of 30 Evidence: expect a good service to look at prior to offering prospective residents a place. Some of the areas included are previous health history, mobility, sleep pattern, diet, present medication, likes and dislikes, preferences as to how they like to spend their time and any aids that they may use in their daily lives. Following discussion with residents it is apparent that the admission process was a positive experience. A relative interviewed about the admission process stated, The manager came to see...in the hospital, you couldnt have asked for better with regard to the admission, we came and viewed the bedroom. The service does not provide intermediate care. Therefore this standard was not assessed. Care Homes for Older People Page 13 of 30 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. Residents needs have been identified and are reflected in the care plans. This ensures that they receive the healthcare and support they need. Further monitoring of medication records need to be carried out to ensure residents are given their prescribed medication. Evidence: Care plans are commenced following a pre admission assessment of prospective residents. The care plans viewed evidence staff and residents signature to agree the care and support that residents will need. A relative interviewed with regard to the care plans stated, Yes, we have talked about it, I slip into the office and they tell me what is going on. Im kept up to date with ...s condition, its excellent. The care plans are specific to the individual resident and reflect their identified needs. Many areas have been covered including health care needs such as medication, mobility, wound care, personal hygiene, pain and specialist input from other health professionals. Residents care documentation evidences that a range of other health professionals are contacted on behalf of the residents who live at Lyndale including, Gps, dentists, Care Homes for Older People Page 14 of 30 Evidence: chiropodist, opticians, wound care specialists, diabetes nurses and specialist Drs. Residents interviewed about the care provided were complimentary and stated, They have been very good with me, I have signed my care plan. The standard of care is good, I have my legs dressed three times a week. The nurse looks at them now and again and changes the treatment and Yes, I have done the care plan with Matron. Residents are encouraged to maintain the independence they have where possible. Staff promote the health and welfare of residents as care records show improvement in their conditions since admission. A visiting health professional interviewed stated, This is one of the better homes, they are very caring. Staff are very good at contacting us if they need help and we dont need to chase staff about the paperwork, they do it. Residents are very happy, its very nice, its clean and has no smells. The medication storage was observed to be tidy and organised. Medication stocks were evidenced and there was no over stocking of any medication. Medication records were clear and instructions for medication management were followed. Where complex prescriptions were recorded the instructions were clear and easy to follow. There are one or two areas that need attention. In particular some signatures were noted to be missing for one or two of the prescribed medication therefore it was not known if the resident had received their medication that day. One resident who was prescribed a dietary supplement was not supplied with sufficient stock to last each month therefore the manager needs to address this issue. If treatment is prescribed by the residents Dr then it is important that the resident receives the treatment prescribed otherwise the residents condition may deteriorate. Residents looked very well groomed and cared for. The laundry service ensures that residents have their own personal clothing to wear each day. For the two residents who share a room there is a fixed screen that can be closed for privacy. A health professional was noted to consult with a resident in their room and residents interviewed confirmed that this was the usual practice. Some of the residents have their own private telephones and there is a public telephone for residents use. Residents who wish to can also use the office telephone in privacy. A relative interviewed confirmed that staff were courteous in their approach to residents, and stated, I hear them talking with other residents, they treat everyone the same, they look after you and they always knock on the door. Care Homes for Older People Page 15 of 30 Care Homes for Older People Page 16 of 30 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. Residents who live in Lyndale are happy with how they live their lives. They are able to express their wishes and choices within their abilities with staff supporting them where needed. Evidence: Residents who live in Lyndale are happy with how they live their lives. Residents interviewed stated, I am very happy here, I like to get up at 7.30 and stay up until 11pm, I do have a choice and You can please yourself, I like to get up early, they are very good, I go to bed at 10.45, its my choice. Residents are also able to have the same gender carer to look after them. One resident interviewed confirmed this and stated, Female carers look after me, I prefer that. A key worker system has commenced, which gives individual residents a particular carer who helps them with personal needs. Time is spent on a one to one basis with the resident. Staff confirmed this through the Commission surveys and commented, We have introduced a key worker system where each member of staff has 2-3 residents to look after, in terms of mainly being a friend, help to tidy their rooms, make sure they have sufficient clothes and accessories and Each service user has a Care Homes for Older People Page 17 of 30 Evidence: key worker to tend to their extra needs, a personal carer to talk to, they do shopping, letter writing, sewing or labeling. Activities are arranged on a regular basis for residents who wish to participate and where residents prefer their own company this is accommodated. Activities arranged include the reading circle, twice a week exercise classes, monthly entertainment, monthly film show, guitar player and a lady who sings also visit monthly. In the warmer months residents are taken out by their families or staff. Residents receive regular visitors and they are welcomed by staff. One relative interviewed stated, I come every day, sometimes twice a day, staff always say hello. If I want a cup of tea, I can have one. One resident interviewed stated, I get plenty visitors, Im very lucky, they visit when they want to. The service arrange for residents religious needs to be met. Residents who are unable to attend church have Holy Communion provided at Lyndale with visits from local churches of different faiths. Residents who wish to, handle their own financial affairs with family support where needed. Advocacy contact details are available for residents who may need them. Residents bedrooms were seen to be personalised making them individual to the residents who live there. Residents interviewed confirmed they were able to bring their own belongings to the service. One resident interviewed stated, I brought several tins of stuff and my tv. One of the residents was observed to have a pet budgie, which was well cared for. The service have a printed menu, which is changed regularly. The menu seen was varied and offered a nutritious diet. Specialist diets are catered for. The menu does not evidence alternative choices at mealtimes although the chef told us that he checks with residents the day before to find out if they would like an alternative to the menu. Residents confirmed they did have a choice. Residents interviewed gave conflicting views of the food served. Residents interviewed stated, The chefs not so good, its edible, we have the same puddings all the time and we dont like the mashed potato swimming in watery gravy and The food is reasonable I think. The Commission surveys returned were generally satisfactory with one relative commenting food could be improved. Care Homes for Older People Page 18 of 30 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. The service ensure residents and their families are able to voice any concerns they may have and residents are confident that they will be listened to. Evidence: The service has a complaints procedure that residents and their families are aware of. One relative interviewed stated, We have had no need to make a complaint, we know how to, you couldnt complain here. Residents have also been encouraged to give their views through the service surveys and some concerns have been raised this way. The manager told us that any issues raised have been fully investigated with outcomes satisfactory for the residents. The complaints log evidences the issues investigated and records the outcomes for the complainant. All were resolved to their satisfaction. Through discussion with residents, they told us they were confident that staff would listen to them and address any concerns they had. The service also have an up to date copy of the Sefton adult protection procedure. There have been no referrals in this area. Staff have attended the specialist training provided by Sefton to ensure staff are fully aware of the procedures and have the ability to recognise abuse. Residents who wish to vote use the postal system and are supported in this by the administrator. Care Homes for Older People Page 19 of 30 Care Homes for Older People Page 20 of 30 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. Residents live in a well maintained and comfortable environment. Evidence: Lyndale offers residents a warm and comfortable home. The service is furnished to a good standard and all areas are decorated in an attractive, domestic style with good quality fittings throughout. The service is well maintained and new furniture, furnishings and carpeting have been replaced in the lounge and other areas of the service including some of the bedrooms. The maintenance programme is ongoing and areas are upgraded as they need it. The service is cleaned to a very high standard as seen during the visit. Residents were happy with their bedrooms and told us that they lived in comfortable surroundings. Residents interviewed stated, I chose this bedroom, I was upstairs but I wanted a bigger room, I like this room better and I like my bedroom, its very nice. A relative interviewed stated, Its the best in Southport, Its just great, no smells, I looked at four or five homes. Care Homes for Older People Page 21 of 30 Evidence: There are adaptations and fittings throughout, which help residents to access the public areas of the service. There are chair lifts in place to access the two floor levels that the lift does not reach. Residents who live on these floors have been fully assessed with regard to their mobility before being offered bedrooms on these floors. The laundry facility has sufficient equipment to ensure that residents personal laundry is catered for. The laundry facility was clean, tidy and organised during the visit. Residents laundry is separated into individual baskets personal to them. The kitchen is clean and organised. The food stores evidenced plenty of fresh, frozen and dried foods for residents. The maintenance person carries out the routine work and larger jobs are contracted out. The necessary fire precautions and testing of equipment are all carried out and in date. The garden grounds and outside areas are all well maintained and mature planting and shrubs are in place to the benefit of residents. Care Homes for Older People Page 22 of 30 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. Lyndale has improved its recruitment procedures and this ensures that residents are better protected. Evidence: The duty rota was viewed and evidences that there were sufficient staff employed in the service to ensure residents needs were being met. Staff canvassed for their views were generally happy with the staffing levels. Four care staff have the NVQ in care qualification and the service are supporting a further seven care staff to gain this qualification. Feedback from residents, relatives and a health professional about staff employed at Lyndale was positive. Relatives commented, I have not seen or heard of any situation where the member of staff was not fully up to the task, all staff seem to have excellent people skills, the home is very supportive, nursing care is excellent, .... has shown a huge improvement since her arrival, Very impressed and Very pleased with the quality of life they help her to enjoy. One relative interviewed stated, You couldnt find more dedicated staff anywhere. During the visit to the service all staff were observed to be polite and courteous to residents and visitors. Care Homes for Older People Page 23 of 30 Evidence: The administrator processes staff application forms and two staff files were viewed for the purpose of this inspection. Both files evidence that all pre employment checks were in place prior to them commencing work at Lyndale. Recruitment procedures have improved since the last inspection. All police checks have been carried out prior to new staff commencing work. Both staff have job descriptions and signed contracts stating their terms and conditions. Registered Nurse checks have been carried out to ensure the nurse is up to date with their registration. Application forms have been completed. One application form did not contain very much information. Therefore this needs to be improved. Two written references have been received for both staff files. One of the staff files evidence individual staff induction on the first day. One staff commented, I was with the Matron during my induction. She taught me everything very well and in proper ways. Both files evidence previous training attended and training they have done at Lyndale. Further infection control training is planned for the end of February. Staff canvassed for their views about the training at Lyndale commented, Courses are always available for staff in house or at various venues, all the staff find these very helpful and We have schedules of training in our home, I regularly attend training in our home, it is very helpful, it enhances my skills and updates my knowledge. Training provided by Lyndale also includes safeguarding, fire safety, manual handling, first aid, basic food hygiene, health and safety and palliative care. The service have appraised individual staff and identified their training needs for the year ahead. There is evidence in staff files that staff have read the policies and procedure of the service. Care Homes for Older People Page 24 of 30 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. Residents are protected by the good management systems in place. Residents, their relatives and staff are listened to. Evidence: The registered manager, Linda Mitchell has been in post since 2007. Linda Mitchell is a registered nurse and is in the process of completing the Registered Managers Award. Linda also keeps up to date by attending various training courses in regard to her position as manager and registered nurse. Linda is supported in this position by the owner of the service Mr Burdett. Mr Burdett works closely with the manager, administrator and staff. Staff were complimentary about the support they received from the management and commented, Our Matron is very approachable and supportive to the staff as well as very good in handling the residents. One staff interviewed confirmed that they enjoyed working at Lyndale and was complimentary about how the service was run and stated, Richard (owner) is very nice, Nyree also (administrator) and Linda is great. A relative interviewed stated, Mr Burdett tours Care Homes for Older People Page 25 of 30 Evidence: the whole place and says Good afternoon hes quite a nice chappy, keeps an eye on everything. Through discussion with the manager it is apparent that she is familiar with and understands conditions that affect the older person. Effective quality assurance systems are in place. The service has been awarded an external quality assurance award. Residents and their families are canvassed for their views on a regular basis. The results of which were viewed and showed positive responses. Meetings for residents are held occasionally as confirmed by a relative. The minutes of one from last year was read. Residents are encouraged to participate and various items are discussed. The manager also told us that she speaks with residents each day and residents interviewed confirmed this. Staff meetings are also held on a regular basis throughout the year with various issues discussed as viewed on minutes recorded. Policies and procedures are updated by the manager each year. Mr Burdett manages the financial transactions and the administrator deals with the incidental expenses. Receipts are in place for the incidental expenses with staff signatures where appropriate. Residents are invoiced each month for services and items such as newspapers and hairdressing, which are not included in the fees. Relatives canvassed for their views with regard to this area were satisfied and commented, They keep good control of ....incidental expenses. The AQAA (Annual Quality Assurance Assessment) provided evidence of the servicing of equipment, including fire equipment and maintenance contracts. These were up to date and further information looked at on the day of the visit confirmed all areas were covered including the passenger lift, hoists, electrical and gas certificates. Mandatory training is provided to staff and staff files evidence the training attended. Further training has been planned for this year and includes infection control. Staff have also attended up to date first aid and food hygiene training. Staff canvassed for their views with regard to training confirmed that they had a good training programme. One staff interviewed stated, I had fire training during my induction with Nyree and am doing infection control this month. Records show that fire risk assessments are carried out for each resident, fire alarms and emergency lighting checks are also logged. The manager understood the procedure of reporting accidents and accident records show that reports are completed correctly. The storage cupboard for cleaning fluids was open during the inspection therefore this Care Homes for Older People Page 26 of 30 Evidence: needs locking at all times. Care Homes for Older People Page 27 of 30 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 28 of 30 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 It is recommended that regular audits should be carried out to ensure all registered nurses sign medication records immediately following administration of medication. This will ensure residents receive their prescribed medication at the correct time. It is recommended that further advice should be sought with regard to the insufficient amount of the prescribed dietary supplement for one of the residents. This will ensure that the resident receives the recommended prescribed dietary supplement in sufficient quantities to last the month. It is recommended that the menus should be improved to ensure alternative meals are available for lunch and tea. Residents should be canvassed for their views on what type of meals they would like. This will ensure they have a choice that is suitable for them. It is recommended that the storage cupboard for cleaning fluids should be locked at all times. This will ensure residents safety is promoted. 2 9 3 15 4 38 Care Homes for Older People Page 29 of 30 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk 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. 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