Care Home: Lyndel Homes

What the care home does well The home is very well presented to people wishing to move into the home, both in general appearance and in the excellent sources of information provided. The assessment of needs and derived care plans achieve very good outcomes for the people using the service. Care is delivered in an individual way and as the people wish by well trained, competent and caring staff. Staff appear friendly and sensitive in their dealings with people using the service who in conversations with us, were very complementary. The home delivers safe services such as medication administration, a safe and healthy environment and has adult protection as a priority. People who use the service are particularly pleased with the high standard and variety of the meals. Individual bedrooms are comfortable, furnished and decorated to peoples personal choice and with many personal possessions. The allocation of well trained staff is appropriate to the needs of the current people using the service and staff demonstrate the skills necessary to meet their needs. What has improved since the last inspection? At the last full inspection two requirements and eight recommendations of good practice were made and these have been fully implemented. The requirements were to complete a programme of refurbishment and replacement of lounge furniture. This is now complete including the fitting of a new kitchen, internal and external decoration and the replacement of arm chairs. The other requirement was to improve the delivery of supervision to staff and this now meets the frequency requirements of the standard. Good practice recommendations were to make improvements within the homes internal quality assurance processes and these were taken on and are now well established. Record keeping has been improved in areas such as medication management, complaints procedure and providing written confirmation to potential service users that there needs can be met by the service. What the care home could do better: The service has just completed a programme addressing all previous requirements and good practice recommendations arising from the previous key inspection. The home now requires a period of consolidation to ensure they are maintained at the current high standard. As a result no new requirements are made at this inspection. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Lyndel Homes 9 Radnor Road Handsworth Birmingham West Midlands B20 3SP     The quality rating for this care home is:   three star excellent 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: Richard Eaves     Date: 1 5 1 2 2 0 0 8 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 27 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 27 Information about the care home Name of care home: Address: Lyndel Homes 9 Radnor Road Handsworth Birmingham West Midlands B20 3SP 01215070708 01215152544 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mrs Delores Matadeen care home 15 Number of places (if applicable): Under 65 Over 65 0 mental disorder, excluding learning disability or dementia Additional conditions: Date of last inspection Brief description of the care home 15 9 Radnor Road is located in a residential street of North Birmingham. It is close to local shops, health services, public transport and places of worship. The building has been sensitively restored into an attractive and useable property. The home has 15 bedrooms located on the ground, first and second floors. These are both single and shared rooms. No rooms are en-suite. The home has a passenger lift which enables access to all floors. On the ground floor are a variety of lounge areas including a conservatory and seperate dining room. This was seen to be a popular place for some residents to sit and chat outside of meal times. Bathrooms, showers and toilets are located on all floors. The home has a laundry in which staff can undertake the routine laundry of most clothing. The home has a large kitchen and all meals are cooked on site. At the rear of the property is a garden. The home provides a service to persons of old age with a mental disorder. Fees for the home range from £328.00 and £425.00 each week. Hairdressing, some chiropody, toiletries, clothing, items specifically requested by residents such as daily papers, magazines and make up are additional Care Homes for Older People Page 4 of 27 Brief description of the care home costs paid for individually. The fee information given applied at the time of inspection; persons may wish to obtain mor up to date information from the service. Care Homes for Older People Page 5 of 27 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: three star excellent 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 quality rating for this service is 3 star. This means the people who use this service experience excellent quality outcomes. We the Commission for Social Care Inspection undertook this inspection over one day using the following information: reports from the organisation relating to the conduct of the home, records maintained at the home, the Annual Quality Assurance Self Assessment, and reports by other agencies. The AQAA is a set of questions put to the home to answer and once completed provides information on what the home has done and what it intends to do and improve on in the future. The inspection involved looking around the home including, a number of bedrooms, the communal rooms and service areas and provided an opportunity to speak with the people who use the service and Care Homes for Older People Page 6 of 27 the staff. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.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 8 of 27 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 27 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 good sources of information to help them make an informed choice to enter the home. People wishing to move into the home can be confident that the home can meet their needs and they have an opportunity to visit the home before making a decision. Evidence: The homes Statement of Purpose and Service User Guide are kept under review and are very good sources of information for current and prospective people using the service including their families. We found that the guide was available in the reception area and is issued to each person. Service user guides are available in other languages, currently a Punjabi language copy is in use. The Annual Quality Assurance self assessment, AQAA identifies that work is underway to produce the information in picture format. Care Homes for Older People Page 10 of 27 Evidence: We selected four peoples files to check in detail, we call this case tracking and we saw a copy of the contract/terms and conditions and in each a letter confirming that the home can meet their agreed needs following assessment. The assessments are undertaken before admission by the care manager and in addition to the sample of four, three others were viewed briefly to ensure consistency. The assessment process in each of the files inspected was thoroughly completed and informative and consisted of activities of daily living and a range of individual risk assessments for nutrition, pressure areas, falls, manual handling, social, mental health and specific risks. Diversity is included within the assessment process and for the current people using the service this includes areas such as gender, ethnicity and spiritual wishes. The AQAA identifies that the assessment process considers aspects of race, age, gender, disability, religion or belief. This helps to assist in meeting needs such as religious and cultural dietary needs such as providing meals with Halal meat and vegan options. The AQAA also identifies that they encourage and assist people in the home to uphold their beliefs by participating religious ceremonies and festivals either at the home or in the community. Staff receive training to understand the diversity presented by the multicultural nature of the local community. The home does not provide an intermediate care service. Care Homes for Older People Page 11 of 27 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can be assured that the home is able to meet the health and personal care needs of the people using the service with detailed assessments and care planning, respect and privacy and access to health care. Medications are well managed, facilitating the promotion of peoples health and well being. Evidence: Care plans for those people who were case tracked were seen to be drawn from the comprehensive assessments, they were well organised, current, clearly written and comprehensively include the range of care areas necessary to ensure the delivery of care appropriate to the general needs of each person. Since the previous inspection plans have been introduced for medication given on an as required basis. Diversity needs are addressed, these currently include spiritual, ethnicity, cultural and gender. Clear guidance is provided for staff to meet specific individual needs, such as giving personal care, meals and appearance of dress. Care Homes for Older People Page 12 of 27 Evidence: All people using the service are registered with a local GP and records show that there are regular visits from other health professionals such as Chiropodist, Dentist, Optician and District Nurse. Where posible the records show that people attend appointments to see Community Health Care Professionals. People using the service are assessed by senior staff in such areas as pressure relief, continence and referred as required for professional advice. While there are currently no pressure sores among people at the home, this is also assured by the provision of pressure relieving mattresses for all beds and higher specification mattresses for those at highest risk. Nutrition and falls are risk assessed and necessary interventions and monitoring arrangements are in place including, meals taken, weight monitoring and plans to minimise the risk of falls. To assist in monitoring weight, sit on scales have been obtained. The largest proportion of medicines are administered from a monitored dosage cassette system. None of the people using the service are assessed as able to self medicate. Each file includes a summary of medication and evidences the reviews undertaken by the medical practitioners. Staff involved with medication administration have received accredited training. We saw that the booking in and returns records are well kept and the Pharmacist provides advice and independent audits quarterly. The procedure for administering medication are kept within the folder holding the MAR charts. Facility for receipt and storage of controlled drugs are available but none are currently in use at the home. The MAR charts are fronted by a photograph of the person and essential information, such as allergies completed. The MAR charts are completed thoroughly and appropriate ommissions fully documented. Over the summer the home has introduced weekly delivery of medicines to reduce wastage. In conversation with people using the service they all expressed satisfaction with the home and the meals, a large part of the satisfaction is derived from the sensitive involvement of the staff who people said ensure they have free choice and respect their privacy. People said that their clothes are looked after and help them to maintain a good appearance. Over the day staff were observed to interact with respect, knocking doors before entering and checking individual wishes such as, are you ready to come for lunch? The topic of respect is given a high profile during the staff induction programme. Terms of address are identified and staff spoken with said they know of each persons preference, particularly where shortened names are used. Care Homes for Older People Page 13 of 27 Care Homes for Older People Page 14 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a varied social and recreational activity programme that provides interest and pleasure for the people using the service. People can be assured that the home is able to meet their social and personal needs both in the home and the community. Meals at the home are wholesome and meet the nutritional and personal needs of the people using the service. Evidence: The home has an activities programme, which is displayed on the notice board and is flexible in implementation according to the wishes of those who want to participate. Records of who attended, what happened and how well received the event was. Activities included sing along, board games, church service, relaxation and beauty sessions and videos film sessions. People at the home who were able to talk with us said they enjoyed the activities. The input from the local churches is very popular in particular the hymns. A number of people are assisted to attend the temple and this is recognised as very important in their lives, another attends the local mosque. Activities are discussed and planned at weekly meetings and are said to be led by the wishes of the people at the home. Day trips are arranged regularly the last being to Care Homes for Older People Page 15 of 27 Evidence: Dudley zoo. Younger people at the home also take holidays and weekend breaks with one person having spent a week away with his day group and day trips arranged by them. A family member was met who said that the family member in the home was content and settled and the family were very pleased with the care they observe being delivered. A church visitor was also met who said they were well received by staff and the people in the home really enjoyed getting invoplved in services. The current occupants of the home have diverse religious faiths and it was seen that each person was supported to follow their faith. People with families living far away are assisted to make contact with examples seen of contact made over the internet to South Africa and another person maintaining regular contact by telephone to Canada. At the time of the inspection the staff and people who live at the home were busy planning a Christmas party which they traditionally put on for families including the children of the extended family. The home has a rotating menu developed with the diverse needs of the people at the home addressed. These include, foods such as a softer option and diabetes but also European, Asian and Caribbean meals prepared each day. Those persons requiring assistence with meals were seen giving assistance and people were noted to eat their meal at their own pace. Staff described what was on the plate and politely had a discussion about food. The menu is healthy, nutritious and varied. Care plans are prepared for mealtimes, closely monitored, recorded and reported timely action taken when required. Care Homes for Older People Page 16 of 27 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 using the service and their supporters can be confident that their views will be listened to and acted upon. Staff are taught how to uphold the welfare of the people using the service and to protect their rights. Evidence: The home has a complaints procedure that is included in the Service User Guide and promoted widely including notices throughout the home. The procedure provides for timely response, investigation and recording of the outcomes of any complaints, the AQAA identifies this as an area they have proactively improved over the last year. The home has not received any complaints over the past year. The AQAA emphasises the involvement of all levels of staff in responding to concerns informally to resolve issues early but also that these are recorded and reported to senior staff. The AQAA identifies an open door approach to the running of the home. People spoken with said they know whom to approach if they have concerns and worries. The home has policies and procedures in place to protect the people using the service from abuse, and this includes a whistle blowing policy. They also have a copy of the local multi agency policy for responding to abuse, and the Department of Health No Secrets document. Care Homes for Older People Page 17 of 27 Evidence: Staff have all received training in the Protection Of Vulnerable Adults, although recent appointments have as yet only received in house training as part of their induction. The staff we spoke to said they know what constitutes abuse and are confident that they would respond to any signs that they may observe. The adult protection training video is also shown to the people who use the service to raise their awareness. There have been two safeguarding referrals during the past year, one being unsubstantiated while the second was as a result of a late referral following a fall. An internal review and findings of the investigation resulted in actions implemented to ensure that future incidents get refferred appropriately. Care Homes for Older People Page 18 of 27 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service live in a comfortable home that offers them a life style suited to their needs. Equipment, consistent with the needs of the people at the home is available to facilitate the provision of care. Evidence: The home is well maintained with a rolling programme of decoration and refurbishment including the kitchen and exterior completed this year with the whole programme reaching completion this month with the final delivery of furniture. The home provides comfortable accommodation over three floors with a mix of double and single room accommodation. During the tour of the building we visited a number of bedrooms and saw how people had personalised their rooms with pictures, ornaments and examples of hobbies and interests. The home has two communal lounges and a separate dining room. These rooms are all pleasantly decorated and lit in domestic character, a small conservatory is available for smoking. The home was found to be clean, hygienic and free from any odours throughout. A laundry room is equipped with modern machines, the washer having a programme for sluicing should it be required. Care Homes for Older People Page 19 of 27 Care Homes for Older People Page 20 of 27 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can be sure that staff are clear as to their individual roles and responsibilities are enthusiastic, sufficient in numbers, well trained and committed to maximising the quality of lives of the people using the service. The recruitment practices and staff training contribute to ensuring the needs of people using the service are met. Evidence: The rotas confirm that staff numbers across the 24hour period are appropriate to the needs of the people using the service. Care staff are supported by catering staff and a housekeeper. A contract service is employed to undertake a cleaning programme and a very good standard is achieved. All staff hold the National Vocational Qualification in care at level 2 with 2 having level 4 and 4 having level 3. Other training is also of a high standard; the training matrix shows that mandatory training is up to date including, fire safety, moving and handling, first aid, infection control and safeguarding. Other training provided includes food hygiene and accredited medication administration. While no new staff have been appointed recently a Skills for Care standard induction programme is available. A sample of two staff files were inspected including the most recent appointments and Care Homes for Older People Page 21 of 27 Evidence: these were found to be satisfactory. Both files included evidence of a Criminal Records Bureau, including POVA check, completed application forms, references, interview records and copies of qualification certificates. This gives the people using the service confidence that they are supported by the right staff. Staff receive a statement of terms and conditions and a copy of the GSCC code of conduct. Care Homes for Older People Page 22 of 27 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. The management systems in the home are open, positive and protect the people using the service. Evidence: The manager is experienced and well qualified, holding the Registered Managers Award as does the deputy and one other senior member of staff. The management systems in the home are open, positive and protect the people using the service. The ethos of the home is open and transparent and promotes the involvement of people who use the service and staff in its day-to-day running. The service formally audits the homes quality on a regular basis including care plans, infection control, finances and dignity. Surveys are undertaken as part of the quality assurance process and this year the views of families, people who use the service and stakeholders were sought. Results of surveys were seen and action plans developed and undertaken to address findings. Care Homes for Older People Page 23 of 27 Evidence: The people using the service or their families take responsibility for the control of their money. Where the home provides support and assistance written records are maintained of all transactions and receipts kept, this is subject to regular audit. Secure facilities are available for the safekeeping of money. Staff supervision is well established at the home and is relevant in content and well received by staff. Health and Safety is given appropriate priority with a broad range of monitoring and maintenance in place with all staff receiving health and safety training at induction and on annual mandatory up dates. During the tour of the building it was observed that all corridors were clear of obstructions and the premises are kept in a safe condition. Appropriate arrangements are in place for the monitoring, recording and reporting of accidents. An inspection of the service and inspection certificates identified these to be up to date. Documentation also show that staff working at the home hold up to date certificates in first aid, manual handling, food hygiene and fire safety. Care Homes for Older People Page 24 of 27 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 25 of 27 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 Care Homes for Older People Page 26 of 27 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. 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. Care Homes for Older People Page 27 of 27 - 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!