Care Home: Lyndhurst

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What the care home does well The home is well managed and run in the best interest of the people living there. Anyone thinking of moving in can go and look around to see for themselves if they think the home is suitable for them. If they decide to move in staff Lyndhurst DS0000026278.V376346.R01.S.doc Version 5.2 from the home will carry out an assessment to make sure that they can meet that persons needs and arrange a day for admission. Everyone is very friendly; they make visitors feel welcome when they call at the home. Each person has an individual care plan that sets out what care and support they require from staff. The care plans are updated, as people`s needs change. People living at the home and their relatives are invited to be actively involved in reviews of the plan. In the surveys, people told us they received the care and support they needed. People look well cared for. All the people who live in the home spoke well of staff and they felt that they were kind and caring. There are activities on offer for people to join with if they want to. We asked people to tell us what the home does well. These are some of their comments: "Everything" "They provide warmth and security" "Good care-good meals" "They are good at communication and working in partnership" What has improved since the last inspection? The dining room, hallway and some bedrooms have been redecorated and there is new carpet in one of the lounges. The manager is now registered with us. The improvements to the garden and creation of a vegetable growing area has been a big success. What the care home could do better: Key inspection report CARE HOMES FOR OLDER PEOPLE Lyndhurst 20 Oxford Road Dewsbury West Yorkshire WF13 4JT Lead Inspector Lynda Jones Key Unannounced Inspection 6th July 2009 10:00 DS0000026278.V376346.R01.S.do c Version 5.2 Page 1 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should: • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care homes for older people can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop. The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Lyndhurst DS0000026278.V376346.R01.S.doc Version 5.2 Page 2 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Lyndhurst DS0000026278.V376346.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Lyndhurst Address 20 Oxford Road Dewsbury West Yorkshire WF13 4JT Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01924 459666 01924 455223 Mr Annamalai Subramanian Mrs Meena Subramanian, Dr Mohammed Ismail Kardasha Jennifer Ann Stanley Care Home 15 Category(ies) of Old age, not falling within any other category registration, with number (15) of places Lyndhurst DS0000026278.V376346.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 7th July 2008 Brief Description of the Service: Lyndhurst is a care home registered to provide care and accommodation for up to fifteen older people. It is situated in a residential area of Dewsbury, set in extensive grounds. The home was formerly a private house that has been adapted for its current use. The accommodation is on two floors, with the majority of bedrooms being on the first floor. People who live at the home need to be reasonably mobile. The first floor can be accessed by stair lift but people need to cross the landing to access a second staircase leading to additional bedrooms. The provider informed us that the fees range from £385.87 to £397.65 per week. There are additional charges for chiropody, optician, dentist, hairdressing and newspapers. Lyndhurst DS0000026278.V376346.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations, but only when it is considered that people who use the service are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. This inspection was carried out to assess the quality of care provided to people living at the home. The inspection process included looking at the information we have received about the home since the last key inspection as well as a visit to the home by 2 inspectors, which lasted approximately 5 hours. During the visit we spoke to 6 people living in the home, the manager and members of staff on duty. We also observed staff delivering care, looked at various records and looked around the home. Surveys were sent to 6 people living in the home and to 4 health care professionals; these surveys provide an opportunity for people to share their views of the service with us. Information received in this way is shared with the home without identifying who has provided it. We received completed surveys from 5 people using the service and one Community Nurse who visits the home. Their comments have been used in this report. What the service does well: The home is well managed and run in the best interest of the people living there. Anyone thinking of moving in can go and look around to see for themselves if they think the home is suitable for them. If they decide to move in staff Lyndhurst DS0000026278.V376346.R01.S.doc Version 5.2 Page 6 from the home will carry out an assessment to make sure that they can meet that persons needs and arrange a day for admission. Everyone is very friendly; they make visitors feel welcome when they call at the home. Each person has an individual care plan that sets out what care and support they require from staff. The care plans are updated, as peoples needs change. People living at the home and their relatives are invited to be actively involved in reviews of the plan. In the surveys, people told us they received the care and support they needed. People look well cared for. All the people who live in the home spoke well of staff and they felt that they were kind and caring. There are activities on offer for people to join with if they want to. We asked people to tell us what the home does well. These are some of their comments: “Everything” “They provide warmth and security” “Good care-good meals” “They are good at communication and working in partnership” What has improved since the last inspection? What they could do better: Create a shower room so that people can choose whether they want a bath or a shower. Replace the floor covering in the downstairs toilet so that it is odour free and hygienic. Lyndhurst DS0000026278.V376346.R01.S.doc Version 5.2 Page 7 Provide monthly reports about the conduct of the home that are available on site. Continue to improve the home by upgrading the décor and furniture. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line – 0870 240 7535. Lyndhurst DS0000026278.V376346.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection Lyndhurst DS0000026278.V376346.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 & 5 (standard 6 does not apply) People using the 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 assessed before they move in to make sure that all their needs can be met. Information is available about the home to help people make a decision about whether the service is suitable for them. EVIDENCE: Lyndhurst DS0000026278.V376346.R01.S.doc Version 5.2 Page 10 There is an up to date Statement of Purpose and Service User Guide, a copy is on display in the entrance area. Copies are also available on request from the home for people to take away with them to look at later. These documents provide people with information about the fees, the facilities at the home and about the service they can expect. People are encouraged to visit the home and meet people to see if it suits them, the manager said people are welcome to stay for a meal & to visit as many times as they want to. Information in the care plans shows that people are assessed before they move into the home. This is done to make sure that the home is the right place for them and that all of their needs can be met. The home does not provide intermediate care. Lyndhurst DS0000026278.V376346.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 &10. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Information in the care plans outlines the care and support that each person requires; which should ensure that their needs health and personal care needs are met. Medication is safely managed. EVIDENCE: We looked at three care plans because we wanted to see what individual needs had been identified and what action staff have to take to meet these needs. Lyndhurst DS0000026278.V376346.R01.S.doc Version 5.2 Page 12 We found that the care plans were detailed and easy to follow. The care plans contain some useful information about the sort of daily routines that people prefer. Personal support is tailored to meet individual needs and there is evidence that people are being consulted about how they want their care and support to be delivered. We observed staff treating people with dignity and providing personal care in private. We also observed staff assisting people using moving and handling equipment. They were very patient and they explained to each person they were assisting, what they were doing and why. Peoples health care needs are being identified and met. Staff are vigilant and evidence shows that other health care professionals are being involved as necessary. Details of any visits by health care professionals are clearly documented in the residents care plan, together with the advice that has been given. We found moving and handling plans, nutritional assessments and Waterlow pressure sore risk assessments in the care plans. In the surveys, people told us that they get the medical care that they need. Everyone looked well cared for. Peoples hair was brushed or combed, spectacles were clean and peoples personal and oral hygiene was well maintained. In the surveys people told us that they get the care and support they need and that staff listen to them and act upon what they say. The manager said all of the staff have good contact and relationships with family members that visit Lyndhurst. They keep them up to date and involve them in the care planning process. Medication is safely stored and well managed. The records show that people get their medication as it is prescribed by their doctor. Lyndhurst DS0000026278.V376346.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13,14 & 15. People using the 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 staff have plenty of contact with people and they respect their preferred routines. People are treated with respect and dignity. EVIDENCE: Lyndhurst a friendly place with a relaxed atmosphere. The staff are pleasant and they make sure they have time to chat to people. They know people really well and a lot of good-humoured banter is exchanged. The staff know lots about people’s lives and about their interests and hobbies; this gives them a Lyndhurst DS0000026278.V376346.R01.S.doc Version 5.2 Page 14 useful point of contact and helps them to support people to maintain up their hobbies. They have recently started to grow some of their own fruit and vegetables, coopting help from a relative of a member of staff. The manager said this has been a successful project that has received a lot of interest from people living there. They have just entered a local garden competition. Relatives are always made welcome; the staff know them well and invite them to stay for a meal if they wish. We were told one person had several members of her family at Lyndhurst for Christmas dinner. The staff told us about a visit they had recently from a group of students and tutors from Dewsbury College who brought a Wii console and games for people to try out. They said this was a new experience that everyone took part in and enjoyed and some surprising “sporting” skills emerged. They are now saving to buy their own console. At lunchtime there is a set meal, but there are a range of alternatives on offer if people do not like the dish of the day. People received a well presented meal, in a pleasant setting. There is plenty of choice at teatime and suppertime and snacks and drinks are always available. Lyndhurst DS0000026278.V376346.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Complaints and adult protection issues are being dealt with properly. This means that staff are listening to people and keeping them safe. EVIDENCE: In the surveys, people told us they know about the complaints procedure and they know how to make a complaint. People told us that the know who to talk to if they are unhappy. There is a complaints log to records the details and outcomes of any complaints made to the home. No complaints have been made to us since our last inspection in July 2008. The deputy manager told us that all of the staff have received training about their responsibility to safeguard people in their care. This is also part of the induction process for any new staff that start work at the home. Lyndhurst DS0000026278.V376346.R01.S.doc Version 5.2 Page 16 The manager and deputy manager have attended recent training provided by the local authority about safeguarding procedures. They said they intend to cascade the training to all of the staff. Lyndhurst DS0000026278.V376346.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 19, 21, 24 and 26. People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a comfortable home but the refurbishment and redecoration needs to continue to improve the facilities. EVIDENCE: The communal areas of the home are clean and comfortable. Everyone who completed a survey said the home was always clean. Lyndhurst DS0000026278.V376346.R01.S.doc Version 5.2 Page 18 The bedrooms we looked at are personalised, most people have lots of ornaments and photographs around them. Everyone is encouraged to bring personal items with them when they move in. Since our last visit the hallway and dining room has been redecorated and there is a new carpet in one of the lounges. Some of the bedrooms have also been redecorated. The decoration in one of the lounges needs attention, the room is dark and part of the wallpaper above the door has been stripped off but no further work has been carried out, this room needs attention. The manager said there is a plan for refurbishment but we didn’t see it. The downstairs toilet on the main corridor requires attention, it smells strongly of urine and the odour can be detected on the corridor. In order to ensure that this area is clean, hygienic and odour free, the floor covering needs to be replaced. The home has two bathrooms but as only one is fitted with adaptations, the second bathroom is not used. It would be useful to create a shower/wet room in the second bathroom to provide people with a choice of bathing facilities. On the upstairs landing some of the wall lights have been disconnected leaving exposed, taped up wiring. The manager said she had already made arrangements for an electrician to check the wiring later in the week. Lyndhurst DS0000026278.V376346.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are enough staff on duty to meet peoples needs. Staff are well trained and competent to do their job. EVIDENCE: The home is adequately staffed at all times to meet the needs of the people living there. During the day there is one senior member of the team on duty with two care staff, plus the manager. Throughout the night, there are two care staff on duty. There is domestic cover every day for five hours and a cook is available every day between 7.30 am and 2.45 pm. In the surveys, we asked people living at the home if staff are available when they are needed, everyone said “always”. A training matrix shows at a glance what training staff have undertaken and what needs to be renewed. Most people have completed all of the required mandatory training. Staff have good training opportunities available to them; we saw details of the training that is planned for the coming months. Lyndhurst DS0000026278.V376346.R01.S.doc Version 5.2 Page 20 We looked at a sample of staff records to see if new staff are being appropriately checked before they start work at the home. This is to make sure that staff are suitable and to keep people safe. Most records were complete but one staff file we looked at only contained one reference, we discussed this with the deputy manager who made immediate arrangements for a second reference to be faxed to the home. Lyndhurst DS0000026278.V376346.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 and 38. People using the 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 home is well managed and run in the best interests of the people living there. People are consulted about the service and asked if it can be improved in any way. EVIDENCE: Lyndhurst DS0000026278.V376346.R01.S.doc Version 5.2 Page 22 The manager has a number of year’s experience of working with older people in a residential setting. She has previously been the registered manager of a care home. She has been in post since August 2007 and was registered with us as the manager of Lyndhurst in August 2008. The home is run in the best interests of the people living there. The manager talks to people each day and she is open and approachable. People were very positive in their comments about the whole staff team and said they would talk to them if they had any concerns. People’s views on the service are welcome. House meetings are convened when people have issues they want to discuss, they set their own agenda’s and have elected a spokesperson to take issues up with management and report back to them. Relatives are surveyed periodically throughout the year and asked for their views on the service provided. The management team are open to suggestions about any improvements people suggest to them. We wanted to look at the monthly reports that the provider has to write about the conduct and management of the home. We saw copies of these last year but none were available on this visit. We have made a requirement in this inspection report for monthly reports to re-commence. The manager said the provider visits the home every week and this requirement will be met. We looked at the records of money held for safekeeping on behalf of three people. The records could be reconciled with the money held for two people but there was a small discrepancy in the record keeping for the third. We asked the manager to look into this. All staff are receiving supervision from the management team. Evidence shows that supervision is pre planned and takes place on a regular basis. There is a written Health and Safety policy. Staff receive moving and handling, health and safety, food hygiene, fire safety, first aid and infection control training. The service reports for the stair lift and bath hoists were seen and were up to date. Lyndhurst DS0000026278.V376346.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 x 3 x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 x 2 x x 2 x 2 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 2 3 x 3 Lyndhurst DS0000026278.V376346.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 OP26 Standard Regulation 13 Requirement All parts of the home must be clean, hygienic and free from offensive odours. This is to control the spread of infection and ensure that the home is a pleasant place to live in. All new staff must be appropriately checked before starting work at the home. This is to make sure they are suitable and people living at the home are protected. Monthly reports must be completed on the conduct and standard of care in the home. This is to ensure that people are safe and their needs are being met. Individual finance records must be accurate and must balance with the amount of money held for safekeeping. This is to make sure that people’s financial interests are safeguarded. Timescale for action 31/08/09 2 OP29 19 31/08/09 3 OP33 26 31/08/09 4 OP35 17 31/08/09 Lyndhurst DS0000026278.V376346.R01.S.doc Version 5.2 Page 25 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 OP21 Refer to Standard Good Practice Recommendations Consideration should be given to creating a shower room in the unused bathroom. This would give people a choice of bathing facilities. Lyndhurst DS0000026278.V376346.R01.S.doc Version 5.2 Page 26 Care Quality Commission North Eastern Region Citygate Gallowgate Newcastle Upon Tyne NE1 4PA National Enquiry Line: Telephone: 03000 616161 Email: enquiries.northeastern@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). 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