Care Home: Lynmere Nursing Home

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What the care home does well People are assessed before coming to live at the home so staff can be sure they will be able to meet their needs. Care plans are written for each person, which generally provided good information to staff about the care they needed to deliver.Residents who returned surveys were satisfied that staff listened to and acted on what they said and felt they got the medical support they needed. Comments from people returning surveys included "The staff are caring and considerate. When I ask for anything on behalf of mum it happens", "X is always clean, well dressed and looks cared for. People are constantly checking all is well with people who are in their own rooms", "My daughter is notified when I require treatment. I was really poorly over Christmas and the staff were wonderful", "All the staff are dedicated and very efficient", "X seems happy and more settled since moving in", "Excellent care", "The staff are very attentive" and "We feel that if we were to hand pick the staff we couldn`t do any better". Residents and relatives expressed satisfaction with the manager, saying she was approachable and would sort out any problems for them. The manager operates an open door policy and is available most of the time, around and about the home. A satisfaction survey had been undertaken in October 2007 and residents` feedback had been taken into account when the manager made plans for how to develop the home over the next year. We have received no complaints about this service since the last inspection. Staffing levels at the home appeared to be suitable to meet the needs of people living there and it was reported that 69% had attained an NVQ qualification. It was reported that another four staff were undertaking the training. What has improved since the last inspection? Since the last inspection procedures regarding the management of medicines have been improved and we identified no problems with the current practices in place. We looked at some staff files to see what checks had been made before they started working at the home. The system has improved since the last inspection and all the necessary information was in place. The service user guide now contains a copy of the home`s terms and conditions. What the care home could do better: The manager had already identified most of the areas that need development and improvement. Plans had been developed to improve these areas but these now need to be taken forward and acted on assiduously. Although, since the last inspection staff have devised a new form for residents to complete, so they can get a better understanding of their social interests and potential needs, this information could still be better used to expand the social opportunities for residents and make them more person-centred. Consideration is also needed as to how residents can be encouraged to exercise choice, for example, with revision of the menu. Mealtimes could be made more sociable occasions by looking at the layout of the lounge/dining room and reassessing what furniture is required. Although some areas of the home have been redecorated, some areas do need the carpets replacing, as they detract from the overall appearance of the environment. The bathrooms are also somewhat uninviting and would benefit from some upgrading. CARE HOMES FOR OLDER PEOPLE Lynmere Nursing Home 278 Buxton Road Great Moor Stockport Cheshire SK2 7AN Lead Inspector Mrs Fiona Bryan Unannounced Inspection 18th August 2008 10:00 X10015.doc Version 1.40 Page 1 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 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Lynmere Nursing Home DS0000064700.V363623.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Lynmere Nursing Home DS0000064700.V363623.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Lynmere Nursing Home Address 278 Buxton Road Great Moor Stockport Cheshire SK2 7AN 0161 456 2634 F/P 0161 456 2634 lynmerenh@tiscali.co.uk 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) RMD Care Services Ltd Susan Jackson Care Home 20 Category(ies) of Old age, not falling within any other category registration, with number (20), Physical disability (20), Physical disability of places over 65 years of age (20) Lynmere Nursing Home DS0000064700.V363623.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. No more than 20 service users to be admitted to the home No service users under 45 years of age to be admitted into the home Maximum number of service users 20, these to include Old Age, not falling within any other category (20), Physical Disability (20), Physical Disability over 65 years of age (20) 6th December 2006 Date of last inspection Brief Description of the Service: Lynmere is a care home that provides 24 hour nursing care and accommodation to 20 adult service users over the age of 45. Many of the service users accommodated at the home have high physical dependency needs. The home is owned by RMD Care Services Ltd. Lynmere is situated on the main road, the A6, in the Great Moor area of Stockport. The home is close to local shops, churches, a park and bowling green and local public houses. Local bus services are available close by and a train station is five minutes walk away. The main entrance to the home has small borders of flowers and there is a relatively secluded small garden. Car parking facilities are also provided. The home is a single storey building that was purpose built about 20 years ago. All bedrooms are single rooms. En-suite facilities are not available. The home provides a choice of assisted bathing facilities, including a shower. There is one large lounge, which also contains a dining table. A wide variety of adaptations and aids are provided to assist in the nursing of the service users accommodated. The home is a non-smoking environment. A copy of the home’s last inspection report was available from the main reception of the home. Lynmere Nursing Home DS0000064700.V363623.R01.S.doc Version 5.2 Page 5 The current weekly fees start from £408 and vary depending on the package of care required. Further details regarding fees are available from the manager. Additional charges are made for hairdressing, newspapers and other personal requirements. Lynmere Nursing Home DS0000064700.V363623.R01.S.doc Version 5.2 Page 6 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. This key unannounced inspection, which included a site visit, took place on Monday 18th August 2008. The staff at the home did not know that this visit was going to take place. All the key inspection standards were assessed at the site visit and information was taken from various sources, which included observing care practices and talking with people who live at the home, the manager, visitors and other members of the staff team. Three people were looked at in detail, looking at their experience of the home from their admission to the present day. A selection of staff and care records was examined, including medication records, training records and staff duty rotas. Before the inspection, we asked for surveys to be sent out to residents and staff, asking what they thought about the care at the home. Eleven residents and two staff returned their surveys. Comments from these questionnaires are included in the report. We also asked the manager of the home to complete a form called an Annual Quality Assurance Assessment (AQAA) to tell us what they felt they did well, and what they needed to do better. This helps us to determine if the management of the home see the service they provide the same way that we see the service. We feel she completed this well and we agree with what she wrote. She was able to tell us what plans she has in place to continue developing the service. What the service does well: People are assessed before coming to live at the home so staff can be sure they will be able to meet their needs. Care plans are written for each person, which generally provided good information to staff about the care they needed to deliver. Lynmere Nursing Home DS0000064700.V363623.R01.S.doc Version 5.2 Page 7 Residents who returned surveys were satisfied that staff listened to and acted on what they said and felt they got the medical support they needed. Comments from people returning surveys included “The staff are caring and considerate. When I ask for anything on behalf of mum it happens”, “X is always clean, well dressed and looks cared for. People are constantly checking all is well with people who are in their own rooms”, “My daughter is notified when I require treatment. I was really poorly over Christmas and the staff were wonderful”, “All the staff are dedicated and very efficient”, “X seems happy and more settled since moving in”, “Excellent care”, “The staff are very attentive” and “We feel that if we were to hand pick the staff we couldn’t do any better”. Residents and relatives expressed satisfaction with the manager, saying she was approachable and would sort out any problems for them. The manager operates an open door policy and is available most of the time, around and about the home. A satisfaction survey had been undertaken in October 2007 and residents’ feedback had been taken into account when the manager made plans for how to develop the home over the next year. We have received no complaints about this service since the last inspection. Staffing levels at the home appeared to be suitable to meet the needs of people living there and it was reported that 69 had attained an NVQ qualification. It was reported that another four staff were undertaking the training. What has improved since the last inspection? Since the last inspection procedures regarding the management of medicines have been improved and we identified no problems with the current practices in place. We looked at some staff files to see what checks had been made before they started working at the home. The system has improved since the last inspection and all the necessary information was in place. The service user guide now contains a copy of the home’s terms and conditions. Lynmere Nursing Home DS0000064700.V363623.R01.S.doc Version 5.2 Page 8 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Lynmere Nursing Home DS0000064700.V363623.R01.S.doc Version 5.2 Page 9 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 Lynmere Nursing Home DS0000064700.V363623.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 3. Standard 6 is not applicable. Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Residents were assessed in full, being coming into the home, thus ensuring staff were able to meet their identified needs. EVIDENCE: A copy of the statement of purpose and a service user guide were provided in each resident’s room. Information contained in these documents appeared to be reflective of the services offered at the home and included a copy of the complaints procedure and standard terms and conditions of residency. All of the 11 residents who returned surveys said they had received all the information they needed to make a decision to come into the home. Lynmere Nursing Home DS0000064700.V363623.R01.S.doc Version 5.2 Page 11 The care files for three residents were looked at in detail. Pre-admission details were kept in a separate file in the manager’s office but all relevant information appeared to have been entered on to each resident’s admission records. An initial assessment had been undertaken for one resident who had stayed at the home on several occasions for periods of “respite” care, and on each subsequent visit the assessment had been reviewed with the resident to ensure the information was still up to date and accurate. Where residents had been funded by social services or the PCT a copy of the multi-disciplinary assessment was provided. Lynmere Nursing Home DS0000064700.V363623.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Residents’ health and personal care needs were well met by staff who knew the residents’ preferred routines and abilities. EVIDENCE: Three residents were case tracked. Care plans were in place that generally addressed residents’ identified needs, particularly their personal and health care needs. Care plans had been reviewed fairly regularly although not always every month. Some care plans, where the residents’ needs had changed more significantly, had been updated more often. Records showed that residents had seen GP’s, dentists, chiropodists and opticians. Residents confirmed that staff were prompt in requesting a GP visit if they needed one. Lynmere Nursing Home DS0000064700.V363623.R01.S.doc Version 5.2 Page 13 Where one resident had lost weight, advice had been sought from the GP and dietician. The manager said that the dietician was due to review the resident but was unsure when they would visit and agreed to follow this up. Several residents were at high risk of pressure ulcers and had care plans to address this. Where residents require regular positional changes, a record of this being carried out was not always maintained. It would be good practice to complete “turn” charts when this action was identified as necessary in the care plan, so staff can monitor the effect and ensure the care is delivered according to the plan. The procedures for managing medicines within the home were generally satisfactory. The records for several people were examined and had been completed properly. Medicines were stored correctly. Residents and relatives were happy with the care provided by staff. Comments from people spoken to on the day of the site visit included “I am extremely happy here. The staff are so friendly and helpful, they just want to care for you. It is a pleasure to be here”, “the staff are kind and good” and “Mum loves it here – she loves all the staff”. All of the 11 residents who returned surveys before our site visit said that they always or usually got the care and medical support they needed and that staff listened and acted on what they said. Comments from people returning surveys included “Staff are caring and considerate. When I ask for anything on behalf of mum it happens”, “My daughter is notified when I require treatment. I was really poorly over Christmas and the staff were wonderful”, “All the staff are dedicated and very efficient”, “Excellent care”, “The staff are very attentive” and “We feel that if we were to hand pick the staff we couldn’t do any better”. Visitors confirmed that the residents always looked well cared for and that staff kept them informed when there were changes in their condition. One visitor said, “Mum is always clean, well dressed and looks cared for. People are constantly checking all is well with people who are in their own rooms”. Staff were knowledgeable about individual residents’ care preferences and were able to describe their abilities and routines. needs and Lynmere Nursing Home DS0000064700.V363623.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is adequate. This judgement has been made using available evidence, including a visit to this service. Information about residents’ social preferences could be used more effectively to deliver care that better meets people’s social requirements and provides improved opportunities for choice. EVIDENCE: In the AQAA the manager told us that since the last inspection staff had introduced a “getting to know you” form, as part of the assessment of residents social needs and as part of the person centred approach to care plans and the provision of care. In each of the files for the residents we case tracked, this document entitled “About me”, was provided which gave details about the resident’s family and friends, previous occupation and interests and social preferences, such as if they enjoyed company or preferred spending time on their own. Lynmere Nursing Home DS0000064700.V363623.R01.S.doc Version 5.2 Page 15 Further work now needs to take place to try to use this information and plan with residents, activities and social events that they would enjoy. Staff kept a record of activities that residents had participated in, but many entries involved sitting in the lounge and watching television. Most residents when asked were vague about what pastimes were organised that they could join in with and said they sometimes got bored and watched television as there was nothing else to do. Some staff felt that this was an area that still required development. Of the 11 residents that returned surveys, 27 said there was always or usually activities provided but 63 said activities were only sometimes on offer or never provided. One person commented “On the whole, a very caring atmosphere but would like a little more stimulation in the afternoons”. Residents said they were able to choose how they spent their day. Several residents remained in bed out of choice, as they said they felt more comfortable in bed. Residents could be encouraged to exercise more choice however. For example, whilst we were in the lounge we noticed that a carer came in and selected a music CD to put on without asking any of the residents what they would like to listen to or offering them a choice. Residents mainly said they liked the food provided at the home. None of the residents knew what was for lunch and the menu was not displayed anywhere. Most residents were not sure if they could ask for an alternative if they did not like the meal being served, although one resident said he had asked for other options and staff were very obliging. One relative returning a survey on behalf of a resident commented, “X does not complain. I would like to see some salad with the potted meat, cheese, etc., sandwiches at teatime, they seem very uninteresting to me. Staff go to people who eat in their rooms and I see them sit and chat with people, encouraging them to eat. The main meal of the day is fine”. There was not enough space for all the residents to sit at a dining table. There was only one communal room, which served as a lounge and dining room and only one table was provided with seating for four people. The table was situated at the side of the room and staff moved it to the centre of the room before lunch. Staff said they had to rotate who sat at the table and the other residents remained in their armchairs and ate from trays placed on side tables. The dining table was not laid with a cloth or condiments, etc., and more could have been done to make the mealtime a more social and convivial occasion. The environment is discussed in more detail in the relevant section of this report. Lynmere Nursing Home DS0000064700.V363623.R01.S.doc Version 5.2 Page 16 Lunch was pasta shells with bolognaise sauce, chips and mixed vegetables. Most residents said that they enjoyed it. Staff had to assist a number of residents, both in the lounge/dining room and in residents’ own rooms. Staff were seen to help residents in a sensitive manner and did not rush people. Some residents had adapted crockery or cutlery. The menu rotates over a four-week period. No options were provided at the lunchtime meal but there were some limited options at teatime. The main meal of the day was served at lunch and included dishes such as beef burgers, liver and onions, roast dinners, stews, casseroles and fish. The menu could be reviewed, as the choice of vegetables seemed to be limited, with carrots on the menu for six days every week! The teatime menu was lighter and included dishes such as egg or beans on toast, potato cakes, crumpets, salad and bacon and tomatoes. A hot option was usually available and soup and assorted sandwiches were always an alternative. Lynmere Nursing Home DS0000064700.V363623.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Residents can be confident that staff are trained to respond appropriately to suspected abuse and can also be confident that all complaints will be treated seriously. EVIDENCE: All residents had a copy of the service user guide in their room and this contained a copy of the complaints policy. Residents and visitors said they would speak to the manager if they had a concern or complaint. People said the manager was approachable and had confidence that any issues would be taken seriously and dealt with properly. The CSCI have received no complaints about the home over the last year and the manager said she had received no complaints. Staff were able to describe common signs of abuse and were aware of the steps to take to safeguard residents at the home. Lynmere Nursing Home DS0000064700.V363623.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21 and 26 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. The environment provides a safe and clean home for residents to live in. EVIDENCE: A partial tour of the home was undertaken. The home was clean and smelled fresh. All the residents that returned surveys reported that the home was always or usually fresh and clean, although one wrote, “the carpets in the corridors need replacing”. Since the present owners took over the home in October 2006 it was reported that 14 rooms had been redecorated, nine rooms had had new carpets and the communal areas and reception areas had been redecorated. Lynmere Nursing Home DS0000064700.V363623.R01.S.doc Version 5.2 Page 19 A redecoration and refurbishment plan of the bedrooms was being undertaken and the bedrooms that had been redecorated were pleasant. However, the effect in some of them was spoiled as the carpets had not been replaced and a number of carpets in the residents’ rooms needed replacing as they were worn and stained. At the time of the site visit a decorator was at the home painting the corridors and the manager said that new carpets were being provided for the corridors. Other areas that need to be reviewed are the bathrooms and the lounge/dining room. The bathrooms felt very plain and would be improved by creating a more homely and domestic look. As stated in the “daily life and social activities” section, the lounge/dining room does not suit the needs of the residents, as there are insufficient dining spaces. All the armchairs were placed around the perimeters of the room and better use could be made of the space, creating a more homely feel and providing a better dining area. This was discussed with the manager. The kitchen and laundry areas of the home were not seen at this visit. It was reported that there was only one tap in the home (in the kitchen) that provided cold water that was suitable for drinking. The owner should consider providing a water cooler in the lounge so that staff and residents can easily access cold drinks. The external grounds needed some attention, as they were slightly overgrown due to the gardener being on holiday. This had been identified in the development plan for 2008/9 and the manager was aiming to make the gardens more attractive to encourage residents to spend more time outdoors. Lynmere Nursing Home DS0000064700.V363623.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Recruitment vetting practices, staffing levels, training and skill mix were appropriate to meet residents’ needs and promote their health and safety. EVIDENCE: It was reported that there were normally six staff (nurses and carers) on duty each morning and four staff on duty in the afternoons and evenings. One nurse and one carer were on duty at night. Examination of the staff duty rotas for the weeks commencing 11th and 18th August 2008 verified this. All the residents that returned surveys said staff were always or usually available when they needed them. Further comments included “I visit mum at random times and find Lynmere well staffed with pleasant helpful people”, “Being a nursing home some residents require more attention than others. On the odd occasion when the staff are extra busy you may have to wait a while”, “if needed they come instantly” and “the nurses and staff are always on hand”. Two staff personnel files were examined. Both contained the documents and evidence needed to ensure that the people recruited were suitable to work in a care home. Lynmere Nursing Home DS0000064700.V363623.R01.S.doc Version 5.2 Page 21 It was reported in the AQAA that out of 13 care staff, nine had successfully completed NVQs and another four were undertaking the training. The manager said that staff had undertaken training related to safe guarding adults, infection control, food hygiene, fire awareness, dementia care and moving and handling. A small number of staff had undertaken training in wound care and the manager and one of the nurses had attended training in administering the Flu vaccine. The manager was pleased that the home had been chosen to work towards the Gold Standard in palliative care and this will provide additional training for staff. Each staff member had a training file that contained evidence of the training they had undertaken. The home is not yet registered with Skills for Care and therefore does not provide training in line with the Common Induction Standards. However, new staff do receive induction training that is specific to the home. The manager said she intended to enrol with Skills for Care and should do this as soon as possible. Lynmere Nursing Home DS0000064700.V363623.R01.S.doc Version 5.2 Page 22 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. The management of the home promotes the health, safety and wellbeing of the residents. EVIDENCE: The manager is a registered nurse and has completed the Registered Manager’s Award. The manager keeps up to date with current health care practices by attending relevant training, for example, a wound care course and training in the administration of the flu vaccine. The manager said she had also attended a briefing about the Mental Capacity Act and its implications for residents and staff. Lynmere Nursing Home DS0000064700.V363623.R01.S.doc Version 5.2 Page 23 The company had undertaken a satisfaction survey in October 2007 and had produced a report on the findings. A development plan for 2008/9 had been created and comments and feedback from the residents had been taken into account. Areas that need further development, such as the provision of social activities and stimulation had been recognised and these areas now need to be acted on. The manager had tried to arrange residents/relatives meetings but had met with a poor response. As the manager is seen frequently around the home and operates an open door policy residents and relatives said they would approach her with any comments, suggestions or concerns and did not need meetings. The home does not hold any personal money for residents. Residents or their appointee are billed for all expenses incurred. Weekly checks had been made of the building and equipment in respect of fire prevention and health and safety. Records showed that fire drills had been held regularly, but none had been held at times that would include the night staff so this should be arranged. Staff were observed to be working using safe working practices and said they had enough equipment to carry out their jobs appropriately. Lynmere Nursing Home DS0000064700.V363623.R01.S.doc Version 5.2 Page 24 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 X 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 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 2 2 X X X X 3 STAFFING Standard No Score 27 4 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Lynmere Nursing Home DS0000064700.V363623.R01.S.doc Version 5.2 Page 25 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. Standard Regulation Requirement Timescale for action Lynmere Nursing Home DS0000064700.V363623.R01.S.doc Version 5.2 Page 26 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 Refer to Standard OP8 Good Practice Recommendations Where a resident is assessed as being at high risk of pressure ulcers and their care plan indicates that they require regular positional changes, staff should record this so the care being delivered can be accurately monitored and maintained. The registered person should continue to implement the planned improvements in the social activities provided in the home. The manager should review the content of the menus to ensure a varied diet is provided. The menu should be made available to residents and should provide options at each mealtime including lunch. Bedroom, lounge/dining room and hallway carpets should be replaced to enhance the appearance of the home. Provision of a water cooler should be considered to enable staff and residents to easily access cold drinks throughout the day. The layout of the lounge/dining room should be improved and the space better utilised to provide more dining spaces for residents and a more homely and cosy sitting area for their enjoyment. The gardens should be improved and better maintained. The bathrooms should be enhanced to provide a more homely and comfortable experience for people using them. The manager should register with Skills for Care and ensure that new employees receive induction training that meets their specifications. The registered person should ensure that future fire drill practices enable all staff to the have the opportunity to participate in a fire drill including night staff. 2 3 OP12 OP15 4 5 6 OP19 OP19 OP20 7 8 9 10 OP20 OP21 OP30 OP38 Lynmere Nursing Home DS0000064700.V363623.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Manchester Area Office Unit 1, 3rd Floor Tustin Court Port Way Preston PR2 2YQ National Enquiry Line: 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 © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Lynmere Nursing Home DS0000064700.V363623.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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