Care Home: Lyons Court Care Home

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What the care home does well The care plans provide useful information about how individual care needs are to be met. Risk assessment and risk management plans are in place and are regularly reviewed to make sure that they continue to address individual needs. The home now provides good standard of training for the staff. The home is clean and maintained to a good standard. What the care home could do better: The Area Coordinator and the Compliance Manager were advised to ensure that they continue to encourage residents and or their relatives to sign the care plans, indicating their agreement with the care that they receive. Random inspection report Care homes for older people Name: Address: Lyons Court Care Home Stones End Evenwood Bishop Auckland County Durham DL14 9RE two star good service 30/01/2009 The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Sam Doku Date: 2 4 0 8 2 0 1 0 Information about the care home Name of care home: Address: Lyons Court Care Home Stones End Evenwood Bishop Auckland County Durham DL14 9RE 01388834516 01388832327 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Durham Careline Limited Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 50 Number of places (if applicable): Under 65 Over 65 0 50 dementia old age, not falling within any other category Conditions of registration: 50 0 The maximum number of service users who can be accommodated is: 50 The registered person may provide the following category of service only: Care Home with Nursing - Code N To service users of the following gender: Either Whose primary care needs on admission to the Home are within the following categories: Old Age, not falling within any other category, Code OP - maximum number of places 50 Dementia Code DE, maximum number of places 50 Date of last inspection 3 0 0 1 2 0 0 9 Care Homes for Older People Page 2 of 14 Brief description of the care home The home is well designed and has pleasantly landscaped surroundings. It shares a site with its sister home, Bowes Court. There is ample parking space and views of the surrounding countryside. The home has three floors and all are accessible by lift. The home has very generous communal and circulatory space and it has been designed to enhance the experience of the service users and to make operation easier for the staff. There is a generous amount of storage space in the home. This design and build is an example of good practice. There is a good standard of equipment such as mobile and fixed hoists, and specialist beds. A suitable call system has been installed. The scale of charges is between 454.71 and 476.44 Pounds per week depending on whether nursing care is required or not. Care Homes for Older People Page 3 of 14 What we found: This random inspection was carried out on 24 August 2010 by two Compliance Inspectors and took four hours to complete. The reason for this inspection visit was to check whether the provider had complied with the timescales for the four remaining requirements made at the last key inspection. At the last key inspection the homes rating was reduced from Good to Poor. During this inspection the Compliance Inspectors spoke with the providers Compliance Manager and the Area Coordinator. The inspectors looked at records the home keeps about how to care for people, including staff training records, supervision records, care plans and risk assessments. The inspectors found significant improvement in the information in the care plans. Care plans provide details of how individuals should be supported, and these support plans are regularly reviewed and updated when required. A number of files containing risk assessments were examined and the inspectors found that in general, individual risks have been properly assessed and risk management plans have been put in place to manage any identified risks to individuals. The inspectors look at the staff training record. The record shows that the home has taken positive steps in providing staff with all the necessary training to equip them for their care role. The record shows a comprehensive training plan and planned training is to be carried out in the next few weeks. This includes moving and handling, safeguarding of vulnerable adults, dememntia awareness, first aid and infection control. There are suitable arrangements in place for staff supervision. Some of the staff files that were examined had supervision notes in them. There are further arrangement to improve on the current supervision arrangements. What the care home does well: 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 2. Care Homes for Older People Page 4 of 14 Care Homes for Older People Page 5 of 14 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 1 3 14 Ensure that information provided in the nurse assessor/care manager assessments is taken into consideration when care plans are being devised so that all aspects of the residents care needs are provided for in the plans. Care plans did not always reflect all of the residents care needs. 30/07/2010 2 7 14 Ensure that individual service 25/06/2010 user risk assessments are in place and are reviewed and updated to reflect their changing health needs. This is to ensure service users are protected from risk of harm. 3 7 15 Ensure that all service users 01/07/2010 care plans clearly identify all of their individual care needs and how their health and welfare needs are to be met. This is to make sure that staff plan and review how they work with people so that everyone works in the same way to ensure service users needs are being met. Care Homes for Older People Page 6 of 14 Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 4 8 13 Ensure that individual service 09/08/2010 users risk assessments are in place and are reviewed and updated to reflect their changing needs. (This is an outstanding requirement from the last inspection.) This is to ensure service users are protected from risk of harm. 5 8 12 Ensure that the personal 25/06/2010 hygiene needs of individual service users are met. Put in place effective arrangements to ensure that guidance and instruction provided by the multi- disciplinary professionals about care and treatment of service users is relayed to all staff and followed at all times. Put in place effective arrangements to ensure that all staff, including those who prepare food, are aware of individual service users nutritional needs and to ensure that food provided to service users meets their individual nutritional needs. This is to make adequate, proper and prompt provision for the care and treatment of service users generally and in accordance with specific requirements. 6 9 13 Ensure that medication administration records are accurately maintained; that the reasons for non- 25/06/2010 Care Homes for Older People Page 7 of 14 Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action administration of medication are recorded by the timely entry of an appropriate code or entry on the medication administration record; that the meaning of any such codes are clearly explained on each record; and that the person administering the medication completes the medication administration record in respect of each individual service user at the time of administration. This is to make sure that there are arrangements in place to ensure the recording and safe administration of medication. 7 9 13 Ensure that medication 29/07/2010 administration records are accurately maintained; that the reasons for nonadministration of medication are recorded by the timely entry of an appropriate code or entry on the medication administration record; that the meaning of any such codes are clearly explained on each record; and that the person administering the medication completes the medication administration record in respect of each service user at the time of administration. This is to make sure that there are arrangements in place to ensure the recording Care Homes for Older People Page 8 of 14 Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action and safe administration of medication. Previous deadline of 01/07/2010 not met. 8 9 13 Care plans must include 10/08/2010 detailed information and instructions for staff in respect of the administration of medicines, including the reasons to give medicines prescribed as required and how to decide if administration is appropriate. This will make sure that medicines are given in the way intended by the prescriber. 9 9 13 Ensure that there is regular 01/07/2010 and frequent audits of medicines and records must be undertaken to promptly identify and resolve any medication discrepancies and to confirm that staff are closely following the providers medicines policy, and are assessed as competent to administer medicines before undertaking this task. This is to make sure that any discrepancies are detected in time and addressed. 10 9 13 Ensure that all medication is administered as directed by the prescriber to the service user it was prescribed, labelled and supplied for. 01/07/2010 Care Homes for Older People Page 9 of 14 Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action This is to make sure that residents healthcare needs are met. 11 9 12 Effective arrangements must 14/09/2010 be in place to request, obtain and retain adequate supplies of prescribed medicines, including nutritional supplements, for service users. This will make sure that all medicines are available to administer as and when required. 12 9 13 Ensure that all medication is administered as directed by the prescriber to the service user it was prescribed, labelled and supplied for. This is to make sure that residents healthcare needs are met. Previous deadline of 25/06/10 not met. 13 30 18 Undertake a comprehensive 30/07/2010 review of the training provided to current staff at the home and produce an accurate record of all training provided to individual staff members. All staff must receive training in safeguarding adults, mental capacity act and deprivation of liberties safeguards. This is to ensure that the residents legal rights and welfare are protected at all times. Produce an assessment of training needs Page 10 of 14 29/07/2010 Care Homes for Older People Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action for each member of staff to identify the training needed to enable each member of staff to meet service users health and welfare needs. Ensure that as a minimum each member of staff receives training in Understanding Dementia Managing challenging behaviour , Infection Control Health and safety Food Hygiene Ensure that all staff with responsibility for administering medication are trained to do so. Ensure there are sufficient staff employed at the home that are trained in first aid so that there is at all times a minimum of one person on duty who has received first aid training. This is to ensure that the staff receive training appropriate to their work in order to meet the health and welfare needs of the service users accommodated at the home. 14 33 26 Carry out and provide 25/06/2010 adequate evidence of appropriate monthly visits to the home on behalf of the registered provider. This is to ensure that the home is being operated in the best interests of service users and that they are receiving good quality care. Care Homes for Older People Page 11 of 14 Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 15 36 18 Ensure that the staff receive formal and appropriate supervision. This will ensure that staff are appropriately supervised and supported in their work. 30/07/2010 Care Homes for Older People Page 12 of 14 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 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 13 of 14 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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