Care Home: The Lawns Residential Care Home

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What the care home does well People using the service said: `I am happy here`; `I am very satisfied with everything the staff do for me.`A relative who returned a survey said `if family members have any concerns, staff listen and then take appropriate action as soon as possible. We always find the staff pleasant and helpful and feel that they treat residents with kindness and respect. Family members visit almost every day.` The manager has devised a newsletter that informs people and their relatives about important events happening within the home. New staff are provided with copies of the home`s whistle blowing and confidentiality policies on the first day of their employment. The home`s activities co-ordinator has devised an activities programme built around people`s preferences and wishes. Information about activities and events is on display within the home. Staff are polite and courteous, and have developed caring relationships with the people they look after. Over 83% of the staff team have a relevant qualification in caring for older people. Those who do not are undertaking training to obtain a qualification. The home`s furnishings, fittings and decoration are of a good standard. The Lawns is well maintained and has a homely, domestic appearance. The home has attractively landscaped gardens. Vacant bedrooms are refurbished before they are re-occupied. Individual evacuation plans have been devised for each person. All senior staff have received accredited medication training. What has improved since the last inspection? All of the home`s policies and procedures have been reviewed since the last inspection. The service user guide has been made available in large print. The care plan documentation has been revised and improved. The provider and manager have devised a quality assurance system that focuses on how well the home meets the National Minimum Standards. Systems to identify, monitor and meet staffs` training needs have been introduced. Each member of staff has a training file. The manager has devised a `welcome` pack` that provides newly admitted people with information about how the home operates.The home`s pre-admission assessment document has been revised to include a section on people`s ethnic origin to enable, where appropriate, people`s diverse needs to be met. The manager has obtained training materials which enables staff to refresh their training in key areas such as food hygiene and infection control. Two bathrooms have been refurbished and adapted bathing facilities have been installed. A third bathroom is currently being refurbished. The rear garden has been improved to provide people with a very pleasant outdoor area. Extra planting has been provided at the front of the home. What the care home could do better: Ensure that the medication related concerns referred to within this report are addressed. This will help to ensure that people`s health and well-being is promoted and protected. Ensure that safeguarding concerns are handled in line with the home`s protection of vulnerable adults policy and the local authority`s policy and procedures. This will help to ensure that people are protected from potential harm and their well-being promoted. CARE HOMES FOR OLDER PEOPLE The Lawns Residential Care Home 1-2 Kensington Gardens Monkseaton Whitley Bay Tyne & Wear NE25 8AR Lead Inspector Glynis Gaffney Key Unannounced Inspection 19th August 2008 09:30 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 The Lawns Residential Care Home DS0000000308.V370341.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. The Lawns Residential Care Home DS0000000308.V370341.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Lawns Residential Care Home Address 1-2 Kensington Gardens Monkseaton Whitley Bay Tyne & Wear NE25 8AR 0191 2530291 0191 253 7248 thelawns@ascotcare.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) Mr Trevor Nesbit Beverley Olga Allan Care Home 28 Category(ies) of Dementia (15), Old age, not falling within any registration, with number other category (28) of places The Lawns Residential Care Home DS0000000308.V370341.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only - Code PC 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: 28 2. Dementia - Code DE, maximum number of places: 15 The maximum number of service users who can be accommodated is: 28 22nd August 2007 Date of last inspection Brief Description of the Service: The Lawns is situated on Monkseatons high street. The home provides residential care for 28 older people, of whom up to eight may have dementia care needs. Nursing care is not provided. The home is a large older style, detached building and has been adapted to meet the needs of older people. It is a three-storey building and a lift provides access to all floors. There are 26 single bedrooms, one of which has an en-suite facility. There is one double bedroom. On the ground floor there is a kitchen, a large lounge, a smaller lounge, a dining room and a laundry. There are toilets and bathing facilities on each floor. At the front, rear and side of the home, there are pleasant and attractively landscaped gardens. Bus routes, pubs and local shops are all within easy walking distance. The current scale of charges for a place at the Lawns ranges from £373.99 to £414. Additional charges are made for hairdressing, aromatherapy and chiropody. Copies of the Commission’s most recent inspection report, and the home’s statement of purpose and service user guide, had been placed in the main reception area. The Lawns Residential Care Home DS0000000308.V370341.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. How the inspection was carried out: Before the visit: We looked at: • • • • • Information we have received since the last key inspection visit on the 22 August 2007; How the service dealt with any complaints and concerns since the last visit; Any changes to how the home is run; The manager’s view of how well they care for people. We also interviewed three people who use the service and three staff; The views of relatives, other professionals and staff. The Visit: An unannounced visit was made on the 19 August 2008. During the inspection we: • • • • • • Talked with the manager and the home’s operational manager; Looked at information about the people who use the service and how well their needs are met; Looked at other records which must be kept; Checked that staff have the knowledge, skills and training to meet the needs of the people they care for; Looked around the building to make sure it was clean, safe and comfortable; Checked what improvements have been made since the last visit. What the service does well: People using the service said: ‘I am happy here’; ‘I am very satisfied with everything the staff do for me.’ The Lawns Residential Care Home DS0000000308.V370341.R01.S.doc Version 5.2 Page 6 A relative who returned a survey said ‘if family members have any concerns, staff listen and then take appropriate action as soon as possible. We always find the staff pleasant and helpful and feel that they treat residents with kindness and respect. Family members visit almost every day.’ The manager has devised a newsletter that informs people and their relatives about important events happening within the home. New staff are provided with copies of the home’s whistle blowing and confidentiality policies on the first day of their employment. The home’s activities co-ordinator has devised an activities programme built around people’s preferences and wishes. Information about activities and events is on display within the home. Staff are polite and courteous, and have developed caring relationships with the people they look after. Over 83 of the staff team have a relevant qualification in caring for older people. Those who do not are undertaking training to obtain a qualification. The home’s furnishings, fittings and decoration are of a good standard. The Lawns is well maintained and has a homely, domestic appearance. The home has attractively landscaped gardens. Vacant bedrooms are refurbished before they are re-occupied. Individual evacuation plans have been devised for each person. All senior staff have received accredited medication training. What has improved since the last inspection? All of the home’s policies and procedures have been reviewed since the last inspection. The service user guide has been made available in large print. The care plan documentation has been revised and improved. The provider and manager have devised a quality assurance system that focuses on how well the home meets the National Minimum Standards. Systems to identify, monitor and meet staffs’ training needs have been introduced. Each member of staff has a training file. The manager has devised a ‘welcome’ pack’ that provides newly admitted people with information about how the home operates. The Lawns Residential Care Home DS0000000308.V370341.R01.S.doc Version 5.2 Page 7 The home’s pre-admission assessment document has been revised to include a section on people’s ethnic origin to enable, where appropriate, people’s diverse needs to be met. The manager has obtained training materials which enables staff to refresh their training in key areas such as food hygiene and infection control. Two bathrooms have been refurbished and adapted bathing facilities have been installed. A third bathroom is currently being refurbished. The rear garden has been improved to provide people with a very pleasant outdoor area. Extra planting has been provided at the front of the home. 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. The Lawns Residential Care Home DS0000000308.V370341.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 The Lawns Residential Care Home DS0000000308.V370341.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. JUDGEMENT – we looked at outcomes for the following standard(s): 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. There are suitable arrangements for making sure that people’s needs are assessed before they are admitted into the home. This helps to ensure that staff will be able to meet people’s needs on admission. EVIDENCE: Admissions do not take place until a full needs assessment has been carried out. Where the assessment has been undertaken by social services, the home insists on receiving a summary of the assessment. The home also carries out its own pre-admission assessment. Copies of these assessments are in people’s care records. The Lawns Residential Care Home DS0000000308.V370341.R01.S.doc Version 5.2 Page 10 A person using the service said ‘ I read the brochure with my nephew who had also visited to talk to staff and see the room and facilities. I read other brochures, but this was my choice.’ The Lawns Residential Care Home DS0000000308.V370341.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. 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. The arrangements for meeting people’s personal and healthcare needs are generally good. This means that people can feel confident that staff will be clear about how to meet their needs. EVIDENCE: Care plans are person centred and are agreed with the individual and, where appropriate, their representative. Plans are written in plain language, are easy to understand and focus upon people’s assessed needs. A key worker system is in operation that enables staff to work on a one-to-one basis with the people in their care. Staff are encouraged to contribute to people’s care plans as part of their key working responsibilities. The manager proactively monitors staff’s performance and contribution in this area. The Lawns Residential Care Home DS0000000308.V370341.R01.S.doc Version 5.2 Page 12 People’s care records contain a range of information such as: • • • Social history information; Pre-admission assessment information focussing on their needs at the point of admission; Details of people’s individual daily routines and how staff will promote these. Staff view people’s care plans as working documents and are encouraged to be responsible for them. The majority of care plans checked had been regularly reviewed. However, a small number of care plans had not been reviewed on a monthly basis. People’s care plans did not contain reference to equality and diversity issues. A review of each person’s placement is carried out every six months. To ensure that this happens a member of staff has been allocated responsibility for co-ordinating these meetings. People’s care records include a range of risk assessments. For example, each person’s file contained: • • • An individual fire evacuation risk assessment; A risk assessment to prevent the development of pressure sores and skin problems; A risk assessment to prevent people injuring themselves following a fall. More general risk assessments are also carried out. For example, in one person’s care records, the risks posed to their safety had been assessed and control measures put in place to reduce the risks. The manager demonstrated an understanding of the need to carry out robust risk assessments to protect people using the service and the staff who care for them. People using the service said that their health care needs are satisfactorily met. For example, one person said that staff ‘ring the doctor if I need one. Also, the district nurse provides support when required.’ The home ensures that people receive regular chiropody and optical care. People are supported to access local health services such as GP surgeries and community nursing staff, as and when needed. However, details of the outcome of some people’s last dental health check had not been recorded. People’s medication administration records and the records of medication received into the home are well completed. They contain the required entries and have been signed by an appropriate person. As part of the inspection, the process of administering medication was observed. With one exception, people’s medication was administered in a safe and professional manner. However, during the inspection it was noted that the drugs trolley had been left open whilst a senior member of staff administered a person’s medication. The Lawns Residential Care Home DS0000000308.V370341.R01.S.doc Version 5.2 Page 13 In addition, the refrigerator used to store medication requiring cold storage had been left unlocked. Both these matters were dealt with immediately. Staff provide personal care in a kind, considerate and helpful manner. People using the service said that staff respect their privacy and treat them in a dignified manner. The Lawns Residential Care Home DS0000000308.V370341.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 good. This judgement has been made using available evidence including a visit to this service. The arrangements for providing people with opportunities to participate in a range of stimulating social activities and events, and to maintain contact with their families and friends, are good. EVIDENCE: Information about activities and events taking place at The Lawns is displayed on the home’s notice board and in the front entrance. A full time activities organiser is employed to deliver the home’s programme of social activities. The activities programme for the week of the inspection included puzzle time, reminiscence, bingo and arts and craft sessions. A hairdresser visits the home on a weekly basis and an aromatherapist every fortnight. Opportunities to participate in chair-based exercises are provided. The home has a selection of books and access to a mobile library facility is available on request. The home has obtained information about peoples’ The Lawns Residential Care Home DS0000000308.V370341.R01.S.doc Version 5.2 Page 15 previous and current interests and hobbies. social care needs are in place. Care plans addressing peoples’ An annual events list has been devised and includes a fashion show, a garden party and Halloween celebrations. A photographic diary of events held within the home is available in the reception area. During the inspection, people and their families were seen participating in various social activities organised by staff. A family member who returned a survey said ‘various activities are arranged on a regular basis…there are also special outings, parties and events every few weeks which mam is helped to participate in.’ A person using the service said ‘there are a range of games, activities and entertainment, plus TV and music.’ People said that the manager and her staff always made families and friends feel welcome. People are able to choose where they see their visitors. Families and friends can visit the home whenever they like. There is a rotating four-week menu cycle. Details of the menu for the day are displayed on a whiteboard in the main reception area. Choices are offered at all main meal times and a cooked meal is served at the teatime meal. People appeared to enjoy their lunch and staff were on hand to provide support if needed. The food served was of a good quality, nutritious and well presented. Regular drinks and snacks are available throughout the day. People said that they receive enough to eat and drink. The dining area is pleasant and has been nicely decorated. The tables are attractively set. However, the dining room carpet is stained and showing signs of wear and tear. A relative who returned a survey said ‘mam seems to like the meals. Recently she has needed help to eat and she receives this help.’ A person using the service said ‘I have a choice. Food is well prepared and nicely served.’ The Lawns Residential Care Home DS0000000308.V370341.R01.S.doc Version 5.2 Page 16 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. The management of complaints and safeguarding concerns is generally well managed by the home. However, a recent failure to follow the provider’s safeguarding policy and procedures could have placed some of the people living at the home at risk of harm. EVIDENCE: There is a complaints procedure that includes details of how to make a complaint, who the complaint will be handled by and the home’s timescales for completing investigations. People using the service said that they had been made aware of the homes complaints procedure and would be happy to raise matters of concern with any member of staff. One person using the service said ‘I can speak to any of the staff but have someone designated to support me.’ Information about how the home handles complaints has been included in its new ‘welcome’ pack.’ Neither the home nor the Commission has received any complaints since the last inspection. The home’s adult protection policy provides guidance on what action should be taken to protect people from potential harm. The Commission has been informed of three safeguarding concerns since the last inspection of the The Lawns Residential Care Home DS0000000308.V370341.R01.S.doc Version 5.2 Page 17 service. One involved medication being doubled-dispensed and the other an alleged assault between two people living at the home. The medication incident was satisfactorily handled. Appropriate action was taken to safeguard the two people involved in the safeguarding incident. The home worked in cooperation with the local safeguarding team, the person’s family and their care manager. The third concern arose following a physical assault of one service user by another. Although this has now been resolved the local safeguarding team expressed concerns about how the matter, which occurred when the manager was on leave, was handled by the home. The manager has responded positively to the concerns raised and has taken action to prevent a further re-occurrence. The manager is in the process of meeting individually with each member of staff to ensure that they are fully aware of their responsibilities about safeguarding the people in their care. In addition, arrangements have been made for senior staff to complete further safeguarding training. The Lawns Residential Care Home DS0000000308.V370341.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 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People live in a home that has good facilities, is well maintained and clean, and which has been adapted to meet their needs. EVIDENCE: The home provides a physical environment that is appropriate to the needs of the people who live there. The home is well-maintained and provides specialist aids and equipment to meet people’s needs. The Lawns is a pleasant and safe place to live. People have access to a large lounge area, a smaller adjoining lounge and a dining room. There have been improvements made to the rear garden and it provides a pleasant communal space where people can sit with their families. The Lawns Residential Care Home DS0000000308.V370341.R01.S.doc Version 5.2 Page 19 The bathrooms and toilets are fitted with appropriate aids and adaptations to meet the needs of the people who use the service, and are in sufficient numbers and of good quality. The provider plans to carry out improvements to the ground floor toilet adjacent to the reception area. The home is fully accessible to people with physical disabilities with the exception of one of the first floor bathrooms. There is a lift to the first and second floors. The home has an infection control policy and the Department of Health’s infection control checklist has been completed. Anti-bacterial gel hand wash dispensers have been fitted in all toilets and bathrooms. All the staff have completed training in infection control. The bedroom accommodation is generally clean, tidy, nicely decorated and attractively furnished. Each room has been personalised in line with the occupant’s preferences. Some of the bedrooms visited contained furniture that people had brought in with them. There are call points in each bedroom and in the communal areas. Radiators are guarded and have thermostatic controls. There is no unguarded pipe work. Suitable locks have been fitted to bedroom doors enabling people to protect their privacy and staff to gain access in an emergency. The Lawns Residential Care Home DS0000000308.V370341.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. People can feel confident that their needs will be met by professionally qualified staff that are available in sufficient numbers. EVIDENCE: There are rotas that show which staff are on duty and at what times. The staff team consists of the manager and 16 care staff. The rotas show that for up to 27 service users there is always a minimum of three staff on duty between 8 am and 10 pm. In addition, there are extra staff on duty during busier times of the day. Two waking staff cover the night time shift. A cook is on duty between 8am and 5pm each day. Sufficient domestic staff are on duty each day. Time was spent observing staff during the inspection. Although staff were very busy, they remained attentive to people’s needs and ensured that these were met. A person using the service said that they were ‘very satisfied and could not ask for better help.’ The Lawns Residential Care Home DS0000000308.V370341.R01.S.doc Version 5.2 Page 21 However, a member of staff who returned a survey said that the home needed to ‘ensure adequate staffing levels are maintained to meet the needs of residents and ensure staff are not over worked.’ Over 80 of the staff team have obtained a National Vocational Qualification at Levels 2 and 3 and a further two staff are in the process of doing so. A range of pre-employment checks is carried out before staff can commence work at the service. For example: • • • Staff are required to complete an application form, attend a selection interview, provide statements about their physical and mental health and whether they have any convictions; Each person’s identity is checked and verified; Written references and Criminal Records Bureau Disclosure checks are obtained. Staff receive an induction on commencing work at the home. Records are kept of the in-house induction provided to staff and these have been placed in their individual training records. However, evidence confirming that new staff have satisfactorily completed the ‘Skills for Care’ induction training was not always in place. There are opportunities for staff to complete and update their training in key areas. For example, in the sample of staff files examined, there was documentary evidence that all had completed training in first aid, fire safety, infection control, food hygiene, fire safety and health and safety. Of the three staff that returned surveys: • • • • • • • All said the provider had carried out employment checks such as obtaining a Criminal Records Bureau disclosure before they started work at the home; All said that their induction covered everything that they needed to know to do the job; All said that their training was relevant to their role, helped them to understand the needs of people using the service and kept them up to date with new ways of working; All said that their manager met with them ‘regularly’; One said that there are ‘always’ enough staff on duty to meet people’s needs. One person said that there are ‘usually’ enough staff and one other said that this was only ‘sometimes’ the case; All said that they felt they had the right support, experience, and knowledge to meet the different needs of people using the service; All said they are ‘always’ given up to date information about people’s needs. The Lawns Residential Care Home DS0000000308.V370341.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, 36 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is generally well managed and run in the best interests of the people using the service. This means that people can feel confident that their health, welfare and safety will be promoted and protected. EVIDENCE: The manager has the required qualifications and experience and is competent to run the home. The manager has a clear understanding of what constitutes good care and works continuously to improve services. Ms Allan ensures that her staff provide people with a good quality of life with a strong focus on dignity and respect. She leads and supports a strong staff team who have The Lawns Residential Care Home DS0000000308.V370341.R01.S.doc Version 5.2 Page 23 been recruited and trained to a high standard. Ms Allan ensures that her statutory training is kept up to date and attends training that is specific to the needs of the people using the service. She demonstrates good leadership skills and has a clear vision of what improvements she wants to make at the home. Arrangements are in place to monitor the quality of the service. For example: • The provider and manager have devised a quality assurance system that focuses on how well the home meets the National Minimum Standards. Since her recent appointment as the home’s manager, Ms Allan is part way through her first complete audit of the service; People using the service and their families, staff and professionals who have contact with the home, have been issued with surveys that ask for their opinions about how well The Lawns operates; The provider and manager have devised a two year annual development plan that sets out how further improvements will be made to the service; The provider carries out unannounced monthly monitoring visits to ensure that the home is operating to the required standards; All of the home’s policies and procedures have been reviewed during the last 12 months. • • • • A good quality Annual Quality Assurance Assessment was submitted to the Commission before the inspection took place. This contained robust evidence to support the self-assessment judgements that had been reached. Arrangements have been put in place to ensure that staff receive regular supervision. However, some records show that the supervision process is very limited with ‘nothing to discuss’ being recorded on some records. People’s health and safety is promoted. For example: • Following a recent visit carried out by the local environmental health department, improvements in hygiene were noted and the home was commended for the steps it had taken towards implementing the Safer Food Better Business food safety management system. Prompt action had been taken to resolve issues identified during the visit; The home’s electrical equipment has been checked within the last 12 months and there is a current electrical safety certificate; Staff receive certificated fire training; No health and safety concerns were identified during the inspection. Staff receive health and safety training; The home has a current waste disposal contract. • • • • The Lawns Residential Care Home DS0000000308.V370341.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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 2 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 2 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X X 2 X 3 The Lawns Residential Care Home DS0000000308.V370341.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. 1. Standard OP9 Regulation 13(2) Requirement Ensure that: • • The drugs trolley is kept locked when not in use; The refrigerator used to store medicines requiring cold storage is kept secure at all times. Timescale for action 01/09/08 This will help to ensure that people’s health and well-being is promoted and protected. 2. OP18 12(1) & 13(6) Ensure that safeguarding 01/09/08 concerns are handled in line with the home’s protection of vulnerable adults policy and the local authority’s policy and procedures. This will help to ensure that people are protected from potential harm and their wellbeing promoted. The Lawns Residential Care Home DS0000000308.V370341.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. 2. Refer to Standard OP8 OP30 Good Practice Recommendations Ensure that a record is kept of when each person last received a dental health check. Where relevant, ensure that staff’s personnel files contain documentary evidence that they have completed the ‘Skills for Care’ induction training. Ensure that staff supervision sessions cover the following: • • • • • • • The needs of people for whom they hold key working responsibilities; Sharing information relevant to their work; Addressing any current individual or teamwork issues; Identifying and reviewing training and developmental needs; Discussion of any issues which are affecting work performance; The management of any issues that are causing stress; Any issues relating to how they carry out their job. 3. OP36 The Lawns Residential Care Home DS0000000308.V370341.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB 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. 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