Care Home: The Lilacs

Similar services:

• Claremont House
• Oak Ridge
• Sun Court Nursing Home
• Ashville House
• Bilney Hall
• Hill Barn
• Mabbs Hall Nursing Home
• Henrietta House

What the care home does well The managers and staff have been at the service for a number of years and provide consistency of care. What has improved since the last inspection? Some indoor and outdoor redecoration and renewals have taken place. All residents have signed and current contracts in place. What the care home could do better: Overall the manager needs to make sure that all paperwork is consistently filled out and kept within the premises at all times. The information provided with residents files needs to include their views, opinions, wishes and how they want to be supported. Like wise Quality Assurance needs to be carried out for this year to involve all interested parties in how the home can develop in the future. A range of activities needs to be further developed especially for those individuals who choose or have to stay in their rooms or have dementia needs. Additionally staff training, minutes of meetings and supervisions need to be minuted, kept on site and be consistently carried out. Key inspection report Care homes for older people Name: Address: The Lilacs 121 Chalkwell Avenue Westcliff On Sea Essex SS0 8NL     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home 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 full review a ‘key’ inspection. Lead inspector: Sarah Axam     Date: 1 0 0 5 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 26 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: The Lilacs 121 Chalkwell Avenue Westcliff On Sea Essex SS0 8NL 01702712457 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): bwatersbassa@aol.com Mr Barry Norton Waters,Ms Fazlee Painchun Name of registered manager (if applicable) Ms Fazlee Painchun Type of registration: Number of places registered: care home 17 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home The Lilacs provides care and accommodation for up to seventeen older people who may also have dementia. The home is situated in a residential area close to the sea front and a short distance from Chalkwell railway station. The home is a large residential style home on three levels, all areas of the home are accessible by a shaft lift. There is limited parking at the front of the home. There is a good-sized garden at the rear of the home. The registered manager and registered person are closely involved in the daily management of the home. Both have experience of residential care. 1 8 0 8 2 0 0 9 0 0 Over 65 17 17 Care Homes for Older People Page 4 of 26 Brief description of the care home Care Homes for Older People Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: Due to a safe guarding issue raised in 2009 and complaint received, a random Inspection was carried out. As a result of this random inspection, the Key planned inspection was also brought forward. As a result of this we have not have resident, relative or staff surveys returned or a recent Annual Quality Assurance Assessment. (This is a document, which providers are required by regulation to provide us with. The document describes how the service is managed, provides evidence about what the service does well and where improvements can be made.) We did however, speak to two relatives, three residents and two professionals who came into regular contact with the home. All information obtained was triangulated and reviewed against the commissions key Care Homes for Older People Page 6 of 26 lines for regulatory activity. This helps us to use the information to make judgements about the outcomes for the people who use this service in a consistent and fair way. Care Homes for Older People Page 7 of 26 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 8 of 26 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A clear and comprehensive assessment process assures people that their needs could be met prior to moving in their home. Evidence: The manager told us in the Annual Quality Assurance Assessment that there is a statement of purpose and residents guide, which provides information about the home to help people decide if they would be happy there. The manager told us that a copy of the social services or local authority needs assessment is also obtained and that people are invited to visit the home before they move in and once they do a contract would be agreed. These were seen in all residents files. When we visited the home we looked at the way in which eight peoples needs had been assessed. We saw that the assessment covered details of the persons physical and health needs as well as the support the individual required to maintain personal and oral hygiene. In all documentation each persons an outline of support required is recorded to help determine that the home would be able to meet their needs. We saw that statement Care Homes for Older People Page 10 of 26 Evidence: of purpose and residents guide is in place and is up-to-date (which includes a sample of a contract, however these guides are not always made available in a friendly format of peoples choice). These documents gave information about the staff structure, their qualifications, the complaint process,support, accommodation, local area, health and specialist services and activities. Two relatives told us, they were asked if their relative wanted to move into the home and that they had enough information given to them before they moved into the service to make an informed choice. Care Homes for Older People Page 11 of 26 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents assessed needs are followed through in good care plans that give staff the necessary information to provide good care outcomes. Evidence: The manager told us in the Annual Quality Assurance Assessment that the health and personal care needs of residents are met and that staff are trained to administer medicines safely. When we visited the home we looked at how the personal and health care needs of the residents were assessed and how residents were supported. The health care plans of all 8 residents showed us that risk assessments were current and reflected the persons support needs.However information regarding peoples views and how they wanted to be supported by staff were lacking in all files looked through. Health care issues assessed included, physical, mental, dietary, personal care, independence, emotional and wishes of individuals if their health deteriorated for any reason. Through all documentation held there were minutes of meetings, letters and conversation recorded with a number of other specialist services, such as Community psychiatric nurses, consultants, social workers and generally a number of NHS Care Homes for Older People Page 12 of 26 Evidence: community facilities. We saw that all residents were supported in attending routine appointments for health care monitoring and that had access to medical, dental and optician services when needed. It was recorded that residents enjoyed good health and residents looked well cared for. When we visited the home we saw that the administration records were maintained in accordance with agreed procedures and the royal pharmaceutical legislation. At the time of the inspection none of the residents living in the home were capable of safely keeping and administering their medicines, therefore a monitored medication system is in place for each resident. We looked at medicine administration records and these were completed accurately to show that residents received the medicines, which were prescribed for them. There have been no incidents reported around medication issues or practice would suggest that medication is kept to a strict protocol and is maintained consistently to a good standard. Care Homes for Older People Page 13 of 26 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People cannot always be sure that they will be offered appropriate activities and social pursuits. Evidence: On inspection of the activities, we found that some residents participated in activities such as word games, listening to music and watching television and others do not receive meaningful occupation/stimulation. The manager was advised that consideration must also be afforded to those people who have complex needs, poor cognitive development and poor communication. Ideas were discussed in relation to the possibility of exploring activities specifically for those people with dementia creation of memory boxes for individual residents (involving the resident/family members), creating life story books, arts and crafts and accessing the local community, so as to ensure that residents do not become bored and/or frustrated. Comments relating to activities from residents was mixed and included, theres nothing to do, activities are not everyday,when they happen theyre alright and I prefer to do my own thing. During the inspection residents were observed to talk with staff, to watch television, to sit and talk to each other and to read their magazine/book. Care Homes for Older People Page 14 of 26 Evidence: Visiting at the home is open and on the day of inspection visitors were noted to come and go. One visitor advised that staff, are really friendly and welcoming. The lunchtime meal on the day of inspection was observed. Tables were attractively laid with tablecloths, place mats, cups and cutlery. Condiments for residents use were not readily available, however when requested these were provided. Consideration should be given to ensuring that those residents who are able to maximise their independence are actively encouraged so that they maintain this. Those residents who require assistance from staff with their meal, were observed to be supported appropriately. The manager was advised that where individual residents require a soft/pureed diet, this should not be mixed together but portioned separately so that it looks attractive and appetising. The lunchtime meal looked plentiful and appetising for most residents and all residents spoken with made favourable comments about the food provided. One resident was overheard to state, it looks great and its lovely. Additional consideration should be given to ensuring that the menu is written in large print and/or pictorial and that residents are reminded of the choice of meal available. Out of three residents spoken with, only one resident was able to advise as to the choice of lunchtime meal. Care Homes for Older People Page 15 of 26 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are systems in place to ensure that peoples views are listened to acted upon and support residents to be protected from abuse. Evidence: We were told in the Annual Quality Assurance Assessment that any complaints or safeguarding alerts would be dealt with openly and thoroughly. The manager told us that residents relatives are provided with information on how to complain and how their concerns would be dealt with. The manager told us that there had been no new formal complaints made about the service within the past twelve months, but there was still an on going issue in progress. They also told us that staff received information about dealing with complaints and whistle blowing when they commence work at the home. When we visited the home we looked at the policy and procedure in place for recording and dealing with complaints. The manager has a good complaints procedure in place. However not all complaints and safe guarding correspondence were filed consistently, making it sometimes hard to track the progress of issues clearly. All staff told us that they felt, they knew what course of action to take if there was a concern or complaint that was made. Three residents told us that they felt the manager and staff listened to them and felt that if they raised a concern then it had been dealt with satisfactory. Care Homes for Older People Page 16 of 26 Evidence: There is a safeguarding policy and procedure in place and the manager told us that all staff were given this information when they commenced work at the home. All members of staff told us that they had received safeguarding training and they demonstrated that they understood their responsibilities if they witnessed or suspected any ill treatment of residents. There was a whistle blowing policy which staff had access to and when speaking with staff they told us they were aware of this. This helps assure staff that they will be protected from harassment should they need to raise concerns about the home or other staff. We saw that all staff had received safeguarding training to keep them up to date with local policies and procedures and help ensure that all concerns would be treated properly. A past safeguarding issue within the home showed us that the provider/manager worked well with the safe guarding unit. Care Homes for Older People Page 17 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a safe environment for all residents. Evidence: When we did a tour of the premises we found that residents bedrooms were individually personalised, the home was comfortable and appropriate for the residents needs. During a tour of the building we saw that a number of the fixtures and fittings needed replacing and some of the decor requires upgrading.(some that were raised by us at the last Key inspection) When speaking with the manager it seems that essential maintenance is only done when a problem has already arisen rather than there being an on going programme arranged. A strong odour of stale urine was noted within 1 resident bedroom. The manager stated that measures had been undertaken to try and resolve the issue, but this was still proving difficult. The homes tidiness and hygiene was found by us to be lacking in places in general and we saw and were told that the domestic cleaning arrangements were presently the care staff duties. This is until a domestic is employed which the home are in the process of arranging. However the home does not compromise the health and safety of residents. Care Homes for Older People Page 18 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are offered positive relationships by well-supported and caring staff and are protected by staff recruitment, induction and training. Evidence: The manager told us in the Annual Quality Assurance Assessment that the home did not rely on the use of temporary agency staff. That the recruitment policy is fully adhered to at all times including obtaining relevant references,CRB and identity check prior to commencing duties. Appropriate training course are arranged as soon as practicable after commencing duties at the house. The manager told us that if new staff commenced work at the home, then they undertook a period of in house induction to help familiarise themselves with policies, procedures and the needs of residents. The manager told us that they were implementing the Skill for Care Common Induction Standards induction. This is a set of nationally recognised standards and helps to ensure consistency in the delivery of care and support to people who receive social care. Staff told us that they felt, they had up-to-date information provided to them regarding the people they care for, had a good thorough induction and covered everything they needed to know before starting the job and that they were given training relevant to their role and that they were updated regularly. Care Homes for Older People Page 19 of 26 Evidence: We saw that staff had received training in safe moving and handling, safeguarding, administration of medicines, communication, infection control and health and safety. The manager told us that she has plans for all staff to receive specific training in respect of caring for people who have dementia. She told us that over 50 of the staff are being put forward onto the NVQ2 training. The manager told us that at staff meetings individuals residents, team practices, training and general information sharing were discussed. This shows us that the team are discussing the relevant issues and reducing of risks by highlighting what needs to be prioritised. This keeps the residents safe and maintains their health and welfare. We were told that all staff had yearly appraisals in place, supervisions were once a month. However not all were minuted or kept consistently within the premises. Overall records in general were sometimes incomplete of all information expected. When we visited the home we saw by observation and by looking at the staff rota that there were enough staff to cater for all residents needs.Residents said that staff listen to them and act on what they say. When we visited the home we saw by observation that, staff interact well with residents, were motivated, competent and listened to people. Care Homes for Older People Page 20 of 26 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management strategies of the home were stable which ensures the health, safety and welfare of all residents. Evidence: The manager has been in post for many years and holds a wealth of experience and knowledge of the current resident group. The manager told us in the Annual Quality Assurance Assessment that there was a system in place for monitoring the quality of the service, including obtaining the views of residents. The manager told us that this is due to be carried out at the end of this year. Three residents told us that the manager has worked well with them, listens and that their opinions matter to her. Similarly four of the staff on duty felt that she supports them well and have confidence that in her to manage the home effectively. We looked at peoples financial checks and saw that all accounts were updated everyday. We looked at all residents financial sheets, records and receipts. We saw all Care Homes for Older People Page 21 of 26 Evidence: monies well accounted for with receipts for each person kept. We looked at how the home was managed and maintained. There were records and certificates to show that the home was maintained and fit for purpose. Checks were carried out to ensure that systems and equipment such as heating and hot water systems, fire detection installations and electrical equipment were maintained in good safe working order, the service has insurance cover for the registered managers legal liabilities to employees, people using the service and third parties. Care Homes for Older People Page 22 of 26 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, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 1 19 23 The environment needs to be 31/03/2010 kept clean and reasonably decorated. This is to ensure that people live in a clean, safe home. Care Homes for Older People Page 23 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 8 15 Each person must have a 30/09/2010 say in their care plan, which describes their needs, the care and support they are to receive and that they agree to this. Care plans must be reviewed so that they accurately reflect the needs of residents. This is so that residents have accurate and current information about the support they will receive from staff and that all residents have a clear plan in respect of their support and provided in a format of their choice. 2 12 16 Consult residents about their 30/09/2010 social interests and make arrangement for them to engage with local, social and community activities. That residents are involved in the local community more Care Homes for Older People Page 24 of 26 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action so than at present. And that all residents receive appropriate activities, other than just the group activities currently on offer. 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 1 1 That all potential residents have a format of the service user guide in a format of their choice if requested (audio, DVD, braille or pictorial) to enable them to have a better choice and information regarding the home. That all complaints and safeguarding correspondence is kept in one place and kept in a format which is easily cross referenced, corresponds and that all pieces of information is held on the premises. That Quality Assurance is carried out with all residents, families, professionals in regular contact with the home, advocates, friends of the residents and staff for the year 2010. That all staff supervision is recorded minuted and kept on the premises at all times. 2 16 3 33 4 36 Care Homes for Older People Page 25 of 26 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. Care Homes for Older People Page 26 of 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!