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Inspection on 19/11/09 for Skirbeck Court

Also see our care home review for Skirbeck Court for more information

This is the latest available inspection report for this service, carried out on 19th November 2009.

CQC found this care home to be providing an Excellent service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Skirbeck Court is next to the schools in the area and people living there are still part of the community, with constant involvement from visitors. Two visitors commented that a reason for choosing the home was that it had a very good reputation in the area. People are cared for in a clean and comfortable environment and the home is decorated to a good standard. All people spoken with made positive comments about the care they received; one said it would never be home but it was the next best thing and another said that the atmosphere was very friendly. Visitors spoken with said the standard of care was high. The staff group is well trained and knowledgeable about the people living at the home and how they prefer to be cared for. The manager and senior staff work well as a team and there is a stable staff group, enabling good knowledge of the needs of people. People are encouraged to make choices about their daily lifestyles and individual likes and dislikes are catered for. Surveys returned to us were very positive and comments included praise for the staff and the manager.

What has improved since the last inspection?

Improvements have included new care plan paperwork and care plan training for staff. Service users now lead on what they want to do and activities now being a prominent part of the day. There is a new statement of purpose and residents` guide. Improvements to the building have included the modernisation of several bedrooms, taking out old built in storage and modern free standing furniture now in place to lend more individuality to rooms. A conservatory has been built next to the dining room. There is dementia training for all staff, including non care staff and more in house training.There is a human resources net which allows monitoring of staff training and staff absence records, giving managers more support.

What the care home could do better:

The high standard of care at Skirbeck Court has continued and there were no significant improvements to be made on the day of the visit.

Key inspection report Care homes for older people Name: Address: Skirbeck Court 55a Spilsby Road Boston Lincs PE21 9NU     The quality rating for this care home is:   three star excellent 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: Julie Western     Date: 1 9 1 1 2 0 0 9 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 22 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) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 22 Information about the care home Name of care home: Address: Skirbeck Court 55a Spilsby Road Boston Lincs PE21 9NU 01205361444 01205358005 manager.skirbeck@osjctlincs.co.uk www.osjct.co.uk The Orders Of St John Care Trust Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Susan Wallace Type of registration: Number of places registered: care home 39 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The home is registered to provide personal care to service users whose primary needs fall within the following categories: Old age, not falling within any other category (OP) 39 The maximum number of service users to be accommodated is 39 Date of last inspection Brief description of the care home Skirbeck Court is a purpose-built home, owned and formerly managed by Lincolnshire County Council and now managed by the Orders of St. John Care Trust. It is registered to give care and accommodation for up to 41 residents over 65 years of age, one of these with a learning disability, in 31 single and 4 double rooms, all at ground level. On the day of the visit 35 residents were being accommodated. The home is set in its own spacious grounds in a quiet residential area of Boston and is adjacent to local schools, overlooking the school grounds. Shops and local facilities are a short walk Care Homes for Older People Page 4 of 22 Over 65 39 0 Brief description of the care home away and transport can be arranged for those unable to walk into the town centre. The homes stated aims are to provide the highest quality of residential care. Fees range from £459 to £571 and information about these and the other facilities offered are available in the entrance hall or from the manager. Care Homes for Older People Page 5 of 22 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: three star excellent 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: The quality rating for this service is three star. This means the people who use this service experience excellent quality outcomes. This was an unannounced visit and it formed part of a key inspection, focusing on key standards, which have the potential to affect the health, safety and welfare of people who use the service. Throughout this report the terms we and us refer to The Care Quality Commission (CQC). The visit lasted approximately four hours and we took into account previous information held by us including the previous inspection report, their service history and records of any incidents that we had been notified of since the last inspection. Before we made our visit the provider had returned the Annual Quality Assurance Assessment (AQAA). This gave us information about their own assessment of how well they are meeting standards and their plans to improve aspects of the service. We sent Care Homes for Older People Page 6 of 22 out surveys to people before we visited the service. The main method of collecting information during this visit is called case tracking, which includes following the care of a sample of four people through their records and assessing their care. We spoke with four people who use the service and saw rooms of those people who said we could. We spoke with three visitors and to four staff members. The manager was present throughout the visit and the general outcomes of the visit were discussed with her and another manager from the Trust. Care Homes for Older People Page 7 of 22 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 22 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 22 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use this service have extensive information about the home in order to make an informed decision about whether the service is right for them. Evidence: We saw the statement of purpose which was very comprehensive and contained terms and conditions and contracts. The service user guide we saw contained useful information for people. In the information folder there is the Trusts quarterly magazine, the Lincolnshire Trust quarterly newsletter, a quarterly in house newsletter, list of fees charged and sample activities programmes. All this information is kept in the entrance area. People are also given copies of the residents handbook in each room. The manager said that she or a senior member of staff always visited prospective residents at home or in a care setting such as a hospital to undertake a thorough assessment of all their care needs. Records we saw confirmed this. We saw written admission records that were clear and gave staff all the information Care Homes for Older People Page 10 of 22 Evidence: they needed to meet the needs of people. A resident we spoke with described how she had visited twice for a morning and then for the day before she was sure she wanted to move in permanently. A relative told us that this home had been chosen because it was the best of the ones in the area and had been recommended. A staff member described the admission process and the importance of making new residents and their families welcomed. Care Homes for Older People Page 11 of 22 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. Care plans are in enough detail to ensure that the care needs of people can be met. Evidence: Care plans we saw contained information about the health and personal care needs of people. They were reviewed regularly and signed where possible by people or their relatives or advocates. We saw a medication policy that was clear and comprehensive. The pharmacist visited regularly, the last visit being on and no issues were identified. People received regular visits from district nurses, Macmillan nurses, CPNs and other agencies involved with their care. We saw staff carrying out their duties with kindness and sensitivity towards people, especially when attending to their personal needs. A visiting GP said the home was excellent and he was very happy with the standard of care. Care Homes for Older People Page 12 of 22 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Social activities are regular and are tailored to suit the needs of individuals. People have a choice of meals from a balanced and varied menu. Evidence: Care plans we saw showed that individuals are assessed for their needs and wishes regarding lifestyle and daily activities. We found that the home has an activities coordinator, who works 25 hours weekly and provides a variety of activities for residents including entertainers, exercises, indoor games such as board and card games and trips to local pubs and shops. On the day of our visit people were discussing the Christmas pantomime which comes into the home and there was painting in the activities room. In the afternoon one resident was being taken shopping by staff for a new television set in Boston. Activities this summer included a boat trip, theatre trips and the annual hog roast, attended by the mayoress of Boston. A volunteer was asking all residents for their wishes for the Wish List Fund, funded and judged by the Trust, the winners to have their wishes met. Recent winning wishes included such as flying in a hot air balloon and tickets to see the TV show Celebrity Come Dancing. People we spoke with all said they had a choice of whether or not to take part. Some told us they preferred to sit in a quiet lounge instead. Clergy visit the home and offer Care Homes for Older People Page 13 of 22 Evidence: services to those who wish to attend. The activities programme is depicted in pictorial form on the notice board, to ensure that all residents are kept informed. People we spoke with all said they enjoyed the meals served. One said the mid-day meal was marvellous and another that it was lovely having your meals cooked for you and with such variety.The menu for the day was displayed in the dining room and offered alternative choices of meals. The cook said that if people did not like any of these choices, she would make them an alternative within reason. The cook has the City and Guilds qualification in catering. She was knowledgeable about the nutritional needs of service users and described cooking for diabetics and people with gluten-free diets. Care Homes for Older People Page 14 of 22 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. The procedures for addressing complaints and for protection from abuse are clear. People and their families are confident that their comments and concerns will be listened to. Evidence: People spoken with said they did not wish to complain but knew how to make a complaint. The home had an up to date copy of the Local Authority adult protection procedures; staff members said they had read it. The training programme showed that there was a rolling training course for staff on safeguarding issues. Staff members spoken with knew what to do in the event of a serious concern and confirmed they received regular training. The manager said that residents and their families were regularly asked for their views regarding the running of the home. A resident said I am sure that if I had a complaint the manager would see to it and visitors spoken with said that they were given information on how to make complaints. There was a compliments and complaints record, which contained no complaints and many compliments. Since the last inspection there had been no complaints. Care Homes for Older People Page 15 of 22 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a comfortable and pleasant environment with both private and communal space that is generally suitable for their needs. Evidence: Overall, the standard of decoration internal was high and people said they were comfortable in their surroundings. The gardens were well maintained and offered pleasant places for people to sit out in good weather. Staff described how any maintenance issues were addressed quickly by the maintenance personnel. Recent improvements included the modernisation of several bedrooms, taking out old built in storage and modern free standing furniture now in place to lend more individuality to rooms. A new conservatory has been built off the dining room, adding extra space and light for people to sit in. There were safety notices around the building to prevent the spread of infection and COSHH regulations were observed throughout. Although the building has different levels and steps throughout there is a lift and a stair lift to enable people to access the whole building. The most recent visit from the Environmental Health Officer found no issues of concern and the service had been awarded a good standard. The building smelled clean and fresh throughout. Care Homes for Older People Page 16 of 22 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff numbers are in sufficient quantity and staff members are suitably trained, qualified and competent to meet the needs of people. Evidence: The staff rota we saw showed that there was a senior carer plus four carers on duty for 35 people. In addition there was a manager from Monday to Friday, three housekeepers, an admin. assistant Monday to Friday and two gardeners. We saw training records for staff and these showed that all except two members of staff have achieved the National Vocational Qualification [a nationally recognised qualification] at Level 2 and all five senior staff members had achieved Level 3. We spoke with staff members who described how they had an interview, gave three references and underwent legal safeguarding checks and had induction before starting work. Staff records we saw confirmed this. Training records we saw showed that the training required by law has been undertaken, with moving and handling and infection control being the next training. The organisation has a training manager and a training co-ordinator and a comprehensive training plan with individual training files for all staff. We saw that staff members all receive regular supervision and they confirmed this. There were also minutes of staff meetings, which staff members also confirmed. Care Homes for Older People Page 17 of 22 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed and the health, safety and welfare of people are promoted. The management system ensures that people are protected and included in decisions affecting them. Evidence: The manager has been in post since March 2009 and has a great deal of experience in the care profession, having worked for the Orders of St. John Care Trust in a managerial position for many years. She has two managerial qualifications. People we spoke with all made positive comments about the way the manager ran the home, finding her approachable and supportive. The manager and and senior carers work very much as a team and staff members spoken with said they were very approachable and accessible. There is a clearly written quality assurance procedure, with separate questionnaires given to people, their relatives/visitors and staff. The results are collated and subsequently acted upon. Finances are audited regularly from the headquarters of the organisation. Care Homes for Older People Page 18 of 22 Evidence: Health and safety policies are well documented and demonstrate a clear commitment to ensuring the wellbeing of people. Care Homes for Older People Page 19 of 22 Are there any outstanding requirements from the last inspection? Yes £ No R 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 Care Homes for Older People Page 20 of 22 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 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 21 of 22 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. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 22 of 22 - 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!