Inspection on 23/05/06 for Ermine House

This inspection was carried out on 23rd May 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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.

Other inspections for this house

Ermine House 20/10/05

Ermine House 05/07/05

Ermine House 21/03/05

Ermine House 07/07/04

Ermine House 09/02/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Ermine House Laughton Way Lincoln Lincs LN2 2EX Lead Inspector Mr Doug Tunmore Key Unannounced Inspection 23rd May 2006 09:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Ermine House DS0000002355.V294012.R01.S.doc Version 5.1 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. Ermine House DS0000002355.V294012.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Ermine House Address Laughton Way Lincoln Lincs LN2 2EX 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) 01522 529093 The Orders Of St John Care Trust Mrs Tracy Turfrey Care Home 43 Category(ies) of Old age, not falling within any other category registration, with number (43) of places Ermine House DS0000002355.V294012.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection Brief Description of the Service: Ermine House is situated on the Ermine Estate in the City of Lincoln and is approximately one and a half miles from the City Centre. The home is close to local shops, library and church and is on a direct bus route into Lincoln. The home is registered for 43 residents over the age of 65. Accommodation is provided on two floors, which is accessible via a shaft lift or stairs. Lounges are situated on both floors with the dining room situated on the ground floor. The homes statement of purpose states that the home aims to provide its residents with secure, relaxed and a homely environment in which their care, wellbeing and comfort are of prime importance. The home is a group of homes run by the Order of St John Trust, (OSJT) which is a registered charitable organisation. Limited car parking is to the front of the building for the use of visitors and care staff. The current scale of charges at this home starts at £335.00 to £449.00 per week. Ermine House DS0000002355.V294012.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection was unannounced and took into account any previous information held by CSCI including the homes previous inspection reports, their service history, the homes pre-inspection questionnaire and residents questionnaires sent to the home by the Commission prior to this inspection. The site inspection consisted of case tracking a sample of two resident’s records and assessing their care. The inspector spoke with the residents who was being case tracked and joined two other residents for lunch. The inspector also spent time with three relatives with one member of staff and the registered manager. A partial tour of the home and a review of a sample of the records was also included. What the service does well: What has improved since the last inspection? The home has addressed those requirements made at the last inspection. The home has amended the complaints format to include a space for complainants to sign regarding the agreed outcome. The home has also ensured that interview records of all new care staff are kept and placed in their personnel files. Since the last inspection general improvements and maintenance of the home including a new disabled toilet has been installed, both downstairs corridors decorated with new carpets, three bedrooms decorated and four having new carpets fitted. Other improvements have also been made to the home. Ermine House DS0000002355.V294012.R01.S.doc Version 5.1 Page 6 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. Ermine House DS0000002355.V294012.R01.S.doc Version 5.1 Page 7 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 Ermine House DS0000002355.V294012.R01.S.doc Version 5.1 Page 8 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3 & 6 The quality outcome in this area is good. This judgement has been made using available evidence including a visit to this service. The home has not updated the service users guide, which enables prospective residents to make an informed choice about coming to live at this home. Residents are admitted into the home only after a full needs assessment has been carried out either by the home and or health care or social care agencies. Written confirmation that the home can meet a prospective residents needs is also undertaken prior to admission. This home does not provide intermediate care. EVIDENCE: The home has a “Resident’s Handbook” which does not include all the information required to meet those regulations and standards pertaining to the Service Users guide. There must be a document provided that meets all service user guide requirements including a brief description of the accommodation and services provided, the age of prospective service users that the home can admit, (65) or over, service users fees charges, service user Ermine House DS0000002355.V294012.R01.S.doc Version 5.1 Page 9 views and key contract terms including method of payment of fees. The Commission has been informed that this document is now being reviewed. A review of all information available prior to this inspection and evidence seen at this inspection in residents files and care plans showed that the home does not admit residents without a care assessment being undertaken. Prospective residents are also written to by the home confirming that they can meet the residents care needs or not. One resident confirmed that he had respite care at this home and decided to stay as ‘the home is excellent’. A visitor confirmed that his relative had assessments from various professionals before admission and ‘the staff were very welcoming’. Questionnaires returned to The Commission show that fourteen of the seventeen received from residents confirmed that they had information about the home prior to admission. One resident was unsure and another felt that she did not get sufficient information but stated that ‘but I feel that I made the right decision’. Thirteen residents commented that they received a contract. The rest were unsure about having a contract. The homes administrator evidenced in the residents finance files that those residents who were being case tracked had current contracts. Ermine House DS0000002355.V294012.R01.S.doc Version 5.1 Page 10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 & 10 The quality outcome in this area is good. This judgement has been made using available evidence including a visit to this service. Residents or their representatives are involved in the care plans. The home administers medication appropriately to all residents. There is good care planning in this home, which helps ensure that the general health and welfare of residents is addressed. EVIDENCE: A review of all information available prior to this inspection and a previous key inspection carried out in July 2005 at this home has evidenced that either residents or their relatives are involved in the care plans. All residents have detailed care plans, which describe their health and welfare needs. Care plans outlined risk assessments, nutritional and dependency assessments. Care plans also evidenced that they have been reviewed on a monthly basis or sooner depending on changing needs. The reviews and care plans of residents had been signed and dated by the carer and the resident. Due to the complex needs of one resident who was seen by the inspector it was felt that a review Ermine House DS0000002355.V294012.R01.S.doc Version 5.1 Page 11 of his wheelchair requirements should explored. The manager said that this would be undertaken. A contract monitoring visit by Lincolnshire County Council found that ‘service users care plans were examined and found to be well maintained and accurate’. Individual care plans evidenced that accidents are recorded in the home’s accident book and in the resident daily notes. The home also uses body maps for the mapping of any cuts or abrasions to residents. The homes notifiable incidents record was seen and corresponded with the Commissions service history of the home relating to accidents to residents. Files seen confirmed that health care professionals visit the home when required by the residents. A carer was aware of maintaining the privacy and dignity of residents and treating them with respect. Residents questionnaires showed that fifteen felt that they received the support that they need and two said that they usually receive the support that they require. The questionnaires also showed that eight residents felt that staff are always available when they need them and nine residents felt that staff are usually available when they need them. A carer confirmed that she had undertaken National Vocational Training at level 2 in which issues relating to the personal care of residents was addressed. The pharmacist inspected the home on the 22/05/06 and recorded that storage and administration records of medication is carried out appropriately. Due to this no inspection by the regulator of medication was undertaken. Residents questionnaires received back from the home showed that twelve residents felt that they always get the medical support that they need and five felt that they usually did. The homes training file evidenced that care leaders receive training in the administration of medication. Care staff were seen to treat residents with respect and dignity during this inspection. One resident stated that ‘people address me in a pleasant way, not patronising’. Ermine House DS0000002355.V294012.R01.S.doc Version 5.1 Page 12 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 & 15. The quality outcome in this area is good. This judgement has been made using available evidence including a visit to this service. Meals are well managed and reflect resident’s likes and dislikes. Relatives and friends of residents are made welcome in this home. A range of stimulating activities are made available to residents. EVIDENCE: The home undertakes a variety of activities for the stimulation of residents. Copies of the homes notice board activity sheets were received prior to the inspection and evidenced that entertainers attend the home, painting glass classes takes place every Tuesday, clothes parties are held and the summer fayre is planned for July 06. Church service dates were seen and are a monthly event at this home. The hairdresser visits every Monday and Tuesday. The home also offers a club night every Friday, with bingo played on a Wednesday. The home has interviewed for an activities organiser who is awaiting appropriate checks before starting work. Ten residents questionnaires showed that there are activities and they are available to them always, three residents commented that activities are usually available and one said she never takes part. One resident commented that he Ermine House DS0000002355.V294012.R01.S.doc Version 5.1 Page 13 would like to get into town occasionally but would require assistance and special transport facilities. The manager was informed of this request and would discuss trips out with the resident and his family. The minutes of the residents meeting held on the 13/03/06 evidenced when forthcoming entertainments/activities and outings would take place at the home. Previous key inspections of this home found that residents stated that their visitors are made welcome and that they can be seen in the privacy of their room. Those visitors seen at this inspection stated that they are made most welcome when they visit. The homes signing in book showed that the home has a large number of visitors during the day and evening. The Commission has received copies of written accolades concerning the home from relatives voicing praise for the services provided. One relative commented ‘that my mother has settled in nicely and I would like to thank you for all you did to make it possible for her to accept that she really wasn’t able to live by herself anymore’. Another of many positive comments was ‘thank you all so much for the love, kindness and care you gave our dear mum’. The inspector joined two residents for lunch and found that the meal was hot and very tasty and that choices were available. Residents questionnaires evidenced that ten always liked the meals and six usually did with one residents stating they sometimes liked the meals. Copies of the homes menu plan and client satisfaction sheets were seen and for April 06 residents felt that ‘there is a very good choice at breakfast, tea was really nice enjoyed it, the pudding was really refreshing’. No complaints were received during this period. One resident commented that he would like a wider range of condiments on the tables. He also stated that for him ‘breakfast was the best meal of the day, the food is of good quality’. The cook commented that she was aware of residents dietary needs and had information relating to any allergies. The cook is qualified to carryout her tasks. Ermine House DS0000002355.V294012.R01.S.doc Version 5.1 Page 14 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 The quality outcome in this area is excellent. This judgement has been made using available evidence including a visit to this service. The home takes the issue of addressing complaints very seriously and has a comprehensive complaints policy. Staff are aware of how to respond to a complaint or an adult protection allegation. EVIDENCE: Previous inspections of this home has shown that a detailed complaints procedure is in place. The homes complaints pre-inspection questionnaire recorded that one complaint had been made in the last year. The home has amended its complaints form, which now has a signature box for complainants to signed regarding the agreed outcome. Residents questionnaires showed that thirteen residents were aware of how to make a complaint and knew who to speak to if they were unhappy. Six residents indicated that they usually know how to make a complaint and usually know who to speak to if they are unhappy. The home has an independent advocacy service in which residents and their supporters can refer to at no cost to themselves. Evidence was seen in the companies questionnaire that relatives have taken advantage of this service regarding advice on legal issues surrounding power of attorney. The homes training profile shows that safeguarding vulnerable adults training has taken place on the 06/03/06. Ermine House DS0000002355.V294012.R01.S.doc Version 5.1 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 The quality outcome in this area is excellent. This judgement has been made using available evidence including a visit to this service. The home is well maintained, the standard of the environment and its facilities are appropriate to the needs of residents. The home is clean and free of unpleasant odours. EVIDENCE: A partial tour of the home by the inspector found it to be clean and it smelt fresh. A previous inspection undertaken on the 20/10/05 found that residents and visitors alike said that the home is always clean and there are no unpleasant smells. One domestic worker at this time stated that she has undertaken training in moving and handling, infection control, first aid and completed her NVQ (National Vocational Training) level one. Residents questionnaires overwhelmingly showed that they felt the home is always fresh and clean. Ermine House DS0000002355.V294012.R01.S.doc Version 5.1 Page 16 A contract monitoring visit was undertaken by Lincolnshire County Council on the 23/03/06 and found that ‘there is an ongoing programme of improvements throughout the home’. The report also commented that ‘ the home is clean and bright with appropriate furnishings and fittings’. Previous inspections have found that; the home has a maintenance record which records work that has been undertaken and projected work for the coming year. A partial inspection of the home found that it was in a good stated of repair both externally and internally. The homes pre-inspection questionnaire evidenced that various parts of the home have been redecorated. Ermine House DS0000002355.V294012.R01.S.doc Version 5.1 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28, 29 & 30 The quality outcome in this area is excellent. This judgement has been made using available evidence including a visit to this service. Appropriate recruitment practices are in place. Staffing level meets the needs of residents. The home provides adequate training for care staff. Staff were seen to be competent in carrying out their care tasks. EVIDENCE: A review of all information available prior to this inspection including the homes action plan from the inspection carried out in October 2005, showed that; all interview records are kept of prospective appointee care workers who are interviewed and kept on their personnel file. Care workers have been given The General Social Care Council Codes of Practice, which sets out their responsibilities as care workers looking after vulnerable adults. The homes preinspection questionnaires evidences that 51 of carers have NVQ (National Vocational Qualifications) and the home now meets the ratio of 50 of care staff trained to level 2. A contract monitoring visit by Lincolnshire County Council found that ‘there is a comprehensive training and induction programme and tracking record in place’. Ermine House DS0000002355.V294012.R01.S.doc Version 5.1 Page 18 The questionnaire completed by residents showed that fifteen commented that they receive the care that they need and eleven said that staff listen to what I say and act on it. The homes pre-inspection questionnaire evidenced that there are twenty seven care staff, twelve ancillary workers four care leaders and a registered manager. One carer stated that there are enough staff and we spend time with residents. The carer confirmed that that she has undertaken mandatory training as well as induction training carried out at the home and two days at Wellingore (Headquarters). The duty rota showed that adequate staff numbers are on duty to meet the needs of residents during the day and night shift. Ermine House DS0000002355.V294012.R01.S.doc Version 5.1 Page 19 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 & 38 The quality outcome in this area is excellent. This judgement has been made using available evidence including a visit to this service. The registered manager is suitably qualified and experienced to carryout her tasks. Records seen show that residents’ health and general welfare and safety are promoted. The home ensures that that the residents have the opportunity to voice their views and opinions. Accurate records are kept of residents’ monies. EVIDENCE: The registered manager has worked for eighteen years in the caring profession part of which was spent as a relief carer in local authority homes. The manager joined this company in 1992 as a carer then became a care leader and registered manager in September 03. The manager has achieved NVQ level 2, 3 and 4 in care as well as the Registered Managers Award. Ermine House DS0000002355.V294012.R01.S.doc Version 5.1 Page 20 The contract monitoring report stated that ‘there is a homely atmosphere in the home and during the visit it was noted that there is a good rapport between the manager, staff, residents and visitors. The home conducts a quality assurance report. The quality assurance report is posted on the homes notice board for the information of residents and visitors, as is the last Commission for Social Care Inspection report. The quality assurance report is also included in the information pack for prospective residents. This report has been sent to the Commission and shows that positive comments were made in relation to the way this home is managed. The home only deals with personal allowances of residents, which are kept safe. All other monies relating to funding are paid into the companies bank account. Two residents allowances were checked at the last inspection dated 20/10/05 and an accurate record was kept, with two signatures and receipts available for monies spent. The contract monitoring visit dated 23/03/06 sampled service users financial records and found them ‘to be well maintained and accurate’. There are a range of policies and procedures available in the home relating to fire safety and fire risk assessments. The homes pre-inspection questioner evidenced that fire alarm, fire drills and emergency lighting checks have been undertaken. Care staff also receive fire training as part of the homes initial training and as a regular training event. A contract monitoring visit showed that ‘there is a good recording systems in place and policies and procedures are maintained to a high standard’. The homes pre-inspection questioner evidenced that bath hoists, wheelchairs had been serviced on the 01/02/06, with the shaft lift serviced on the 21/03/06. All wheelchairs seen on the day of the inspection had footplates, which were in use. Ermine House DS0000002355.V294012.R01.S.doc Version 5.1 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 x 4 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 4 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 4 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 4 17 x 18 4 4 x x x x x x 4 STAFFING Standard No Score 27 3 28 4 29 4 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 x 4 X 3 x x 4 Ermine House DS0000002355.V294012.R01.S.doc Version 5.1 Page 22 Are there any outstanding requirements from the last inspection? no STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Ermine House DS0000002355.V294012.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Ermine House DS0000002355.V294012.R01.S.doc Version 5.1 Page 24 - 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!