Inspection on 12/12/06 for Ingersley Court

This inspection was carried out on 12th December 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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

Ingersley Court 05/09/07

Ingersley Court 21/09/05

Ingersley Court 18/04/05

Ingersley Court 15/09/04

Ingersley Court 20/04/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Ingersley Court Lowther Street Off Church Street Bollington Cheshire SK10 5QA Lead Inspector A Gillian Matthewson Unannounced Inspection 12th December 2006 10:00 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 Ingersley Court DS0000006668.V321401.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Ingersley Court DS0000006668.V321401.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ingersley Court Address Lowther Street Off Church Street Bollington Cheshire SK10 5QA 01625 574233 01625 573196 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) www.clsgroup.org.uk CLS Care Services Limited Sharon Strain Care Home 34 Category(ies) of Old age, not falling within any other category registration, with number (34) of places Ingersley Court DS0000006668.V321401.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. This home is registered for a maximum of 34 service users in the category of OP (old age, not falling within any other category) 21st September 2005 Date of last inspection Brief Description of the Service: Ingersley Court is a purpose-built care home for older people. It forms part of the CLS Group which is a not for profit organisation based in Cheshire and Wigan. The home is located in the village of Bollington and has access to local facilities such as shops, churches and other community amenities. Macclesfield town centre is approximately five miles away. Ingersley Court is a threestorey building (basement, ground and first floor). Residents are accommodated on the ground and first floors only. Access between floors is via a passenger lift or the stairs. Residents` accommodation currently consists of 33 bedrooms, with one bedroom being used as a double. 18 bedrooms have en-suite facilities and the remaining bedrooms have wash hand basins fitted. There is generous communal space and this comprises 4 lounges, 2 dining rooms and a sitting area in the reception. Ingersley Court has a number of separate toilets and bathrooms. Various aids and adaptations have been provided for service users requiring assistance. There are a number of flats attached to the home. These are occupied by tenants who sometimes come into the home during the day for a meal or company. Fees range from £430 to £470 per week, depending on the accommodation provided. Some bedrooms have an en-suite toilet and some have an en-suite shower and a small kitchen. Ingersley Court DS0000006668.V321401.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. An unannounced visit took place on 12th December 2006 and lasted approximately six and a half hours. The visit was carried out by one regulatory inspector. This visit was just one part of the inspection. Before the visit the manager was asked to complete a questionnaire to provide up to date information about services in the home. Questionnaires were also made available for residents, families and health and social care professionals to find out their views. Other information received since the last key inspection was also reviewed. During the visit various records and the premises were looked at. A number of residents and relatives were also spoken with and they gave their views about the service. What the service does well: The home promotes equality by treating people as individuals and ensuring that diverse needs are appropriately met through the assessment and care planning process. Prospective residents’ needs are assessed prior to admission and they are provided with written information about the home and can visit or stay on a trial basis. This ensures they have all the information necessary to decide whether the home can meet their individual needs. Care plans have been provided which identify the health and personal care needs of residents and provide staff with instructions on how to meet those needs. Residents are treated with respect and daily routines are flexible. Residents can enjoy a varied programme of activities, if they wish, and are supported to meet their spiritual needs. In the main, catering is good. Residents are consulted about their opinion of the home and have access to a robust complaints procedure, should they not be happy about any aspect of the home. Ingersley Court maintains high standards of cleanliness. The accommodation is spacious and comfortable. The standard of décor and furnishings throughout the home is good. Thorough recruitment checks are carried out before staff start work at the home, to ensure the protection of residents. Residents’ property is also safeguarded. Ingersley Court DS0000006668.V321401.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Care plans should all be reviewed at least six monthly to ensure that they still meet the residents’ needs. Residents should be weighed at least three monthly to ensure that their nutritional needs are being met. Some improvements are needed in the recording of medication to maintain a clear audit trail. All staff must be trained in the protection of vulnerable adults. Some attention is needed to the paving at the front of the home to stop it being a slip hazard. Ingersley Court DS0000006668.V321401.R01.S.doc Version 5.2 Page 7 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Ingersley Court DS0000006668.V321401.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Ingersley Court DS0000006668.V321401.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3 & 5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents and their representatives are provided with the information necessary to make a choice about the home. They have their needs assessed before being offered a place. EVIDENCE: Information about Ingersley Court (Service User Guide) was displayed at the entrance. Perspex holders had been fixed to the wall of every bedroom to hold this information and a copy of the last inspection report. The guide had been updated since the last inspection. Ingersley Court DS0000006668.V321401.R01.S.doc Version 5.2 Page 10 The manager or a senior carer assess new residents before they move into the home on a permanent basis to ensure that their needs can be fully met. The assessment documentation of three residents was looked at. This contained all necessary information so that a care plan could be drawn up describing the actions to be taken by care staff to meet their needs. This information also included full details of the residents family history and social care needs. All resident spoken with said they had visited the home prior to admission and two said they had stayed for a short period previously before making a decision to move in permanently. Ingersley Court DS0000006668.V321401.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. On the whole, the health and personal care residents receive is based on their individual needs. The principles of respect, privacy and dignity are put into practice. EVIDENCE: The care plans of three residents were looked at. These identified all areas that residents required assistance in their activities of daily living and areas of risk. The content of the care plans was informative and gave a clear picture of the residents`needs. Two of the care plans had been regularly reviewed, but one had not been reviewed for over a year. Ingersley Court DS0000006668.V321401.R01.S.doc Version 5.2 Page 12 Care staff supported residents to maintain their independence. One resident was being supported to administer their own insulin. The care plan included details about how the blood sugar of the resident was being monitored and the actions to be taken if these were either too low or too high. This was reviewed by the district nurse on a weekly basis. Residents were assessed of their risk of developing pressure sores and appropriate pressure relieving aids were provided if necessary. Residents’ psychological health was monitored and a referral was made to the appropriate services if there were any problems. Residents were weighed on admission, but records showed that they were not routinely weighed after that to determine if they had any nutritional problems. One resident had not been weighed for over a year. A GP present during the inspection was complimentary about the care provided at Ingersley Court. She said it was “a good home, better than the average care home.” Two visitors said that their relative had been very ill a couple of months ago but the staff had given excellent care and she was now much better. The arrangements for the storage, administration and disposal of medicines were satisfactory. However, there were 28 Oxynorm capsules in the controlled drugs cabinet that had not been entered into the controlled drugs register. The medication had been discontinued by the GP prior to being received by the home two weeks earlier and were in a bag labelled “For return”, but they should still have been entered into the register and signed out when they were returned to the pharmacy. This is because if they were stolen the home would have no record of their ever having been in the home. Also, there was a gap on the medication administration record of one resident for one of her medications the previous morning. It was missing from the blister pack and was likely to have been administered with her other medicines, but had not been signed as administered. The residents and relatives spoken with said that staff treated them with respect and helped them to maintain their privacy and dignity. Ingersley Court DS0000006668.V321401.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are able to choose their lifestyle and social activities and keep in contact with family and friends. They also receive a healthy, varied diet. EVIDENCE: Ingersley Court employs an activity co-ordinator for 20 hours a week. An activity programme was displayed around the home for December. This included a poetry reading, a pantomime, a show by Poynton Gilbert & Sullivan society, entertainment provided by three local schools and the Brownies and Guides, a carol service, ending in a Christmas party with entertainers on 21st December. Activities outside the home included shopping trips and a drive out for coffee or afternoon tea. Some residents had been out to a tea dance the previous week. The spiritual needs of residents are met by visits from local clergy from Church of England, Roman Catholic and Methodist churches who Ingersley Court DS0000006668.V321401.R01.S.doc Version 5.2 Page 14 hold regular services. Residents can also attend local churches if they wish. Many residents take a daily newspaper. Relatives confirmed that they could visit their family member in private and that they were kept informed about important matters affecting their family member. Residents spoken to said that they could stay in their own rooms if they wished and were not pressurised into joining in activities. Meals could be taken in the dining room or in the privacy of the residents` own rooms. There was an alternative if anyone did not like the main choice. The lunch was hotpot or Cornish pasty with seasonal vegetables and potatoes. The dessert was Bakewell tart and custard. The evening meal was soup, chicken salad or assorted sandwiches followed by cake or yogurt. The menu was displayed on a board in the corridors outside the dining rooms. They had been revised for the winter and included three new dishes; chicken stroganoff, pork apple and sage crumble and braised beef in beer. Those residents spoken to said that on the whole they liked the food provided. One said “the food is very nice and meals are always well presented, with plenty of choice”. However, some were critical of the food the day before when an agency chef had been on duty. The manager said she was aware of the dissatisfaction because she always observed the food being served and that she would be making a complaint to the agency. One resident said she thought the meals were too close together and another couple of residents said they were never really hungry. The manager said she was trying to get the meals spaced out more but residents were so used to coming to the dining rooms at set times, it was difficult to change. Breakfast was at 8.30am, lunch at 12.15, tea at 4.15pm and supper at 7.30pm. Ingersley Court DS0000006668.V321401.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents have access to a robust, effective complaints procedure and are protected from abuse. EVIDENCE: Ingersley Court had received one complaint from a relative since the last inspection, which had been resolved. The complaints procedure was included within the Service User guide in residents’ rooms. Residents said that they would know who to speak to if they were unhappy about any aspect of their care. Ingersley Court has an adult protection policy and procedure in place. The home had followed the correct procedures following a recent allegation. New staff would receive training in adult protection as part of their induction, but formal training had only been provided for six of the existing staff. Ingersley Court DS0000006668.V321401.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 25 & 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Ingersley Court offers a pleasant and comfortable environment for residents. High standards of cleanliness and hygiene continue to be maintained. EVIDENCE: The pre-inspection questionnaire (PIQ) indicated that some refurbishment had occurred since the last inspection, which included redecoration of bedrooms. The standard of décor in the home was good. Residents said that they were happy with their living environment and that their rooms were kept clean and tidy at all times. Ingersley Court is commended for maintaining high standards of hygiene and cleanliness. Ingersley Court DS0000006668.V321401.R01.S.doc Version 5.2 Page 17 The hot water temperature of a bath was tested and found to be within acceptable limits. Records were seen of the hot water temperatures of baths and wash hand basins. These were all within safe limits. Externally, it was noted that paintwork was peeling and the home lacked a garden. The manager said that she was hoping to get agreement for the provision of a small garden at the front of the home next year, using part of the car park. Some recent monthly monitoring reports by the provider that had been submitted to CSCI had indicated that the paving at the entrance to the home was slippy at times. The maintenance person had tried to clean the paving with a pressure washer but it was still a problem. A request had been submitted to the property management department, but this had not been actioned at the time of the inspection. Ingersley Court DS0000006668.V321401.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Ingersley Court is adequately staffed. Staff are highly regarded by residents and people visiting the home and are supported to undertake appropriate training. EVIDENCE: Ingersley Court employs a number of staff who have worked at the home for several years. This provides the home with continuity and stability. However, there had also been a high use of agency staff in recent months. The manager said that this was now being resolved because she had recruited some new members of staff. There was a senior carer on duty twenty four hours a day. In addition there were three care assistants from 8am to 10pm and one care assistant overnight. The recruitment records of three new members of staff were looked at. These included all necessary documentation. The manager had received enhanced disclosures from the Criminal Records Bureau, which means that new staff are thoroughly vetted before starting work. All new staff are also screened by the Ingersley Court DS0000006668.V321401.R01.S.doc Version 5.2 Page 19 Countess of Chester Hospital Occupational Health Department to make sure they are physically and mentally fit for the job. Staff said that they were supported to undertake training relevant to their role. Domestic as well as care staff are given the opportunity to do training. Eight care staff have achieved NVQ level 2. The PIQ indicates that Ingersley Court has a full training programme including mandatory topics such as fire safety and additional subjects such as medication, care planning and dementia care. The induction process, which lasted for three months, was good and covered all the Skills for Care induction standards. New staff were employed for a six month probationary period and were provided with the General Social Care Council Code of Conduct and Practice. Residents were very complimentary about the staff; “the girls are very good”, “the staff are very nice to me”, “all staff, without exception, are good”. Ingersley Court DS0000006668.V321401.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35, 36 & 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The management of the home is based on openness and respect. EVIDENCE: The registered manager has been in post for approximately six months. She has worked in social care for 15 years and has worked for the registered provider for 11 years. She has an NVQ Level 3 in Care and is currently undertaking the Registered Managers Award (NVQ Level 4), which she anticipates completing by March 2007. Ingersley Court DS0000006668.V321401.R01.S.doc Version 5.2 Page 21 Both staff and residents spoken with said that the manager was very approachable and they could go to her with any concerns. They said they were consulted by her on any issues that concerned them. The manager had recently conducted a customer satisfaction survey and was collating the results at the time of the inspection. There was also a quality audit system in place that covered care plans, medication, accidents, health and safety, catering and maintenance. A representative of the company that owns the home visits monthly and reports are submitted to CSCI. Residents’ meetings are held quarterly. The arrangements for the safekeeping of residents’ monies and valuables were reviewed and found to be satisfactory. The system for formal supervision of care staff was that the manager supervised the Care Team Leaders and they in turn were responsible for the other care staff. However, very little formal supervision of care staff had taken place. The manager had identified that there was a training need for the Care Team Leaders and had arranged for this to be provided. All equipment was serviced and maintained at the required intervals. Staff were issued with a health and safety handbook on induction and received regular training in safe working practices. On the day of the inspection the Fire Safety Officer from Cheshire Fire Brigade was also inspecting the home. He said that he was happy with the fire risk assessment and fire safety arrangements in place and there were just some minor maintenance issues that needed attention. Ingersley Court DS0000006668.V321401.R01.S.doc Version 5.2 Page 22 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 3 3 X 3 N/a HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 X X X X X 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 2 X 3 Ingersley Court DS0000006668.V321401.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP9 Regulation 13(2) Requirement The registered person must ensure that all controlled drugs received into the home are recorded in the controlled drugs register and all medication administered is signed for to provide a clear audit trail. The registered person must ensure that all staff have received training in the protection of vulnerable adults. The registered person must take action to ensure that the paving at the entrance to the home is not a slip hazard for residents. Timescale for action 12/01/07 2 OP18 13(6) 12/03/07 3 OP38 13(4) 31/01/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP7 Good Practice Recommendations Residents’ care plans should be reviewed at least six monthly to ensure that actions indicated still meet their needs. DS0000006668.V321401.R01.S.doc Version 5.2 Page 24 Ingersley Court 2. OP8 The weight of service users should be recorded on admission and kept under review. This should be linked to the nutrition care plan. The exterior of the home should be redecorated to prevent deterioration. 3. OP19 Ingersley Court DS0000006668.V321401.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Ingersley Court DS0000006668.V321401.R01.S.doc Version 5.2 Page 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. 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