Inspection on 27/06/07 for Ixworth Court

This inspection was carried out on 27th June 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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

Ixworth Court 29/06/06

Ixworth Court 19/12/05

Ixworth Court 04/05/05

Ixworth Court 10/02/05

Ixworth Court 03/08/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Ixworth Court Ixworth Court Thetford Road Ixworth Bury St Edmunds Suffolk IP31 2HD Lead Inspector Cecilia McKillop Unannounced Inspection 27th June 2007 11:00 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 Ixworth Court DS0000037046.V344799.R02.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. Ixworth Court DS0000037046.V344799.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ixworth Court Address Ixworth Court Thetford Road Ixworth Bury St Edmunds Suffolk IP31 2HD 01359 230101 01359 232734 joanna.last@socserv.suffolkcc.gov.uk Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Suffolk County Council Position vacant Care Home 22 Category(ies) of Dementia - over 65 years of age (8), Old age, registration, with number not falling within any other category (22) of places Ixworth Court DS0000037046.V344799.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 29th June 2006 Brief Description of the Service: Ixworth Court is a purpose built home that provides well-furnished accommodation for 22 frail elderly, mixed gender and culture, residents. It is situated in Ixworth, which is a village with good community facilities approximately 10 miles from Bury St Edmunds. It is a single storey building separated into 2 units with surrounding safe gardens. Each unit consists of a comfortable lounge, dining room and kitchen area. All bedrooms are single with en-suite facilities. There are also assisted/communal bathrooms and additional toilet facilities. Ixworth court is owned and operated by Suffolk County Council. There is a day care centre within the building where social events are held and a small shop for the purchasing of every-day items. Ixworth Court DS0000037046.V344799.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report follows a key inspection where the key national minimum standards were examined. There has been a change in manager since the last inspection and the new manager Ms Joanna Last was available on the day of the inspection and assisted with the process. The home was caring for eighteen service users on the day of the inspection. A tour of the building was undertaken and care observed. Five service users were spoken to about their experiences at Ixworth Court. Three staff members were interviewed. A sample of records relating to care, resident’s health and staff recruitment were examined. Prior to the inspection the Commission received the Annual Quality Assurance Assessment, which had been completed by the home. What the service does well: The home was clean, tidy and attractively decorated, each bedroom viewed reflected the individuality of the service users. Each of the three units are furnished to a good standard and are self-contained with a separate kitchen, dining and sitting area. Service users can make drinks if they wish and the overall layout affords service users considerable privacy and independence if they wish. The home’s gardens and outdoor seating areas have been well tended and planned out. The home is proactive in involving residents in community-based activities and children from the local school had recently visited the home to plant hanging baskets and pots for the garden. There were also plans for a number of the service users to attend a strawberry tea in the village. The moving in process is well planned. Care plans are maintained in residents rooms and are signed by residents Staff interaction with residents was viewed to be friendly, positive and respectful. A small number of relative’s questionnaires were returned and these were very positive, referring to the care professionalism and experience of staff. Ixworth Court DS0000037046.V344799.R02.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Ixworth Court DS0000037046.V344799.R02.S.doc Version 5.2 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 Ixworth Court DS0000037046.V344799.R02.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3,6. Quality in this outcome area is good. Prospective residents can expect that they will be provided with the information they need to make an informed choice about where to live, that they will have their needs assessed and met and that they will be provided with the opportunity to visit the home before they decide to move in. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home’s statement of purpose was found to comply with the standards and regulations at the last inspection. The document has been updated in line with management changes at the home and clearly outlines the facilities on offer. The home has a clear admission process, which is outlined in the home’s statement of purpose. Prospective residents who plan to use the home for a period of respite attend the home for a pre stay visit. On the day of the inspection a prospective resident and his partner were spending the day at the home, as part of a pre-stay visit. Staff were observed spending time with them discussing how their stay could be made as positive as possible. The home’s Ixworth Court DS0000037046.V344799.R02.S.doc Version 5.2 Page 9 policy is that prospective residents are invited to visit on as many occasions as they wish prior to admission to check the room and discuss any concerns. The inspector was informed that residents who are in hospital or those who are moving into the home on more permanent basis would be visited by the manager or a senior team leader. There was evidence on resident’s files of a pre-admission assessment being undertaken, which is used as the basis for the care plan. Service users who were interviewed reported that the admission process was well managed. The homes manager reported that a number of residents were currently waiting to move into very sheltered housing when this became available. Efforts were being made to assist resident’s to retain their independence. Residents are where possible enabled to look after their own medication and are encouraged to use the kitchen facilities in the communal areas. Ixworth Court DS0000037046.V344799.R02.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10. Quality in this outcome area is good. People who use this service can expect to have their care needs documented and met but more consistent recording of pressure care and medication will ensure quality of care for every resident. This judgement has been made using available evidence including a visit to this service. This judgement has been made using available evidence including a visit to this service. EVIDENCE: During a tour of the building, it was observed that all residents have a copy of their individual care plans in their bedroom, which a number had signed. A sample of care plans were examined and it was noted that each plan had several elements including communication, being safe, personal care, dressing, eating and drinking, sleeping, mobility and recreation needs. All these care plans were clear and easily understood and covered day and night. There were evidence of ongoing monitoring and health records were in place clearly outlining when the residents had last seen the optician or chiropodist. There were assessments in place with regard to nutrition, manual handling and pressure care. The manual handling assessments were of a high standard but Ixworth Court DS0000037046.V344799.R02.S.doc Version 5.2 Page 11 some of the other assessments had not been updated to take account of residents changing needs. One of the residents whose care was tracked as part of the inspection did have a pressure area and while there was evidence that the matter was being managed by the district nurse, clearer guidance in the care plan on the impact on the day to day care and its management would have been beneficial for staff. The inspector observed the end of the medication round and medication was observed being administered appropriately. Seniors carers are responsible for administering medication at the home. There have been a number of small changes to medication administration practices since the last inspection. The home is in the process of moving towards storing residents’ medication in individual medical cupboards in residents’ rooms. The cupboards were domestic in type and provided secure storage. This is positive and should enable more residents to retain control of their own medication. The MAR charts have been changed by the pharmacy and the dates are no longer clearly recorded on the chart. The inspector was informed that the home had already taken this up with the pharmacy and changes to the format are planned. One resident had been prescribed Haloperidol on a PRN basis. The inspector was informed that this was for agitation and while it is clear from the file that this had only been given very occasionally the home must have clear plan in place as to how staff should respond to the residents distress and at what point the medication should be given. There are clear system in place for the administration and recording of creams and ointments. However, this was not always being followed and there were significant gaps in the signatures, making it difficult to see whether the ointment had been applied as prescribed. Staff were observed speaking to residents respectfully and kindly. Residents were positive about staff and said that they were able to come and go as they liked. Care plans referred to the residents preferred term of address and staff were observed knocking on resident’s doors prior to entering. Ixworth Court DS0000037046.V344799.R02.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15. Quality in this outcome area is good. Service users can expect that their social, religious and recreational interests and needs are met and that they are helped to exercise choice and control over their lives. Service users can expect that they receive a wholesome diet and that they maintain contact with others who are important to them. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Residents who were interviewed as part of the inspection confirmed that they were able to maintain regular contact with family and friends and that their visitors were welcomed with a cup of tea. The home has contacts with a number of local groups and the inspector was informed of two strawberry teas, which had been arranged, one in the home and another in the village, which residents planned to attend. Photographs were on display of the local school children’s recent visit to the home. The children had visited and assisted residents with the planting out of garden tubs and other containers. There were no formal activities on the day of the inspection although there was a religious service taking place. The inspector was informed that the previous day a resident had a party in one of the homes function rooms. The home has its own minibus which is used for outings to the local area. Ixworth Court DS0000037046.V344799.R02.S.doc Version 5.2 Page 13 The statement of purpose refers to residents being able to access emails while living at the home. One resident said that they enjoyed reading and going into the garden and overall residents said that they were content with how they spent their day. One residents said that they would like a television in their room and the homes manager agreed to take this forward. Resident’s bedrooms were viewed during a tour of the building. All bedrooms contained service users individual belongings including memorabilia and photographs. Some service users bedrooms contained their own furniture. The menu was on display and the meal served on the day of the inspection was mince cobbler with vegetables. A small number of residents had a baked potato as an alternative. Residents spoke positively about the food and the selection on offer. The inspector was informed that following discussions with residents there had been a recent change in the provision of a cooked breakfast, to ensure that it is ready when residents are ready to eat it. One resident was observed being fed by a member of staff and this was undertaken in a sensitive and unhurried manner. Ixworth Court DS0000037046.V344799.R02.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Quality in this outcome area is good. Residents can expect that any complaints will be handled properly and that they will receive protection from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a complaints procedure, which sits alongside the Suffolk County Council “Comments Compliments and Complaints” procedures. Details of the procedure are included in the statement of purpose and service users guide. CSCI and staff at the home have not received any complaints since the last inspection. The home has a policy for the protection of vulnerable adults and a whistleblowing policy. The manager was familiar with these procedures and had responded appropriately to a recent concern, which had arisen. Staff spoken with had received training and were able to identify appropriate action to take in the event of an allegation being made. Ixworth Court DS0000037046.V344799.R02.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19,26. Quality in this outcome area is excellent. Residents who use this service can expect to find a comfortable clean and well maintained home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home was in a good state of repair and there was evidence of ongoing maintenance. There are three units within the home and each have a communal kitchen, dining and lounge areas. The communal areas are comfortable, light and well furnished. The home has attractive garden areas with garden furniture where residents can sit if they choose. Resident’s bedrooms have appropriate furnishings and fittings, including lockable storage areas, bedroom doors have locks, which service users may use if they choose to. Residents are asked prior to their admission what their colour choice is for their room. Ixworth Court DS0000037046.V344799.R02.S.doc Version 5.2 Page 16 Rooms in one of the units willow have large en suite facilities comprising of a toilet, hand washbasin and shower. The home has a separate sluice room. There is a large laundry room, with two washing machines and a large dryer, the second laundry room provides storage for clean laundry until it is returned to service users and an ironing area. The three rooms contain hand-washing facilities including hand wash gel and disposable towels. The home was observed to be very clean and tidy and without any offensive odours. Storage cupboards were observed to hold protective gloves and aprons for staffs use. Ixworth Court DS0000037046.V344799.R02.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30. Quality in this outcome area is good. Residents can expect that staff that are trained to do their jobs and that they will be protected by the homes recruitment procedures. This judgement has been made using available evidence including a visit to this service. EVIDENCE: During the waking day the home operates with a minimum of three carers and a senior team leader on duty. On the day of inspection staff were observed going about their duties in an unhurried manner and responding to requests for assistance appropriately. Residents who were interviewed reported that there was enough staff around to help. The homes statement of purpose was viewed and included staffing of the home and their qualifications. The inspector was informed that the home has reached over the 50 target of care staff to achieve at least NVQ (National Vocational Qualification) level 2. All the senior staff have achieved NVQ level 3. All newly appointed staff are provided with Skills for Care induction and the home has confirmed that all catering staff have received training in safe food handling. Staff who were interviewed as part of the inspection confirmed that they had received training in a range of areas including dementia, manual handling, protection of vulnerable adults, food hygiene and fire training. Ixworth Court DS0000037046.V344799.R02.S.doc Version 5.2 Page 18 Training was due to be held on infection control and it was agreed with the manager that it would be beneficial for training to held on pressure care. The inspector was informed that staff are being encouraged to look again at the homes polices and procedures and they have recently introduced a procedure of the month as a way of encouraging this. There have been no new care staff appointments during the last six months but there have been some new staff appointed in the kitchen. The recruitment records relating to one of these staff were examined and there was evidence on the file of references, identity checks and criminal record bureau checks. Ixworth Court DS0000037046.V344799.R02.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38. Quality in this outcome area is good. People who use this service can expect that the home will be well managed and that their health and safety will be promoted. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There has been a change of manager since the last inspection. The new manager Ms Joanna Last has a nursing qualification and previously worked as a registered manager of another local authority home for older people. The new manager is aware of the registration requirements and informed the inspector that she had started the process. The manager is assisted by a senior team leader and a number of team leaders who cover both day and night shifts. Ixworth Court DS0000037046.V344799.R02.S.doc Version 5.2 Page 20 Regulation 26 visits had not recently taken place as required due to staff sickness however the inspector was informed that the organisation was in the process of addressing this and was making arrangements for another member of staff to take on these responsibilities. In the pre inspection information the home indicated that they have regular unit meetings with residents and outlined a number of changes that they had made to the service as a result of seeking service users views. The inspector was informed that the home were due to undertake a survey on menu planning. The systems in place to safeguard resident’s finances were not examined at this inspection however these were found to comply with the standards and regulations at the previous inspection. The certificate of employer’s liability was on display in the home Risk assessments were in place for individuals in relation to their needs. The manual handling assessments which were seen were detailed and comprehensive. Dates of servicing of equipment were provided to the Commission as part of the pre-inspection information. On the day of the inspection there was evidence on equipment to confirm that portable electrical equipment had been subject of testing and the hoist had been serviced in the three months prior to the inspection. The inspector was informed by the manager that the requirements made by the fire officer following a visit in 2006, had all been addressed by the homes management. Bath temperatures, which were tested on the day of the inspection, were within the recommended levels. Bath temperatures are measured prior to residents bathing and records maintained on resident’s files. Staff who were interviewed confirmed that they receive regular supervision from a senior member of staff Ixworth Court DS0000037046.V344799.R02.S.doc Version 5.2 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 X X 3 X X 3 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 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 X 3 Ixworth Court DS0000037046.V344799.R02.S.doc Version 5.2 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. 1. Standard OP9 Regulation 13 (2) Requirement Timescale for action 01/08/07 2 OP9 13 (2) 3 OP7 15 When lotions or creams, which are prescribed, are administered to residents it must be clearly recorded to ensure that residents receive the medication when they need it. When medications are prescribed 01/08/07 on a PRN basis there should be a clear plan giving staff guidance as to when the medication should be administered. This will ensure that residents receive medication when they need it. Any incidence of pressure sores 01/08/07 must be recorded monitored and identified in the care plan to ensure that residents needs are met Ixworth Court DS0000037046.V344799.R02.S.doc Version 5.2 Page 23 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 OP8 Good Practice Recommendations Training should be provided to staff on pressure care to ensure that staff are up to date on best practice and the likelihood of a sore developing minimised. Ixworth Court DS0000037046.V344799.R02.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Suffolk Area Office St Vincent House Cutler Street Ipswich Suffolk IP1 1UQ 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 Ixworth Court DS0000037046.V344799.R02.S.doc Version 5.2 Page 25 - 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. 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