Inspection on 05/05/06 for Laburnum Court

This inspection was carried out on 5th May 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Laburnum Court 24/10/07

Laburnum Court 04/10/06

Laburnum Court 02/12/05

Laburnum Court 21/09/05

Laburnum Court 14/02/05

Laburnum Court 29/07/04

Laburnum Court 09/02/04

Laburnum Court 22/07/03

Laburnum Court 30/07/02

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

CARE HOMES FOR OLDER PEOPLE Laburnum Court Priory Grove Lower Broughton Salford M7 2HT Lead Inspector Richard Dankwa Key Unannounced Inspection 12:00 5th May 2006 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 Laburnum Court DS0000006734.V293307.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. Laburnum Court DS0000006734.V293307.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Laburnum Court Address Priory Grove Lower Broughton Salford M7 2HT 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) 0161 708 0171 0161 705 0156 Southern Cross Healthcare Services Limited Marcella Ann Lade Care Home 67 Category(ies) of Dementia (1), Dementia - over 65 years of age registration, with number (29), Old age, not falling within any other of places category (37) Laburnum Court DS0000006734.V293307.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. 6. 7. One named service user who is below 65 years of age is accommodated on the EMI unit. When this service user leaves, the category will revert back to DE(E). Up to 17 service users requiring personal care only may be accommodated on the first floor. The person in charge of the first floor unit caring for people with general nursing needs must be registered on Part 1 or 12 of the Nursing and Midwifery Council register. The person in charge of the unit on the ground floor caring for people with dementia must be registered on Part 3 or 13 of the Nursing and Midwifery Council register. Service users admitted to the unit caring for people with dementia shall not be subject to detention under the terms of the Mental Health Act 1983. Minimum nursing staffing levels as specified in the notice issued under Section 25(3) of the Registered Homes Act 1984 on 10 December 1999 shall be maintained. The home must at all times employ a suitably qualified manager who is registered with the Commission for Social Care Inspection. 2nd December 2005 Date of last inspection Brief Description of the Service: Laburnum Court is a purpose built care home on two floors. The first floor of the building is registered to provide accommodation for 37 older people, up to 17 of who will need personal care only. The ground floor provides accommodation for up to 30 older people whose nursing needs are primarily due to mental ill health. Laburnum Court fees ranges from £355.52-£480 per week. There are additional charges for aromatherapy, chiropody and hairdressing. Accommodation is provided in single en suite bedrooms with a variety of communal space for the residents to use. The home is in Broughton, a residential area of Salford that is close to local shops and within a bus ride of Salford’s shopping precinct. Laburnum Court DS0000006734.V293307.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection visit that took place on the 5th May 2006 and lasted for about three hours. The manager was present during this inspection. The opportunity was taken to speak to some of the residents and staff. The paperwork kept at the home was examined. Also when anything important happens at Laburnum Court for example accidents or incidents, the home informs the Commission for Social Care Inspection so some of the information that helped to write this report was received before the inspection visit as well as information from the last visit. The majority of the areas identified during the last inspection on 2 December 2005 and also the extra inspection that took place on 24 March 2006 had been met. Other areas needing improvements were identified during this inspection visit. The previous report should be read together with this one to get a better picture of the care being provided at the home, as the Commission for Social Care Inspection only looked at the key standards during this inspection visit. What the service does well: What has improved since the last inspection? What they could do better: To ensure that the residents receive safe medication the home must ensure that medicines are not used after the expired date. Laburnum Court DS0000006734.V293307.R01.S.doc Version 5.1 Page 6 During this inspection and the last inspection an area of the home was identified as having unacceptable smell of odour. The home must put the necessary arrangements in place to keep the home free of offensive odours. This will ensure that the residents live in pleasant and hygienic environment. Examination of staff records revealed that one of the first level nurse’s registration with the Nursing and Midwifery Council had expired, and also one nurse did not have all the information required to be kept regarding staff working in a care home (application forms, references, criminal checks, training records). The home must ensure that all first level nurses have current registration with the Nursing and Midwifery Council, and to make sure that all the information required to be kept regarding persons working at the care home is in place. This is to ensure that the right staff are employed to look after vulnerable people. Discussions with staff, residents and their families revealed that the staff needed specialist training such as dementia and diabetes to allow them to look after the residents who need support in these areas appropriately. The staff must receive dementia and diabetes training to help them assist the residents appropriately and to meet their assessed health needs. Examination of records and discussions with the manager, residents and their relatives indicated that the home did not find out from the residents what they think of the service the home provided. A requirement was made during the previous inspection regarding this. In order to improve the quality of care being provided and for the residents to have a say in the delivery of care, the home must carry out surveys to find out from the residents what they think. Staff records indicated that the staff did not receive regular supervision. To further provide good care to the residents the home should ensure that all staff receive regular supervision. 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. Laburnum Court DS0000006734.V293307.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 Laburnum Court DS0000006734.V293307.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): 3 & 6. The quality in this outcome area is good. This judgement has been made using available evidence including a visit to the home. Prospective residents are fully assessed before an offer of a place is confirmed. EVIDENCE: The files of two residents recently admitted to the home were examined and pre-admission assessments were in place. The manager visited the residents to assess them and ensured that the home could meet the needs of the residents. A pre assessment form is used to record the assessment carried out on a prospective resident. One resident who was recently admitted to the home said that he was able to visit the home with his relatives to meet the other residents living in the home before he decided whether to use the service the home provided. The home does not provide intermediate care. Laburnum Court DS0000006734.V293307.R01.S.doc Version 5.1 Page 9 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 judgement in this outcome area is adequate. This judgement has been made using available evidence including a visit to the home. The care needs of the residents were recorded enabling staff to meet the assessed needs of the residents. The staff treated the residents with respect and promoted their independence. The medication procedures were adequate and appropriate, however they were not fully adhered to. EVIDENCE: The examination of paperwork kept on residents’ files indicated that the residents and their relatives/representatives are encouraged to participate in developing their care plans. Detailed care plans and risk assessments were in place and staff who were spoken to have good understanding of the care needs of the residents using these plans for guidance. The home ensures that the individual and diverse needs of the residents are respected and promoted. This ensures that the residents have a fulfilled lifestyle without any barriers. Laburnum Court DS0000006734.V293307.R01.S.doc Version 5.1 Page 10 There are policies and procedures in place for the handling and administration of medication. The home is now using a new pharmacy for supplying medication to the home. The manager said that this has improved the supply of medication to the home with less errors being made. However, examination of medication in the drug trolley revealed that one medication have expired. To ensure that the residents receive safe medication the home must ensure that expired medication is removed from the drug trolley and is replaced. The residents said that they receive their medication on time. The residents who were spoken to and observations during the inspection visit indicated that the residents were treated with respect. The residents were encouraged to do as much as possible for themselves. One of the residents said, “The staff are very helpful and nothing is too much for them”. Laburnum Court DS0000006734.V293307.R01.S.doc Version 5.1 Page 11 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 the home. The residents find the lifestyle experienced in the home matches their expectations and preferences. The residents are supported to maintain contacts with their relatives and friends and also to pursue social and leisure activities. The home continues to provide wholesome balanced diet. EVIDENCE: The home supports the residents to meet their individual lifestyles. A vicar from St Johns Church (Church of England) and a priest from St Thomas Church (Roman Catholic) visits the home on a monthly basis and an entertainer visits on a regular basis. The home has a mini bus and some of the residents recently went to Knowsley Safari Park. Some residents said that they enjoy going to the local pubs for a drink. The home organises bingo, dominoes, big screen cinema, hand and feet massages and card games. The residents spoken to said that they were happy with the leisure activities being provided at the home. The home has an open visit policy that allows the relatives and friends of the residents to visit at any time during the day. The residents are able to receive Laburnum Court DS0000006734.V293307.R01.S.doc Version 5.1 Page 12 visitors in private. One resident said that her relatives are able to visit at any time. The home continues to provide good quality wholesome meals. There was a menu in place that offered the residents a choice of meals. The home provides specialist diets to suit the needs of the residents such as diets for residents who are diabetics and those who need high nutritious diets. All residents who were spoken to said that the home provided good quality food and there is always plenty to eat. Complaints were received by the Commission regarding the home not having fresh fruits and out of date foods in the fridge. Examination of these revealed that the home has acted to resolve the issues. There were plenty of fresh fruits and foods available at the time of the inspection and all foods were up to date and stored correctly. Laburnum Court DS0000006734.V293307.R01.S.doc Version 5.1 Page 13 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 in this outcome is good. This judgement has been made using available evidence including a visit to the home. The home has policies and procedures in place for managing complaints and the residents and their relatives are confident that the home will deal with their complaints appropriately. The policies and practices of the home safeguarded the residents from harm or abuse. EVIDENCE: The home has a complaint logbook for recording all complaints received at the home. Examination of the documentation in the complaints logbook indicates that all complaints are dealt with appropriately. The Commission for Social Care Inspection had received several complaints since the last inspection and the home dealt with them according to their complaints procedure. The residents and relatives who were spoken to said that they know how to make a complaint and felt confident that their complaints would be dealt with appropriately. The Commission received a concern regarding the care of one of the resident and this was passed on to the provider of the home to investigate using their policies and procedures. The Commission awaits the outcome of their investigation. Policies and procedures were in place to help the staff protect the residents from harm or abuse and the staff spoken to were aware of these policies and Laburnum Court DS0000006734.V293307.R01.S.doc Version 5.1 Page 14 procedures. Staff who were spoken to were aware of how to deal with an allegation of abuse and had an understanding of potential indicators of abuse. Examination of training records indicated that the staff receive induction training and Protection of Vulnerable Adults training. Laburnum Court DS0000006734.V293307.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 in this outcome area is adequate. This judgement has been made using available evidence and a visit to the home. The environment appeared safe, and the residents live in a clean and wellmaintained home. However, there was a presence of an offensive odour at the home. EVIDENCE: There is a programme in place to redecorate and refurbish the home and this is on going. There was a fire logbook in place and it indicated the weekly fire and health and safety checks were carried out. The Commission received several complaints about the cleanliness of the home. This was discussed with the manager and the line manager of the home before this inspection visit and was asked to investigate and deal with it accordingly. It was pleasing to note that extra domestic hours have been allocated and there was a noted improvement in the cleanliness of the home Laburnum Court DS0000006734.V293307.R01.S.doc Version 5.1 Page 16 since the last inspection visit. The home has put a cleaning programme in place to ensure that the residents live in a clean environment. A requirement was made at the last inspection of 2 December 2005 and also the additional inspection visit made on the 24 March 2006 to ensure that the home is free from the offensive odour. However, a tour of the premises revealed presence of offensive odour of urine on the ground floor entrance. The home must ensure that this is addressed to allow the residents to live in a pleasant and hygienic environment. This was discussed with the manager and their line manager and they indicated that they have identified the source of the odour and the home is dealing with it. Laburnum Court DS0000006734.V293307.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 adequate. This judgement has been made using existing evidence and a visit to the home. The home has policies and procedures in place that if followed will ensure that the right people are employed to look after vulnerable people. Not all the staff files examined had the required information needed to be kept at a care home. EVIDENCE: The staff rosters examined indicated that the numbers and skill mix of staff on each shift was adequate to meet the needs of the residents. The home had recruitment policies and procedures that if followed, will ensure that the right people are employed to work at the home. However, some of the staff files examined did not contain all the required information needed to be kept at the home. Documents that were not available for inspection included application forms, references, Criminal Records Bureau checks (CRB) and training records. It was also noted that one of the first level nurse’s registration with the Nursing and Midwifery Council (NMC) had expired. The home must check with the NMC to ensure that all nurses have current registration with them and to make sure that the required information needed to be kept regarding people working in a care home is in place. This is to ensure that the right staff are employed to look after vulnerable people and to safeguard the residents from abuse or harm. Laburnum Court DS0000006734.V293307.R01.S.doc Version 5.1 Page 18 The staff receive training that allowed them to do their work appropriately. Training received includes Moving and Handling, however discussions with the staff and relatives of residents indicated that dementia and diabetes training is required. The home must arrange for all staff to receive the specialist training needed to assist them to do their work appropriately, and to meet the residents’ identified needs. Laburnum Court DS0000006734.V293307.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, 36 & 38. The quality of this outcome area is adequate. This judgement has been made using available evidence including a visit to the home. The manager of the home carries out her responsibilities fully. The staff do not receive formal supervision. The policies and procedures that are in place will protect the well being of the residents if followed. EVIDENCE: The manager has been managing the home for a while and runs the home well. The manager is undertaking National Vocational Training (NVQ Level 4). Staff who were spoken to said that the manager carries out her responsibilities fully. They said that the manager listens to any issues they may have and she is approachable. The home now has the necessary procedures in place to find out from the people who use the service what they think of it, however there was no evidence to indicate that this was being carried out. To make sure the home Laburnum Court DS0000006734.V293307.R01.S.doc Version 5.1 Page 20 delivers an appropriate and good service the home must find out from the residents what they think of it. This will allow the residents to have a say in the running of the home. A requirement was made during the last inspection regarding this. Discussions with the manager and the line managers of the home indicate that the provider audits the care being provided at the home on a regular basis. One of the line managers visited the home at 05:30 on the day of the unannounced inspection visit to audit the care being provided. However, copies of the audits were not available for inspection and the home must ensure that copies are kept at the home. Staff files examined indicated that the staff receives supervision however, these were not regular. The home should ensure that the staff receive regular supervision to allow them to further support the residents appropriately. The home has policies and procedures in place to manage the finances of the residents. Records kept at the home indicate that the financial interest of the residents is safeguarded. There are health and safety policies and procedures in place to protect the residents and staff. The staff records examined and the staff who were spoken to indicated that they receive health and safety training. Laburnum Court DS0000006734.V293307.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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 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 3 3 X X X X X X 2 STAFFING Standard No Score 27 3 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 3 X 3 Laburnum Court DS0000006734.V293307.R01.S.doc Version 5.1 Page 22 Are there any outstanding requirements from the last inspection? Yes 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 expired medicines are replaced to ensure that the medication received by the residents is safe. The registered person must keep the home free of offensive odour to allow the residents to live in pleasant and hygienic home. Previous requirement not met (15/01/06). The registered person must ensure that the home maintains the records specified in Schedule 2 of The Care Homes Regulations 2001, and that the home finds out from the Nursing and Midwifery Council that the first level nurses have current registration with them. The registered person must ensure that the staff receives the appropriate specialist training to help them do their work appropriately. The registered person must consult the residents and their representatives about the care being provided and what they think of it. Previous requirement not met (15/1/06). DS0000006734.V293307.R01.S.doc Timescale for action 15/06/06 2. OP26 16 01/07/06 3. OP29 17 & 18 01/07/06 4. OP30 18 10/09/06 5. OP33 24 30/07/06 Laburnum Court Version 5.1 Page 23 6. OP33 26 The registered person must 30/07/06 ensure that copies of audits carried out are kept at the home. 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 OP36 Good Practice Recommendations The registered person should ensure that the staff receives regular supervision to further support the residents appropriately. Laburnum Court DS0000006734.V293307.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection CSCI, Local office 9th Floor Oakland House Talbot Road Manchester M16 0PQ 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 Laburnum Court DS0000006734.V293307.R01.S.doc Version 5.1 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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