Inspection on 14/07/05 for Ladesfield

This inspection was carried out on 14th July 2005.

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

Ladesfield 18/02/09

Ladesfield 25/03/08

Ladesfield 27/07/07

Ladesfield 18/07/06

Ladesfield 06/01/06

Ladesfield 18/01/05

Ladesfield 06/10/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Ladesfield Vulcan Close Whitstable Kent CT5 4LZ Lead Inspector Mark Hemmings Announced 14 July 2005 th 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 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. Ladesfield H56-H05 S37645 Ladesfield V226215 140705 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Ladesfield Address Vulcan Close, Whitstable, Kent. CT5 4LZ Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01227 261090 01227 266201 Kent County Council Mrs Anne Meade (Acting Manager) CRH 25 Category(ies) of OP registration, with number of places Ladesfield H56-H05 S37645 Ladesfield V226215 140705 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Ladesfield (the Home) is registered to provide accommodation and personal care for up to 25 older people (service users). Date of last inspection 18 January 2005 Brief Description of the Service: The premises which were purpose built in the 1970s are a three storey detached property. The ground and the first floor are used for service users’ accommodation. There is provision for all of the service users to have their own bedroom each of which has a private wash hand basin. All of the bedrooms also have a call point which is designed to help service users summon help should it be needed. The second floor of the building is currently not used. The Home is located in a quiet area which is about half a mile or so from the centre of Whitstable. To the rear of the property there is a secluded garden which has a number of sitting areas. The Home is operated by Kent County Council (the Registered Provider). Ladesfield H56-H05 S37645 Ladesfield V226215 140705 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection visit was announced and it took about ten hours to complete over the course of two days. During this time, the Inspector spoke with or spent time with twelve service users. Also, he spoke with the Acting Manager. The Inspector examined various records and he spoke with care workers and with housekeeping staff. The Inspector looked at various parts of the accommodation. This included (by invitation) four of the service user’s bedrooms. The Home continues to provide the service users in residence with the support and assistance they need. There are two Required Developments at the end of this Report. What the service does well: What has improved since the last inspection? The windows in two bedrooms which did not provide a weather-tight seal, have been replaced. A number of staff have undertaken various relevant training courses. Ladesfield H56-H05 S37645 Ladesfield V226215 140705 Stage 4.doc Version 1.30 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Ladesfield H56-H05 S37645 Ladesfield V226215 140705 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Ladesfield H56-H05 S37645 Ladesfield V226215 140705 Stage 4.doc Version 1.30 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 standard(s) 1, 2, 3, 4, 5 and 6. Prospective service users are given the information they need to make an informed decision about living in the Home. Each service user receives a written statement of the terms and conditions of their residency. Service users’ needs for assistance are assessed before admission. Service users are confident that their needs for personal care will be met when they enter the Home. Prospective service users and their representatives are encouraged to visit the Home before a decision is made about moving in. Service users who receive intermediate care in the Home, are assisted to return home. EVIDENCE: There is a Service Users’ Guide. This is a brochure which prospective service users are given and which outlines the facilities and services provided in the Home. In addition to this, the Acting Manager and the senior staff speak with prospective service users to answer any remaining questions they may have. Ladesfield H56-H05 S37645 Ladesfield V226215 140705 Stage 4.doc Version 1.30 Page 9 Each service user receives a written statement of the terms and conditions in accordance with which the Registered Provider delivers accommodation and personal care services in the Home. The document is suitably detailed and is clearly laid out. The Acting Manager said that all new service users and their representatives are given the chance to talk through the document with a senior member of staff, so that any necessary clarification can be given. Service users say or indicate that they were confident at the point of admission to the Home, that their individual needs for support could be met reliably and consistently in the Home. The Acting Manager is aware of the responsibility placed upon her to ensure that only people whose needs for assistance can be met reliably, are admitted to the Home. The Inspector reviewed the circumstances of several recent admissions to the Home. He concluded that in each case, the decision to offer a place had been suitable given the particular needs of the people in question. A number of people are accommodated in the Home for shorter periods of time. Often this is done to enable them to regain a suitable measure of independence before returning home after a stay in hospital. There is evidence which shows that most of these service users do indeed return to their own homes, when this is appropriate. Ladesfield H56-H05 S37645 Ladesfield V226215 140705 Stage 4.doc Version 1.30 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9 and 10. Service users are confident that their present and future needs for personal care will be met in a reliable and consistent manner. They are suitably consulted about the assistance they receive. Service users’ health care needs are met fully. Service users are assisted to manage their own medication if this is appropriate. Service users consider that staff are respectful and that they appreciate their needs for privacy. EVIDENCE: There is a service user plan for each service user. These documents describe the assistance which each person has agreed to receive. The Inspector sample checked several of these plans and he found them to be suitably detailed. Service users say or indicate that they are consulted about the contents of the plans. Service users consider that they receive all the assistance they need. Care workers assist service users in a manner consistent with that described in the individual service user plans. Service users say or indicate that care workers assist them to maintain their health. There is evidence which shows that service users’ doctors are called promptly when there is a concern about someone’s health. The Commission Ladesfield H56-H05 S37645 Ladesfield V226215 140705 Stage 4.doc Version 1.30 Page 11 has not received any expressions of concern from members of the primary health care team about their working relationships with the Home. Service users say that they would be free to manage their own medication if this were their wish. At the time of the present inspection visit, none of then had chosen to act in this capacity. The Home operates suitable arrangements with respect to the storage and administration of service users’ medication. Service users say that care workers are both cordial in their manner towards them, while at the same time being respectful of their individual preferences. The Inspector noted several occasions on which care workers tailored their approach according to what they know to be service users’ different expectations of them. For example, one person wanted to spend quiet time alone in one of the lounges, while another person wanted to chat and laugh with staff. Ladesfield H56-H05 S37645 Ladesfield V226215 140705 Stage 4.doc Version 1.30 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14 and 15. Service users have access to a suitably varied range of social activities. Service users are assisted to maintain normal contacts with family and friends. Service users are enabled to exercise suitable choice in their everyday lives. Service users are offered a suitably healthy diet. EVIDENCE: Various social activities are convened in the Home. Service users consider themselves to be occupied suitably. Service users say that they are assisted to maintain contacts with members of their families and with friends who do not live in the Home. The Inspector has not received any expressions of concern about this matter from members of service users’ families. Service users say or indicate that the pace of daily life in the Home is relaxed and unhurried. There is evidence of service users exercising choice. This includes the fact that some elect to retire to the privacy of their bedroom rather than use one of the lounges. Ladesfield H56-H05 S37645 Ladesfield V226215 140705 Stage 4.doc Version 1.30 Page 13 Service users say that they receive good quality meals and they always have enough to eat. The Inspector joined service users for lunch on both of the days of the inspection visit. He noted that the meals served were presented attractively and that the food was well prepared. The written menu indicates that service users are offered a normally balanced diet. Ladesfield H56-H05 S37645 Ladesfield V226215 140705 Stage 4.doc Version 1.30 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16, 17 and 18. Service users consider that their views are listened to and that as necessary they are acted upon. Service users’ citizenship rights are respected. Service users are protected from abuse, neglect and self harm. EVIDENCE: There is a complaints procedure which explains how service users and other stakeholders can make a complaint about any aspect of the facilities and services provided in the Home. Service users say or indicate that they are confident that any matter they raise will receive serious attention and if possible will be addressed. Service users’ citizenship rights are protected. For example, they are assisted to ensure that their names are entered in the Electoral Register. Also, they are assisted to cast their vote in elections, if this is their wish. Care workers have a good understanding of what constitutes good care practice. As part of this, they are aware of the need to be alert to instances which might jeopardise the well-being of a service user. Service users say or indicate that they feel safe living in Ladesfield. Ladesfield H56-H05 S37645 Ladesfield V226215 140705 Stage 4.doc Version 1.30 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 standard(s) 19, 20, 21, 22, 23, 24, 25 and 26. Service users are provided with a generally satisfactory environment. However, there are a number of obvious defects. There is an adequate provision of shared use facilities. Service users’ bedrooms are suitably equipped and have been personalised by their occupants. Service users live in safe and comfortable surroundings. The accommodation is presented to a normal domestic standard of cleanliness. EVIDENCE: Service users say or indicate that they are comfortable living in Ladesfield. They consider the accommodation to be homely and welcoming. Areas of the exterior of the premises have been allowed to deteriorate to a very poor condition indeed. To the front of the building, a number of the wooden window frames have chipped and discoloured paintwork, or in places have simply rotted away. Also in this area and along both sides of the building, the bargeboards near to the gutters have either defective paintwork or again Ladesfield H56-H05 S37645 Ladesfield V226215 140705 Stage 4.doc Version 1.30 Page 16 have rotted away. Even the sign at the boundary of the Home, has missing letters on it and has discoloured paintwork. All of these defects make the building look run down. They create an introduction to the Home which is inappropriate and disrespectful to the service users in residence. It is inexplicable that an otherwise responsible Registered Provider should be prepared to tolerate this extraordinary situation. Once again, the Inspector invites the Registered Provider to reflect upon the sustainability of its performance in relation to this matter. The Inspector has identified that the window in what used to be the smokers’ lounge has a defective mechanism. This makes it unwieldy to open. This defect should be corrected within the time scale established in the relevant Required Development at the end of this Report. There is an adequate provision of shared use facilities such as lounges, bathrooms and toilets. Service users say or indicate that they have all the facilities they need in their bedrooms in order to make them into the bed-sitting areas envisaged by the Standards. Also, they say that staff have encouraged them to make them into their own private spaces. The Inspector saw evidence of this when he visited several bedrooms. He noted that some service users had elected to bring small items of their own furniture with them and that all had chosen to display various personal ornaments. The Acting Manager said that the accommodation provided for service users is free from any obvious hazards to their health and safety. The Inspector did not notice any such hazards during his examination of the building. Service users say or indicate that the accommodation is kept clean and orderly without being fussy. The Inspector’s assessment was consistent with this view. The Acting Manager said that the kitchen continues to comply with the principal requirements of the local Department of Environmental Health. Ladesfield H56-H05 S37645 Ladesfield V226215 140705 Stage 4.doc Version 1.30 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28, 29 and 30. There is an adequate number of staff on duty to ensure service users’ needs for assistance are met. Care workers have the competencies they need and their practice is monitored. Appropriate steps are taken to ensure that only suitable people work in the Home. EVIDENCE: The staff roster indicates that there are at least three care workers on duty from early in the morning until the mid evening period. At this point, the two waking night care workers come on duty. During the day, there are also other people on duty who do most of the catering or most of the housework. Nearly all of the staff posts in the Home are filled. There are various arrangements in place which are designed to ensure that care workers coordinate their activities. These include handover meetings at the beginning and end of each shift. Also, diary records are completed so that each service user’s changing needs can be identified and met. Service users say or indicate that they receive all the assistance they need from care workers and that this is provided in a timely manner. The Inspector observed instances when a service user operated the call bell. He noted that a care worker was quickly in attendance. Care workers consider the Home to be adequately staffed. Ladesfield H56-H05 S37645 Ladesfield V226215 140705 Stage 4.doc Version 1.30 Page 18 The Inspector observed care workers when they were assisting the service users. He noted this help to be delivered in an appropriate manner, with the care workers being kind and considerate in their approach. The Registered Provider ensures that all new care workers receive introductory training. This is designed to ensure that they have the competencies necessary to enable them to support service users effectively. In addition to this, existing care workers undertake a number of training courses which are designed to enhance their capacity to deliver care. The Acting Manager is going to complement this system by assessing the core competencies of all the care workers currently in post. This will be done by using an appraisal form which has been developed from a model that has been adopted by the Standards. The Acting Manager will complete this exercise by 1 July 2006. There are 23 care workers employed in the Home. Nine of them have acquired a National Vocational Qualification (NVQ) in the delivery of personal care. The Registered Provider completes a number of security-related checks. These are designed to ensure that all members of staff employed in the Home are suitable to be entrusted with access to service users who may be vulnerable. Ladesfield H56-H05 S37645 Ladesfield V226215 140705 Stage 4.doc Version 1.30 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33, 34 35, 36, 37 and 38. There is a suitable management system in place to support the delivery of care and accommodation services in the Home. Service users’ preferences and wishes are reflected in the day to day operation of the Home. Service users’ financial interests are safeguarded. The work completed by members of staff is suitably supervised by senior staff. Service users’ best interests are safeguarded by the way in which policies and procedures are used in the Home. There is an omission in one aspect of the arrangements used to ensure the health, safety and welfare of service users. EVIDENCE: The Acting Manager has only been in her post for a week or so. Consequently, the Inspector cannot reach an informed judgement about the adequacy of the regime she will use to supervise the administration of the Home. However, he Ladesfield H56-H05 S37645 Ladesfield V226215 140705 Stage 4.doc Version 1.30 Page 20 can note that she has considerable experience of the provision and the management of residential care services. Also, that she has acquired one of the two formal qualifications which the Standards specify for her role and that she intends to acquire the other Award within the prescribed timescale. There is an established senior management team in the Home. This comprises the Deputy Manager and three Team Leaders. All of these people have a detailed knowledge both of the people in residence and of the systems used to operate the Home. There is always someone senior on the premises. Regular staff meetings are convened in the Home to help ensure that good team working is promoted. Staff say that Ladesfield in general is a happy place in which to work and they consider that this is noticed by the service users. Some of the service users told the Inspector that they have indeed noticed this and that they find it be reassuring to know that staff get on well together. Service users say or indicate that the Home is run without there being any intrusive rules or routines. This means that they can continue to experience a normal home life of their choosing. The Registered Provider operates a system by means of which service users are invited to comment about their Home. The Acting Manager is going to develop this arrangement further. This will be done by her preparing an annual Quality Report. This will summarise the feedback which has been received from service users. Also, it will explain how and when their suggested improvements will be actioned. The first such Report will be available by 1 July 2006. Some of the service users have asked the Acting Manager to assist them with managing their personal spending monies. There are suitable arrangements in place in relation to this matter, including a record of all the various transactions involved. Each person who works in the Home reports to a senior member of staff. This means that their work is monitored in order to ensure that it meets service users’ needs and that it contributes to the orderly running of the Home. The Registered Provider maintains various records in the Home, including those required by the Regulations. Most of these documents are in place to help to ensure that service users receive reliable and consistent assistance. The Inspector noted a number of examples of care workers organising their work in accordance with a selection of these documents. The Acting Manager said that all items of equipment in use in the Home remain in good working order. The Inspector sample checked the service documents for the Home’s gas appliances and he found the engineer’s report to be satisfactory. Ladesfield H56-H05 S37645 Ladesfield V226215 140705 Stage 4.doc Version 1.30 Page 21 The Acting Manager says that the premises continue to comply with the principal requirements of the Kent Fire Service. There is a pattern of omissions in what should be the programme of periodic checks to ensure that all members of staff remain conversant with how best to prevent the occurrence of a fire safety emergency and with how to respond effectively to one should the need arise. The Acting Manager needs to address this important oversight within the timescale established in the Required Development at the end of this Report. Ladesfield H56-H05 S37645 Ladesfield V226215 140705 Stage 4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 3 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 1 3 3 3 3 3 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 Standard No 16 17 18 Score 3 3 3 x 3 2 3 3 3 3 2 Ladesfield H56-H05 S37645 Ladesfield V226215 140705 Stage 4.doc Version 1.30 Page 23 No Are there any outstanding requirements from the last inspection? 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 19 Regulation 23 Requirement Timescale for action 01.10.05 2. 38 13 The Registered Provider should repair the defective mechanism by which the window in the former smoking lounge is opened and closed. 01.09.05. The Registered Provider should ensure that all members of staff are included within a suitably specified programme of fire safety competency confirmation. This should verify that all members of staff are aware of how best to avoid the occurrence of a fire safety emergency and how to respond effectively to one should the need arise. 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 None Good Practice Recommendations Ladesfield H56-H05 S37645 Ladesfield V226215 140705 Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection Address 1 Address 2 Address 3 Address 4 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 Ladesfield H56-H05 S37645 Ladesfield V226215 140705 Stage 4.doc Version 1.30 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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