Inspection on 06/01/06 for Ladesfield

This inspection was carried out on 6th January 2006.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Ladesfield 18/02/09

Ladesfield 25/03/08

Ladesfield 27/07/07

Ladesfield 18/07/06

Ladesfield 14/07/05

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 Borstal Hill Whitstable Kent CT5 4LZ Lead Inspector Mark Hemmings Unannounced Inspection 6th January 2006 09:30 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 Ladesfield DS0000037645.V264005.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. Ladesfield DS0000037645.V264005.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Ladesfield Address Vulcan Close Borstal Hill Whitstable Kent CT5 4LZ 01227 261090 01227 266201 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) Kent County Council Vacant Care Home 25 Category(ies) of Old age, not falling within any other category registration, with number (25) of places Ladesfield DS0000037645.V264005.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 14th July 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 currently is 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). The day to day operation of the Home is supervised by the Acting Manager, the Deputy Manager and by a number of Team Leaders. Ladesfield DS0000037645.V264005.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection visit was unannounced and it took about three hours to complete. During this time, the Inspector spoke with or spent time with five service users. He spoke with the Acting Manager, with the Deputy Manager and with two of the Team Leaders. Also, he spoke with one of the care workers and with two of the housekeepers. The Inspector examined various documents and a selection of records. In addition to this, he looked at various parts of the accommodation. This included (by invitation) three of the service users’ bedrooms. The Home continues to provide the service users in residence with the support and assistance they need within a comfortable setting. There is one Required Development at the end of this Inspection Report. The Inspector did not examine all of the Standards on this occasion. Consequently, the reader is asked to read this Inspection Report in conjunction with the previous Inspection Report. This will enable the reader to obtain a more comprehensive account of the Inspector’s current evaluation of the facilities and services available in Ladesfield. What the service does well: The Home provides service users with a relaxed and comfortable setting within which to make their home. The assistance each service user receives is provided in consultation with them and takes place within a prudent assessment of potential risks to health and safety. The Home’s catering service provides the service users with meals which they consider to be enjoyable and sufficient. Ladesfield DS0000037645.V264005.R01.S.doc Version 5.1 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. Ladesfield DS0000037645.V264005.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 Ladesfield DS0000037645.V264005.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4 and 5. 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. 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 Deputy Manager and the Team Leaders speak with prospective service users in order to answer any remaining questions they may have. Ladesfield DS0000037645.V264005.R01.S.doc Version 5.1 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 it is clearly laid out. The Inspector understands that all new service users and their representatives continue to be given an opportunity to talk through the document with a senior member of staff. This is done so that any necessary clarification can be given. On this occasion, the Inspector did not speak with any service users about their experiences of moving into Ladesfield. However when he last did so, they said that they were confident at the point of admission to the Home, that their individual needs for support could be met reliably and consistently. The Registered Provider is aware of the responsibility placed upon it to ensure that only people whose needs for assistance can be met reliably, are admitted to the Home. Ladesfield DS0000037645.V264005.R01.S.doc Version 5.1 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 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. Suitable arrangements are in place with respect to the administration of service users’ medication. Service users consider that members of staff are respectful and that they appreciate their needs for privacy. EVIDENCE: There is a service user plan for each service user. These documents should reflect a clear understanding between service users and care workers about the personal care support to be provided. The Inspector sample checked aspects of one of the documents in this system. He found it to be suitably detailed. The Acting Manager said that the Registered Provider intends to introduce a new way of presenting information held in the service user planning system. This is being done to make it more accessible to everyone concerned, including of course the service users concerned. Ladesfield DS0000037645.V264005.R01.S.doc Version 5.1 Page 11 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. The Inspector observed examples of care workers assisting service users in a manner consistent with that described in the Registered Provider’s assessment of their individual needs. 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 Inspector noted there to be suitable arrangements in place to support any service user who might wish to administer their own medication. Also noted, were the appropriate systems used by the Registered Provider to administer and to dispense the other service users’ medicines. Service users say or indicate that care workers are 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 varied their approach according to what they know to be service users’ different expectations of them. For example, some people wanted to rest quietly in their bedroom, while others wanted to be up and about in the various lounges. Ladesfield DS0000037645.V264005.R01.S.doc Version 5.1 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 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. The small number of service users who commented upon the matter, said that they are occupied suitably. Previously, service users have said 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. For Ladesfield DS0000037645.V264005.R01.S.doc Version 5.1 Page 13 example, people observed that they decide for themselves when to get up and when to go to bed and how to spend their day. Service users say that they receive good quality meals and they always have enough to eat. On this occasion, the Inspector did not have the opportunity to join service users for a meal. However when he last did so, he noted the food to have been well prepared and that the portions were of an adequate size. Also noted previously, was the written menu which indicated that service users are offered a normally balanced diet. Ladesfield DS0000037645.V264005.R01.S.doc Version 5.1 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Service users consider that their views are listened to and that as necessary they are acted upon. Arrangements are in place which are designed to protect service users 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. The care workers have a sound 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. Also, they are aware of the various agencies external to the Home to which reference can be made should they become concerned about a service user’s wellbeing. Service users say or indicate that they feel safe living in Ladesfield. Ladesfield DS0000037645.V264005.R01.S.doc Version 5.1 Page 15 Ladesfield DS0000037645.V264005.R01.S.doc Version 5.1 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following 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. There is an adequate provision of special equipment to support those service users who experience a measure of reduced mobility. 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 Ladesfield DS0000037645.V264005.R01.S.doc Version 5.1 Page 17 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 have rotted away. In one place the gutter has become so blocked with weeds and grass, that the additional weight has bent the normal guttering profile. 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 and possibly dangerous to open. This defect should have been corrected by now but the Inspector noted it to still be in place. The Registered Provider must now address this matter within the revised timescale specified in the relevant Required Development listed at the end of this Report. Failure to now action this matter will result in the Commission considering what further formal action needs to be instituted in order to secure the Registered Provider’s compliance. There is an adequate provision of shared use facilities such as lounges, bathrooms and toilets. There are various items of equipment in the Home to assist those service users who experience a measure of reduced mobility. These include a passenger lift which gives step free access between the floors. Also, there are hoists in the bathrooms to help people use bathing facilities in safety and comfort. 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. When the Inspector was present in the Home the accommodation was pleasantly warm. Service users said that this always is the case. The Inspector noted there to be an adequate supply of hot water. Again, service users confirmed this to be the normal state of affairs. The Inspector understands that the Registered Provider has continued to take effective precautions against someone being accidentally burnt or scalded. Ladesfield DS0000037645.V264005.R01.S.doc Version 5.1 Page 18 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 Deputy Manager said that the kitchen continues to comply with the principal requirements of the local Department of Environmental Health. Ladesfield DS0000037645.V264005.R01.S.doc Version 5.1 Page 19 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 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 five 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. The Home has an extended complement of staff at the moment. This is due to the relocation of a number of personnel from another of the Registered Provider’s establishments which recently has been closed. 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 which are organised either by the Deputy Manager or by one of the Team Leaders. Also, diary records are completed so that each service user’s changing needs can be identified and met. Ladesfield DS0000037645.V264005.R01.S.doc Version 5.1 Page 20 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 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 is responsible for ensuring that all of the care workers have the skills and knowledge required in order to provide an effective and reliable response to service users’ needs for assistance. For example, this means that everyone should know how best to support a service user who has an unstable gait, or who needs help in the bathroom. Previously, the Inspector has established that the Registered Provider is aware of its responsibility with respect to this matter and that arrangements are in place to ensure that all new care workers receive introductory training. In addition to this, existing care workers undertake a number of training courses which are designed to enhance their capacity to deliver care. The Inspector understands that at least half of the care workers have acquired a National Vocational Qualification (NVQ) in the delivery of personal care. The course leading to the achievement of this Award, is designed to further consolidate the competencies required by care workers when assisting older people. 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 DS0000037645.V264005.R01.S.doc Version 5.1 Page 21 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, 32, 33, 36 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. The work completed by members of staff is suitably supervised by senior staff. Suitable arrangements are in place to promote the health and safety of service users and members of staff. EVIDENCE: The Acting Manager has only been in her post for a few weeks or so. Consequently, the Inspector cannot reach an informed judgement about the adequacy of the regime she will use to supervise the administration of Ladesfield DS0000037645.V264005.R01.S.doc Version 5.1 Page 22 Ladesfield. However, he can note that she has considerable experience of the provision and the management of residential care services. Also, that she has acquired the two formal qualifications which the Standards specify for her role. There is an established senior management team in the Home. As noted already, this comprises the Deputy Manager and various 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. Several service users confirmed this account. 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. Previously, the Inspector has identified the need for this arrangement to be developed further. This is to be done by the preparation of 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 is due to be made available by 1 July 2006. 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 Deputy Manager said that all items of equipment in use in the Home remain in good working order and that they have been serviced in accordance with the manufacturers’ instructions. The Inspector understands that the premises continue to comply with the principal requirements of the Kent Fire Service. The Deputy Manager said that the premises are routinely inspected so that potential hazards to health and safety can be identified and resolved. She said that no such problems have been identified in the recent past. The Inspector did not notice any obvious hazards when he examined selected areas of the accommodation. Ladesfield DS0000037645.V264005.R01.S.doc Version 5.1 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 3 3 X 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 Standard No Score 16 3 17 X 18 3 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 X 3 3 X X 3 X 3 Ladesfield DS0000037645.V264005.R01.S.doc Version 5.1 Page 24 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 19 Regulation 23 Requirement The Registered Provider should repair the defective mechanism by which the window in the former smoking lounge is opened and closed (the timescale specified previously in relation to this matter was 01/10/05). Timescale for action 01/04/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Ladesfield DS0000037645.V264005.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Kent and Medway Area Office 11th Floor International House Dover Place Ashford Kent TN23 1HU 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 DS0000037645.V264005.R01.S.doc Version 5.1 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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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