Inspection on 01/12/05 for Ladyfield House

This inspection was carried out on 1st December 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Ladyfield House 31/10/06

Ladyfield House 23/04/06

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

CARE HOMES FOR OLDER PEOPLE Ladyfield House Nursing Home Pack Mill View, Ladyfield Road Kiveton Park Sheffield South Yorkshire S26 6NR Lead Inspector Janet McBride Unannounced Inspection 09:50 1 December 2005 st 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 Ladyfield House Nursing Home DS0000065777.V281050.R01.S.doc Version 5.0 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. Ladyfield House Nursing Home DS0000065777.V281050.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Ladyfield House Nursing Home Address Pack Mill View, Ladyfield Road Kiveton Park Sheffield South Yorkshire S26 6NR 01909 771571 01909 773989 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) Ridgmont Care Homes Limited Post Vacant Care Home 50 Category(ies) of Dementia - over 65 years of age (24), Old age, registration, with number not falling within any other category (26), of places Physical disability over 65 years of age (26) Ladyfield House Nursing Home DS0000065777.V281050.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The home may accommodate 26 service users on the Salvin Wing in the category of (OP) or (PD(E)). The home may accommodate 24 service users on the Hewitt Wing in the category of (DE(E)). To allow one named service user to remain in the EMI unit in the category of (OP) nursing. 7th June 2005 Date of last inspection Brief Description of the Service: Ladyfield Nursing home offering service users residential or nursing care, and can accommodate fifty residents. The home was purpose built in 1993, and is situated in the Kiveton area of Rotherham, the home has two units; Salvin wing provides nursing and residential care, and Hewitt wing provides residential EMI care. Accommodation is provided in forty-six single rooms and two double rooms, with each unit having its own lounge and dining areas. The home has a garden with a patio area at the rear of the home, which is enclosed for the safety of EMI residents to be able to wander around the garden should they wish. Car parking spaces are available at the front of the home. Ladyfield House Nursing Home DS0000065777.V281050.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. One Inspector from the Commission for Social Care Inspection carried out this unannounced inspection at Ladyfield Nursing Home, on the 1st of December 2005, commencing at 09:50 and finished at 15:40,this was the homes second Inspection since April 2005,any standards not covered in this inspection were covered in the unannounced inspection that was conducted early in the year. It may be the case that some standards will be covered twice in the inspection year 2005/2006, which is considered good practice, and consistent with a professional approach to regulation. During the Inspection we looked at chosen number of documents, sampling of records, tour of the premises and direct and indirect observation of staff interaction with residents, this Inspection also included individual and group discussions with staff, residents, and feedback from visitors on the day. Any issues or concerns that were raised were discussed with the Manager during and at the end of the Inspection. What the service does well: What has improved since the last inspection? General appearance of the home has improved with some decoration, but fabric of the home remains outstanding with regard to environmental standards, although this does not pose any risks to residents, it does not create a pleasant and homely environment to live in. Ladyfield House Nursing Home DS0000065777.V281050.R01.S.doc Version 5.0 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. Ladyfield House Nursing Home DS0000065777.V281050.R01.S.doc Version 5.0 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 Ladyfield House Nursing Home DS0000065777.V281050.R01.S.doc Version 5.0 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): 126 Residents and prospective service users do not have up to date information regarding the registered provider, or have up to date contracts/statement of terms and conditions with the home. EVIDENCE: The home does have a statement of purpose, however this requires updating to state the correct registered provider. All service users did have contracts or statement of terms and conditions with the home, some of these were still with Ridgemont and others with Ashbourne, this issue requires addressing. This was evident when talking to visitors and residents on the day that some issues were raised regarding the change of providers had caused some confusion with some people. Ladyfield House Nursing Home DS0000065777.V281050.R01.S.doc Version 5.0 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 Arrangements for dealing with resident’s health issues are adequately met by staff at the home, with support from health professionals, and care planning systems are sufficiently detailed to enable staff to deliver the care to residents who have specific identified needs and promoting good health. EVIDENCE: Care plans were case tracked on the last inspection, therefore only discussed with the manager on this visit. Care plans have been changed to the Ashbourne format and the manager has carried out audits on the care plans, although some issues were raised they have been addressed and the manager feels that they are improving. Accident records were examined and records show that staff complete appropriate documentation, these reports are also analysed by the manager on a monthly basis. Medication policies and procedures were discussed with members of staff on both units, qualified nurses have responsibility for administering medications Ladyfield House Nursing Home DS0000065777.V281050.R01.S.doc Version 5.0 Page 10 on the nursing and residential unit, and senior care staff administer medicines to the residents on the EMI unit. An audit of medication stocks and records was examined and were found to be correct with two issues being raised; large quantity of medication for one resident, and staff who administer medication on the EMI unit must complete accredited training. Records examined and discussion with the staff confirmed resident’s healthcare needs are met. The qualified nurses are able to carry out nursing requirements for those residents who fall into the nursing category. District nurses also attend the home to carry out injections, take bloods and attend to dressing for residents who are residential. There were many examples of good practise observed on the day, good interactions between staff, residents and the visiting relatives. Most residents were referred to by their first name and this was with the approval of residents and would be recorded in their care plan. Residents spoken to confirmed they were happy with care they received, and the staff at the home. Ladyfield House Nursing Home DS0000065777.V281050.R01.S.doc Version 5.0 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 Dietary needs of residents are well catered for with a balanced and varied selection of food available that meets resident’s tastes and choices. Social interaction on the day provided stimulation and interest for those residents that took part. EVIDENCE: A number of residents were spoken to and everyone who commented on the food said they looked forward to meal times and they liked the choices offered. Menus offered a balanced and varied diet, when the cook was interviewed she confirmed that food and drinks always available for residents, all residents have nutritional assessment completed and dietician is used when needed. Observation at mealtime was unhurried and residents that need assistance, staff ensured this was given individually. The home has recently appointed an activities organiser but she’s not in post yet, however some staff members were arranging activities on the day; one was doing a quiz that provided a lot of stimulation and laughter for those taking part. Another resident said that they did not want to be involved in any social activities and only enjoyed watching sky TV. Ladyfield House Nursing Home DS0000065777.V281050.R01.S.doc Version 5.0 Page 12 Observation saw visitors in and out of the home most of the day, when they were spoken to confirm they could visit at any time, and could see their relative in either the lounge areas or the resident’s own bedroom. Some families have been involved in care planning whenever possible, and have been asked about the residents interests and likes and dislikes. Some visitors have raised concerns about the being taken over by different company yet again in a short space of time. Staff was indirectly observed throughout the Inspection, good interactions between staff and residents and the visiting relatives, staff encouraged residents to make choices whenever possible. Tour of bedrooms found that most had been made very homely and residents had some personal possessions in their rooms. Ladyfield House Nursing Home DS0000065777.V281050.R01.S.doc Version 5.0 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 Residents and relatives are provided with information to enable them to raise concerns or complaints about the home and their care. Staff had knowledge and understanding of adult protection issues, which promotes protection of residents from abuse. EVIDENCE: Ashbourne complaints policy and procedure is clear and accessible to all residents and visitors. The home had nine complaints since the last Inspection, these were discussed with the manager and records examined. Records show that all have been fully investigated and if upheld what action had been taken, with feedback to the complainant. One remains outstanding, this is still under investigation, and the company are ensuring that the Commission for Social Care Inspection is kept informed of any progress. The home has policies and procedures for adult protection; manager aware of local adult protection team and staff spoken to confirm they are aware of these polices and procedures, but have not received any formal training. Ladyfield House Nursing Home DS0000065777.V281050.R01.S.doc Version 5.0 Page 14 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 24 26 General appearance of the home has improved with some decoration, but fabric of the home remains outstanding with regard to environmental standards, although this does not pose any risks to residents, it does not create a pleasant and homely environment to live in. EVIDENCE: General appearance of the home has improved; some decorations throughout the home and carpets in the corridors have been replaced. Fabric of the home requires attention for example; chairs in the lounge are showing signs of wear and tear and in need of replacing, they all are the same size and some not suitable for the client group, residents didn’t have any were to put drinks when sat in the lounge, they need small tables to be able to have drinks near to hand. Communal space is available on each of the units, which includes various lounge and dining areas, safe outdoor garden area for EMI residents. One issue that was discussed was the lighting in the home is very poor in some areas, e.g. lounge, corridors and some bedrooms. Ladyfield House Nursing Home DS0000065777.V281050.R01.S.doc Version 5.0 Page 15 Random bedrooms seen on both units, these were homely and personalised, most of the beds are old metal type and are being replaced. Some issues were raised e.g. carpets worn and stained and need replacing, curtains and bedcovers don’t match. Locks on bedroom doors in the EMI unit; the home must ensure the safety of residents with regards to lock on bedroom doors, these must suit resident’s capabilities and accessible to staff in emergencies, this discussed with the manager, who is addressing this situation immediately. Issues regarding laundry facilities remain the same (requirement made on the last inspection not addressed) they have two washing machines (one small type) and only one dryer, which in the past has been sufficient, but due to the type of service users and the increase in occupancy this has put a strain on laundry services and needs to be re-assessed. Ladyfield House Nursing Home DS0000065777.V281050.R01.S.doc Version 5.0 Page 16 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 30 Staff seen on the day very enthusiastic and are working positively to meet residents care needs and improve their quality of life, but the registered provider must provide appropriate training to ensure that residents needs are met. EVIDENCE: Staffing and skill mix was discussed with the manager and duty rota checked, which shows that staffs are on duty at appropriate times. The homes manager who is totally responsible for the running of the home, and as introduced a new staffing structure in place, which appears to be appropriate and shows capacity of staff role. The home also has a care manager; housekeeper, handyman administrator and activities person will be in post soon. Training was discussed with the manager, staff and training records checked. Staff can access NVQ training and out of the 31 care staff six staff has already completed NVQ 2, and seven other members of staff have commenced on their training. New staff receives two-day induction to the home, but no evidence was found that staff receive foundation training that equips staff to meet the needs of residents. Other training needs were identified staff require training in dementia, abuse and first aid. Ladyfield House Nursing Home DS0000065777.V281050.R01.S.doc Version 5.0 Page 17 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 36 38 The home is managed to ensure leadership, guidance and direction to staff to ensure residents receive consistent quality care. This results in the health, safety and welfare of residents and staff being promoted and protected. EVIDENCE: The homes registered manager who is new in post, but as been approved by the Commission for Social Care Inspection. She demonstrated that she his qualified and competent to run the home, aware of her responsibilities and aims to run the home in the best interest of service users. Since being in post she’s made herself available to residents, staff and visitors to listen to any issues or concerns and try and address them. Supervision and appraisal of staff was discussed with manager and staff that were interviewed. Ladyfield House Nursing Home DS0000065777.V281050.R01.S.doc Version 5.0 Page 18 Although staff are supervised as part of the normal management process, records show that formal supervision, as not been done on a regular basis, and that most staff require their yearly appraisal. This practice as not been completed because of change of manager and registered provider. Safe working practice was discussed briefly with the manager, as this standard was fully assessed on the last Inspection and met, however observation of safe working practice was seen during the inspection e.g. staff using wheelchairs and hoists with residents and found satisfactory. Ladyfield House Nursing Home DS0000065777.V281050.R01.S.doc Version 5.0 Page 19 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 2 2 X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 X 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 2 2 X X X 2 X 2 STAFFING Standard No Score 27 3 28 2 29 X 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X X 2 X 3 Ladyfield House Nursing Home DS0000065777.V281050.R01.S.doc Version 5.0 Page 20 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 OP1 Regulation 6(a) Scheduale 1 6(a) Requirement The Registered Person must update the statement of purpose and service users guide. The Registered Person must update the contracts/statement of terms and conditions for service users. Medication; 1) Care staff must complete an accredited medicines course. 2) Service users who self medicate must be risk assessed and have care plan in place. 3) Stocks of medication should be checked and rotated. Protection procedures; The Registered person must ensure that staff has training in abuse policy and procedures to prevent service users being placed at risk. Timescale for action 01/01/06 2 OP2 01/01/06 3 OP9 13 31/03/06 4 OP9 13 01/01/06 5 OP18 13(6) 31/03/06 Ladyfield House Nursing Home DS0000065777.V281050.R01.S.doc Version 5.0 Page 21 6 OP19 23(2)(b)( o) 7 OP20 23(2)(b) 8 OP24 23 Communal Areas, 1) Replace lounge chairs that are suitable for client group. 2) Purchase small tables for residents use in lounges. Communal Areas, lighting is very poor in some areas and needs assessing to ensure it is suitable for client group. The home must ensure the safety of residents with regards to lock on bedroom doors, these must suit resident’s capabilities and accessible to staff in emergencies. Bedrooms; 1) Identified carpets must be replaced. 2) Some curtains and bedspreads require replacing. Laundry facilities must meet service users needs. (Timescale of 1st August 2005 not met.) Training; 1) New staff must receive foundation training to NTO specification to equip them to meet service users needs. 2) A number of staff requires training in, Dementia and First aid. All staff must receive appropriate training to the work they perform. The registered person ensures that the supervision and Appraisals arrangements are put into practice. (Timescale of 1st August 2005 not met) 31/03/06 31/03/06 01/01/06 9 OP24 23 31/03/06 10 11 OP26 OP30 16(2)(e) 18(1)(c) 01/01/06 31/03/06 12 OP36 18(2) 01/02/06 Ladyfield House Nursing Home DS0000065777.V281050.R01.S.doc Version 5.0 Page 22 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 OP28 Good Practice Recommendations A minimum ratio of 50 trained members of care staff (NVQ Level 2 or equivalent) is achieved by 31st December 2005, excluding the registered manager and/or care manager, and in care homes providing nursing, excluding those members of care staff who are registered nurses. Ladyfield House Nursing Home DS0000065777.V281050.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Doncaster Area Office 1st Floor, Barclay Court Heavens Walk Doncaster Carr Doncaster DN4 5HZ 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. 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