Inspection on 23/04/06 for Ladyfield House

This inspection was carried out on 23rd April 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 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

Ladyfield House 31/10/06

Ladyfield House 01/12/05

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Larchfield Manor

Hawkhills

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The Grove Waltham

Carentan House

Ravensworth Lodge

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

CARE HOMES FOR OLDER PEOPLE Ladyfield House Pack Mill View, Ladyfield Road Kiveton Park Sheffield South Yorkshire S26 6NR Lead Inspector Ms Rosemary Reid Key Unannounced Inspection 23rd April 2006 14:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Ladyfield House DS0000065777.V288975.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. Ladyfield House DS0000065777.V288975.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Ladyfield House Address Pack Mill View, Ladyfield Road Kiveton Park Sheffield South Yorkshire S26 6NR 0207 9293444 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) Ashbourne (Eton) 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 DS0000065777.V288975.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 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 DE(E) 01/12/05 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 residents who have dementia to be able to wander around the garden should they wish. Car parking spaces are available at the front of the home. Fees range from Nursing Care £344 - £430, Dementia Care £370 - £385, Residential Care £ 329 – £375 per week, as at 1st April 2005 and additional charges are made for hairdressing from £5:00, Chiropody from £9:50, Optical, Dental services, specialised toiletries, and magazines etc. The registered person makes information about the service available to residents and their families via the home’s Statement of Purpose and the Service User Guide, which are in each bedroom. The home is not on a direct bus service route and a distance from the main road. Ladyfield House DS0000065777.V288975.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced key inspection took place on the 23rd April from 2:00pm to 5:30pm and on the 24th April from 7:30am to 12:45 to speak with the appointed manager Mrs Angela Turner. The inspection focused on the requirements from the previous inspection of 1st December 2005, four residents’ files were case tracked along with key standards of the National Minimum Standards for Older People and four staff records were also assessed. The newly appointed manager Mrs Angela Turner has been in post for approximately six weeks. Action had been taken on all the requirement from the previous inspection. Four residents files (two files from Salvin and two files from Hewitt unit) were cased tracked. Each file examined had assessments, pressure care, care plan, monthly reviews and up to date information in the daily recording. Supporting documents were also seen for example unit diaries, medication records, staff files. The home has an activities organiser and there are a variety of events and activities in and out of the home. Four service users were spoken with on the Salvin unit and on the Hewitt unit (unit for people with dementia) residents and staff were spoken with but mainly observed. Feedback of the inspection was given to the manager and arrangements were made to attend a relative meeting on the 25th May 2006 at 18:00. What the service does well: Residents who were spoken with said that they liked the staff and the improvements that were taking place within the home, food was discussed and they stated that it was good, dietary needs of residents seem well catered for with a balanced and varied selection of food available that meets resident’s tastes and choices. The manager and staff that were observed were enthusiastic and talked positively of improving the quality of life for residents within the home. Ladyfield House DS0000065777.V288975.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. Ladyfield House DS0000065777.V288975.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 Ladyfield House DS0000065777.V288975.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): 1,2,3,4,5 Quality in this outcome area is adequate, and this judgement has been made using the evidence available. Service users and prospective service users do have up to date information regarding the registered provider. New service users have up to date contract/statement of terms and conditions with the home. However, the new company have not yet issued contracts/terms and conditions of residency to existing service users. EVIDENCE: The home has a Statement of Purpose, which has up to date information and is available in the office and in each bedroom of all service users to read. In discussions with service users, family and staff confirm that the Service User Guide is given to prospective service users and/or relatives and observed in the bedrooms. The four service users’ files that were case tracked had copies of contract/statement of terms and conditions of their residency and delivery of care. Ladyfield House DS0000065777.V288975.R01.S.doc Version 5.1 Page 9 As a result of the recent take over of Ashbourne by Southern Cross not all service users had contracts/terms and conditions of Southern Cross. Preadmission assessment is undertaken and this was recorded within the individual service user’s care file to ensure that the home can meet their needs. Records show and in discussions with service users and families confirmed that the home welcome visits before admission to assess the quality, facilities and suitability of the home. The home does not offer intermediate care. As new service users are admitted they are issued with contracts/statement of terms and conditions from Southern Cross. The next stage is that all existing service users need to be issued with up to date contracts/statement of terms and conditions of residency. Ladyfield House DS0000065777.V288975.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): 7,8,9,10,11 Quality in this outcome area is good, and this judgement has been made using the evidence available. 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 two inspections and four care plans were examined. Care plans have been changed to the Ashbourne format and the previous manager carried out audits on the care plans. Southern Cross has given 12 weeks to the senior staff to change the care plans over to their care plan format. Two files had been changed at the time of inspection. Accident records were examined and records show that staff complete appropriate documentation, these reports are also analysed by the manager on a monthly basis. Ladyfield House DS0000065777.V288975.R01.S.doc Version 5.1 Page 11 Since the previous inspection each unit manager order medication separately to ensure that minimum supplies are ordered. Medication policies and procedures were discussed with members of staff on both units, qualified nurses have responsibility for administering medications on the nursing and residential unit, and senior care staff administer medicines to the residents on the EMI unit. Senior staff are to attend an accredited training course on the administration of medication and have completed application forms. An audit of medication stocks and records was examined and were found to be correct. 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. Although improvements have taken place storage was poor for one resident who self administrates and action needs to take place to ensure safe storage of medication. 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 recorded in their care plan. The home will contact the spiritual advisor of the individual resident’s choice. Residents were seen to be treated as individuals and this was confirmed by residents along with their relatives. Ladyfield House DS0000065777.V288975.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): 12,13,14,15 Quality in this outcome area is good, and this judgement has been made using the evidence available. 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: Eight residents were spoken with 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. 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 had appointed an activities organiser and a range of activities had been undertaken for example Easter Bonnet Parade and it is planned for a number of residents to visit a garden centre to obtain plants for the gardens. Ladyfield House DS0000065777.V288975.R01.S.doc Version 5.1 Page 13 A summer fayre is planned. There were residents who used their bedrooms as bed-sitting rooms and did not want to be involved in the social activities in the home. There is a church service held in the home once a month. Service users and or relatives are asked with regard to the resident’s religious/spiritual needs as part of the admission process so that the staff can contact the local religious representative to visit. Through observation the inspector saw visitors in and out of the home during the two visits to the home. They confirmed 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 home being taken over by a different company yet again in a short space of time and the manager has tried to allay their fears. Meetings for relatives have been held and it is the intention of the manager to have these meetings on a monthly basis. 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 DS0000065777.V288975.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): 16,17,18 Quality in this outcome area is good, and this judgement has been made using the evidence available. 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 and training, has taken place on this matter. EVIDENCE: The home’s complaints policy and procedure is clear and accessible to all residents and visitors. The home had two complaints since the previous 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. The home has policies and procedures for adult protection staff spoken with confirm they are aware of these polices and procedures and training sessions have taken place. Ladyfield House DS0000065777.V288975.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 Quality in this outcome area is adequate but the company is actively working to improve environment, and this judgement has been made using the evidence available. General appearance of the home has improved with some decoration, and the company and manager are working to improve the environment and the furnishings and fitting in the home. EVIDENCE: General appearance of the home has improved; corridors have been decorated. Six bedrooms had new carpets replaced. New armchairs and small tables had been ordered and due to be delivered in May. Improved lighting had been fitted to the corridor areas. Communal space is available on each of the units, which includes various lounge and dining areas, safe enclosed outdoor garden area for residents who have dementia. Ladyfield House DS0000065777.V288975.R01.S.doc Version 5.1 Page 16 All bedrooms were seen on both units, these were homely and personalised; most of the beds are old metal type and are being replaced over a period of time. However, sixteen of the fifty beds had no headboards. There have been improvements to the replacement of curtains and bedcovers. Locks on bedroom doors in the EMI unit suit the residents needs and are accessible to staff in emergencies. Issues regarding laundry facilities remain the same (requirement made on the last inspection not addressed). However, plans have been drawn to improve the facilities but no date for the work to commence has been given. The sluice door had a star key and chain, which were used for safety reasons. These measures must be removed and a keypad fitted. The television reception within the home is poor and action is needed to ensure a good reception to all television sets. Ladyfield House DS0000065777.V288975.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 Quality in this outcome area is good, and this judgement has been made using the evidence available. 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 have provided appropriate training to ensure that residents needs are met. EVIDENCE: The home has an appointed care manager; housekeeper, handyman administrator and activities person along with kitchen, care and domestic staff. Training was discussed with the manager; four staff and training records were assessed. Staff can access NVQ training and out of the thirty-one care staff, six staff had already completed NVQ 2, and seven other members of staff are working towards achieving the award. Seven domestic staff members are currently undertaking NVQ level 1training. New staff receives two-day induction to the home. Training courses had commence for example: ten staff had dementia training, five staff are undertaking Skills for life, eleven staff attended the adult protection training and first aid, which comply with the requirements of the previous inspection report. Ladyfield House DS0000065777.V288975.R01.S.doc Version 5.1 Page 18 Residents spoken with confirmed they were happy with care they received, and with the delivery of care by the staff at the home. All residents and/or relatives spoken with were highly satisfied with the delivery of care. They said that they enjoyed the food at the home and said, “the food is good ”, and “my mother said that she enjoys her meal”. Six visitors to the home said that they were satisfied with the care that had been given by staff. One resident said, “I have absolutely no complaints whatsoever and I don’t know what could be done better”. The visitors said that they felt confident with the manager and staff. They went on to say that they felt that all members of staff were very approachable and extremely thoughtful. All said they knew how to make a complaint and felt certain that it would be dealt with in a professional manner. Residents and relatives said that staff were kind, good at their jobs and had no complaints, only compliments. Ladyfield House DS0000065777.V288975.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): 32,33,34,35,36,37,38 Quality in this outcome area is good, and this judgement has been made using the evidence available. The company and the appointed manager are working 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 appointed manager who is new in post, but as been previously approved as a registered manager by the Commission for Social Care Inspection. She is experienced and is qualified nurse and has completed a management qualification who is aware of her responsibilities and aims to run the home in the best interest of service users. Ladyfield House DS0000065777.V288975.R01.S.doc Version 5.1 Page 20 In the six weeks she has been in post she’s made herself available to residents, staff and visitors to listen to any issues or concerns and try and address them. Relatives meetings have taken place and it is the intention of the manager to have these meetings on a monthly basis. Supervision sessions and appraisal of staff were discussed with the manager and staff that were interviewed. These have not taken place but it must be highlighted that the manager has only been in post for six weeks. The inspector arranged with the manager for a plan to be formulated by the 25th May when the inspector would attend a relatives’ meeting. The organisation has policies on equality and diversity. The appointed manager has taken action to ensure health & safety measures are undertaken and are up to date. Ladyfield House DS0000065777.V288975.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 3 2 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 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 3 18 3 2 X X X X X X 2 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 3 3 2 3 3 Ladyfield House DS0000065777.V288975.R01.S.doc Version 5.1 Page 22 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP26 Regulation 16(2)(e) Requirement The registered Person must ensure that the laundry facilities meet service users needs. (Timescale of 1st August 2005 and 01/01/06 not met.) A minimum ratio of 50 trained members of care staff (NVQ Level 2 or equivalent) is achieved excluding the registered manager and/or care manager, and in care homes providing nursing, excluding those members of care staff who are registered nurses. The registered person ensures that the supervision and Appraisals arrangements are put into practice. (Timescale of 1st August 2005 not met) Timescale for action 01/09/06 2 OP28 18(1) 01/09/06 3 OP36 18(2) 25/05/06 4 OP2 5 OP19 The Registered Person must update the contracts/statement of terms and conditions for existing service users. 16(2)(c)(d) The Registered Person must , Sch 4(10) ensure that each bed has a bedheadboard. DS0000065777.V288975.R01.S.doc 6(a) 01/06/06 01/07/06 Ladyfield House Version 5.1 Page 23 6 OP19 23(2)(k) 7 OP19 8 OP9 The Registered Person must 25/05/06 ensure the safety of service users namely that the Star key and chain to be removed from the sluice door. 16(2)(m)(n The Registered Person must take 01/06/06 ) action to ensure that television reception for service users to watch television 13(2), The Registered Person must 01/05/06 Sch3(3)(i) ensure that if mediation in a resident bedroom must be stored according to legislation. Ladyfield House DS0000065777.V288975.R01.S.doc Version 5.1 Page 24 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 Ladyfield House DS0000065777.V288975.R01.S.doc Version 5.1 Page 25 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. Extracts may not be used or reproduced without the express permission of CSCI Ladyfield House DS0000065777.V288975.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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!