Inspection on 17/07/07 for Lea Green Court

This inspection was carried out on 17th July 2007.

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

Lea Green Court 25/06/09

Lea Green Court 23/02/09

Lea Green Court 29/10/08

Lea Green Court 01/07/08

Lea Green Court 10/07/06

Lea Green Court 24/10/05

Lea Green Court 13/06/05

Lea Green Court 23/09/04

Lea Green Court 10/05/04

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

CARE HOMES FOR OLDER PEOPLE Lea Green Court Kenton Road Gosforth Newcastle Upon Tyne NE3 3UW Lead Inspector Ian Armstrong Unannounced Inspection 17th July 2007 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 Lea Green Court DS0000000401.V343471.R01.S.doc Version 5.2 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. Lea Green Court DS0000000401.V343471.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Lea Green Court Address Kenton Road Gosforth Newcastle Upon Tyne NE3 3UW 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) 0191 285 1720 0191 2851960 lea_green.court@fshc.co.uk www.fshc.co.uk Tamaris Healthcare (England) Ltd Mr Anthony Edward Olson Care Home 45 Category(ies) of Dementia - over 65 years of age (45) registration, with number of places Lea Green Court DS0000000401.V343471.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. One named service user is under 65 years of age, category DE. No further admissions are permitted in this category without the prior agreement of CSCI. 10th July 2006 Date of last inspection Brief Description of the Service: Lea Green Court is a care home with nursing. Providing care for older people with enduring mental health problems. Care in the home is provided by Registered Mental Nurses supported by care staff. The home is owned and managed by Four Seasons Healthcare Limited a large national provider of care services to vulnerable client groups. The home is situated in Gosforth in the city of Newcastle upon Tyne close to local shops and good public transport links. The building is comprised of two floors with 45 single bedrooms on each floor. All bedrooms have en-suite facilities. On each floor there are separate lounge and dining rooms. There are also a number of toilets and bathrooms. The home also has its own kitchen and laundry facilities. The philosophy of care in the home is to support the residents in their activities of daily living and to provide for their physical and mental health needs. Fees in the home are £383 - £724 this does not include hairdressing and toiletries. Lea Green Court DS0000000401.V343471.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Before the visit: We looked at: • Information we have received since the last visit on 08/01/07. • How the service dealt with any complaints & concerns since the last visit. • Any changes to how the home is run. • The provider’s view of how well they care for people. • The views of people who use the service & their relatives, staff & other professionals. The Visit: An unannounced visit was made on 17/07/07. During the visit we: • • • • • • Talked with people who use the service, relatives, staff, the manager & visitors. Looked at information about the people who use the service & how well their needs are met, Looked at other records which must be kept, Checked that staff had the knowledge, skills & training to meet the needs of the people they care for, Looked around the parts of the building to make sure it was clean, safe & comfortable, Checked what improvements had been made since the last visit. We told the manager/provider what we found. What the service does well: What has improved since the last inspection? A lounge area has been nicely decorated making the living environment for residents more homely. Lea Green Court DS0000000401.V343471.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Lea Green Court DS0000000401.V343471.R01.S.doc Version 5.2 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 Lea Green Court DS0000000401.V343471.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 & 6. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Good pre-admission assessments are completed by the home this ensures that peoples needs can be planned and met. Detailed information is given to residents relatives to help them make choices about the service before moving into the home. Intermediate care is not provided by the home. EVIDENCE: Information that is given to relatives prior to admission was seen this includes the statement of purpose, service users guide and complaints policy all of these documents are of a good standard. Four residents pre-admission documents were checked and were completed to a satisfactory standard. A relative was spoken to who said they had been given the opportunity to visit the home prior to admission and had been given good information about the Lea Green Court DS0000000401.V343471.R01.S.doc Version 5.2 Page 9 homes services, facilities. All four residents had in their files written contracts regarding the conditions of their stay these were satisfactory. Lea Green Court DS0000000401.V343471.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, & 10. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The standard of care planning is improved however individual residents social care needs are not being well met. Residents healthcare needs are generally being met they are treated with respect by staff in the home. The management of medications is good. EVIDENCE: Four residents care records were read. These had a good range of assessments completed with evidence of regular evaluations of these taking place. Care plans were also well written with the exception of social care plans which were not addressing individual needs identified in the social assessment documents. Relatives spoken to said they were involved in discussions about the care plans. Reviews of care needs were well structured and carried out. Records Lea Green Court DS0000000401.V343471.R01.S.doc Version 5.2 Page 11 showed that residents were regularly visited by their GPs and other healthcare professionals and that their needs were being identified and met. Staff spoken to said they knock before entering residents bedrooms. Records show that gender of staff for personal care tasks is identified and met. The systems for the administration, receipt storage and disposal of medicines were checked and met. Staff were knowledgeable of the procedures for medicines. A controlled medicine stock balance was checked and found to be correct. Lea Green Court DS0000000401.V343471.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Residents social care needs are currently being badly met. Social care records are poorly written and do not address individuals needs. Activities for residents are not taking place staff are not implementing the weekly activities programme. EVIDENCE: The weekly activities programme is currently not occurring and this has been the case for the last four weeks since the activities coordinator went on compassionate leave. Staff spoken to said little or no activities were occurring. A relative said there was no activities happening. There has been no trips out for residents of late. No visiting entertainers. Some individual one to one interactions between residents and staff have been recorded. Written social care plans are very generalised information in social assessments is not being used to develop good individual social care plans. A local vicar visits the home every other week and holds a service in the home. Menus were seen these showed a fair range and choice of food being offered. Buffets when provided in menus should state what food is being offered this is not the case at present. Lea Green Court DS0000000401.V343471.R01.S.doc Version 5.2 Page 13 The lunchtime meal was observed the food looked well cooked and appealing with the exception of soft food diets, consideration should be given for the use of food moulds to make soft diets more attractive. Condiments were not present on all of the dining tables. Lea Green Court DS0000000401.V343471.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The systems in the home for the protection of residents are good, policies and procedures are well written and staff are trained and aware of the procedures to follow. Clear protection procedures are in place to protect residents from risk of harm. EVIDENCE: The homes policies in regard to complaints and protection of vulnerable adults were read and are of a good standard. Staff spoken to are aware of the procedures to follow. Staff training about these subjects was checked and is satisfactory. A relative spoken to said he had been given a copy of the homes complaints procedure and was sure the home would deal with any concerns that he might have. Three complaints had been logged since the last inspection two of these had been substantiated and appropriate actions taken to resolve issues of concern. One POVA incident had been reported by the home and resolved to the satisfaction of the social service strategy group. A further relative spoken to expressed some concerns about the levels of staffing in the home particularly in recent weeks I informed her I would investigate her concerns. After investigation I informed her that her concerns were substantiated and she was satisfied with the actions I was taking in making the Lea Green Court DS0000000401.V343471.R01.S.doc Version 5.2 Page 15 home address the matter. Staff spoken to were aware of the procedures to follow for the protection of vulnerable adults. Lea Green Court DS0000000401.V343471.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 24 & 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is being well maintained both externally and internally records in the home show that regular checks of the environment are carried out. This provides a comfortable and homely setting for residents. EVIDENCE: Residents bedrooms seen were well decorated and clean with evidence of lots of personal possessions and effects. A lounge area on the ground floor has been nicely decorated since the last inspection. Toilet and bathroom areas were also clean and tidy. The laundry room was clean COSSH information was on display here. The kitchen was visited this also was clean, equipment was being well maintained. Cleaning schedules were checked and were satisfactory. Food temperature records were checked and were satisfactory. Good stocks of Lea Green Court DS0000000401.V343471.R01.S.doc Version 5.2 Page 17 food was seen. The staff toilet area was visited the toilet seat cover was seen to be broken. Gardens and grounds around the home were viewed and these were being well maintained. Plans for further development of the gardens were shown, an application for a grant for this has been applied for from the local council. Relatives spoken to said the home is clean and tidy when they visit. There was no obvious smells or odours in the home. Staff spoken to are aware of the procedures to follow for the control of infection. Lea Green Court DS0000000401.V343471.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Residents needs are not currently being fully met due to a failure by the home to maintain adequate staffing levels. The homes recruitment policies and practise evidenced by checks carried out is robust which helps prevent risk of harm to residents. Staff are trained and generally competent to do their jobs however less than 50 of care staff have NVQ training. EVIDENCE: Duty rosters in the home were checked these showed evidence on a number of weeks of staff shortages of either one or in some cases two care staff below those required for the residents needs. Staff spoken to also said that staffing levels were not being maintained. A relative spoken to said she visits the home each day and described staffing levels as being below the numbers required. Two recently recruited staff files were checked, CRB checks had been done, 2 written references had been received, proof of identity recorded, application form and health questionnaire all completed to a good standard. Statutory training for staff was being achieved to satisfactory levels however NVQ training for care staff is currently less than 50 of the workforce. Staff supervision records were checked and were satisfactory. Staff spoken to were aware of the procedures to follow for the protection of vulnerable adults. Lea Green Court DS0000000401.V343471.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is generally run and effectively managed by an experienced practitioner. Systems are in place to ensure the service is run in the best interests of the residents. Residents financial interests are safeguarded the systems in place for this are satisfactory. Residents and staff’s health, safety and welfare are protected thus ensuring they are safe from risk or harm. EVIDENCE: Manager of the home is an experienced Registered Mental Nurse. He also has a Diploma in management of care services. He has managed the home for almost four years. Relative meeting minutes and staff meeting minutes were Lea Green Court DS0000000401.V343471.R01.S.doc Version 5.2 Page 20 read and were appropriate, evidence of actions taken when issues raised were seen. Regular health and safety meetings are held minutes for these showed appropriate agendas and matters being addressed when required. Regulation 26 managers visit reports were read and are satisfactory. The fire log book and the homes accident books were read, records are being satisfactorily maintained. The systems for residents personal monies were checked three residents personal transactions were seen there was evidence of regular expenditures with receipts kept, money balances were correct. The homes utility certificates were all checked and were all up to date and satisfactory. The home has recently had returned relative questionnaires seeking feedback about services provided the results of these have been collated and show a high percentage of satisfaction. Lea Green Court DS0000000401.V343471.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X 3 X 3 STAFFING Standard No Score 27 1 28 3 29 4 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Lea Green Court DS0000000401.V343471.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation 15.1 Requirement Social assessments must be completed for all residents. Social care plans must be written which meet each individuals needs. Outstanding since 31/03/07 2. OP12 16.2 (m&n) Social activities for residents in the home must be maintained activity programmes must be carried out each week. Buffet’s in menus must state what food is being provided. The toilet seat in the kitchen area which is broken needs to be replaced. Staffing levels must be maintained in the home at all times according to the numbers and assessed needs of the residents. 50 of care staff employed in the home must be trained at NVQ level 2 or above. 24/07/07 Timescale for action 31/10/07 3. 4. 5. OP15 OP19 OP27 16.2(i) 23.2(b) 18.1(a) 31/07/07 31/07/07 18/07/07 6. OP30 18.1(c) 30/09/07 Lea Green Court DS0000000401.V343471.R01.S.doc Version 5.2 Page 23 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 OP15 Good Practice Recommendations Food moulds should be used to make soft food diets more appealing for the residents. Condiments should be made available to all residents at mealtimes. Lea Green Court DS0000000401.V343471.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Cramlington Area Office Northumbria House Manor Walks Cramlington Northumberland NE23 6UR National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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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