Inspection on 13/12/08 for Leaholme

This inspection was carried out on 13th December 2008.

CSCI found this care home to be providing an Adequate service.

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Leaholme 08/01/07

Leaholme 26/09/05

Leaholme 11/05/05

Leaholme 09/11/04

Leaholme 09/06/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

Extracts from inspection reports are licensed from CQC, this page was updated on 06/02/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Leaholme 8 Springfield Road Leicester LE2 3BA     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Keith Charlton     Date: 1 3 1 2 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Leaholme 8 Springfield Road Leicester LE2 3BA 01162702665 01162702667 mandy@leaholme.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Zelda Lee Type of registration: Number of places registered: Your Health Ltd care home 17 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category physical disability Additional conditions: The maximum number of service users who can be accommodated is: 17 The registered person may provide the following category of service only:- Care Home only - Code PC To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age not falling within any other category - Code OP Dementia - Code DE and DE(E) Physical Disability - Code PD and PD(E) Date of last inspection Brief description of the care home The fees for 2006/07 are #350-#420. The latest inspection report can be found in the reception area of the home. Leaholme is registered to accommodate up to seventeen older people and older people with physical disability. There are thirteen single rooms and two double rooms. The home is part of a national company called Your Health Limited. Leaholme is a large, detached three-story Victorian house. The home is Care Homes for Older People Page 4 of 27 Over 65 17 17 17 17 0 0 Brief description of the care home situated in a quiet tree-line road, which runs off a busy main road, in the Stoneygate area. The home is ten-minute bus journey from the city centre and close to the railway station. The home is clean bright, with comfortable furniture and decor to match. There is a separate dining room and two large lounges. The bedrooms on the first and second floor are accessible via the passenger lift. There is a large mature garden at the rear of the property, which continues at the side and to the front of the home. The garden is accessible via a gradual slope and ramp for service users requiring the use of walking aids. The home has a stable compliment of staff, some having worked at the home for many years. A number of staff have commenced the National Vocational Qualifications level 2. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This key inspection included a visit to the service. We (the CSCI) visited Leaholme on the 13th December 2008. The Registered Manager and staff in the home helped us during the visit. The main method of inspection we used was case tracking. This means looking at the care given to people in different ways. We did this by: - talking to the people who live in the home, - talking to staff and management, Care Homes for Older People Page 6 of 27 - watching how people are given support, - looking at records. We also looked at the Annual Quality Assurance Assessment (AQAA). This is a document the provider (the person who owns the service sends to us at the CSCI, and it tells us what the provider thinks about the service they deliver to people who live at Leaholme. As well as this, we looked at information that had come to our attention since the last key inspection in January 2007. We spoke with seven people who live at during our visit. People told us that staff were good and helped them. One person said staff are really nice and friendly. Another who had recently arrived at Leaholme, said staff have been very good, and helped me to settle in. None of the people spoken with had any complaints about attitude of staff, however three commented on the lack of availability of staff. One person said I think we need the staff to have more time to talk to us like they use to do before we had people with more infirmities moving in. We spoke with four members of staff during our visit to the home who told us about working in the home and gave us their views. They all were very positive about working at Leaholme and wanted to provide excellent care to people living there. One staff member said: We are well supported by Zelda, the Manager, who will help anyone with a problem. We checked all the standards that the Commission for Social Care Inspection has decided are key standards during this inspection. The information below is based only on what we checked in this inspection. We have kept details about individual people out of the report to make sure we respected their confidences. What the care home does well: What has improved since the last inspection? What they could do better: Medication must always be administered safely. We found that the person issuing medication was not the same one who was giving it to residents, there were some gaps in the recording of medication, and the storage of controlled medication was not up to current requirements. There needs to be a review of food and drink items to ensure they are all of a quality standard that residents like. There must be a clearer understanding of how to safeguard people who live at Leaholme. We found some staff were not fully aware of practice, policies and procedures that protect people at the home from abuse, and that written staff references were not in place to protect residents from unsuitable staff. The service would benefit from having the environment audited by a dementia Care Homes for Older People Page 8 of 27 specialist to help improve the quality of life of people living at with dementia. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 27 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Leaholme have had their needs properly assessed before moving into the home. Evidence: We case tracked a person living in the home who had recently moved in to Leaholme. We checked that she had received information to help with the choice of home, and she said she had received enough information. We also checked that the person now living at the home had her needs properly assessed prior to moving in, to ensure that the staff at the home could meet her needs. Care Homes for Older People Page 11 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Health and social care practice at Leaholme is good though some aspects need to improve to ensure people living at the home at never at risk of their physical needs not being met. Evidence: Residents spoken to said they had a care plan and that the Manager consulted them about this. Yes, I remember Zelda going through this with me and I was able to see if it was right, one resident said. We checked the care plans of three people living at the home who were case tracked and had care plans to support their care. Plans showed good detail regarding the support required by staff to ensure the physical health of people living at the home, and there was information to inform staff of the lives people led prior to living at Leaholme and this translated into action plans to ensure social and emotional wellbeing is fully supported. There was evidence that the Manager uses a dementia specialist for support and advice. Care Homes for Older People Page 12 of 27 Evidence: Accident records were also checked and whilst practice was generally good there was one occasion when medical services were not contacted when a resident had a bump to their head following a fall and one record which did not detail whether an injury had occurred following a fall. We checked the medication records, and found that mostly there was accurate recording of the administration of the medicines in the home except where there were a small number of gaps where staff had not signed that medication had been issued to residents, therefore potentially compromising their health if the medication had not been supplied. It was also found that staff issuing the medication did not supply this directly to residents but signed the record when they did not witness it being taken. This could mean the resident did not take it even though it was signed as the resident taking it, with implications for their health. We spent time watching staff interaction with people living at . We saw staff being gentle and caring to people as they got up and had their breakfast, and throughout the day we observed the staff at Leaholme as doing their best to meet the needs of people living at the home. We observed that people are treated with respect and their right to privacy was respected. A resident said, the staff here are wonderful. They will go out of their way to help you. Care Homes for Older People Page 13 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are opportunities for people to take part in activities and have a relaxed lifestyle. Evidence: Residents said that they were satisfied with the current activities. One resident said: There is enough for me and we are not forced to do things. Visitors are welcomed at Leaholme and we were informed by one visiting family member that he was always made to feel welcome and staff were very friendly and kept him informed about his mothers condition if this was needed. We saw lunch being served. Staff specifically support people who are unable to feed themselves. This was done with a great deal of respect, and maintained the dignity of people whilst they were being supported in eating. There are one-to-one activities such as walking around the garden, taking residents to the shops if they want to go, reminiscing with people, communal activities such as chair exercises and games. Residents were seen to be involved in a craft activity in the Care Homes for Older People Page 14 of 27 Evidence: morning and there was an organised Xmas party planned for the following day, and a resident showed us what she has made in terms of table furniture. Many people living at the home have some form of dementia, and we found out that staff have attended a course to help them understand more fully how to care for people with dementia. We saw breakfast and lunch being served. Staff support people who are unable to feed themselves. This was done with a great deal of respect, and maintained the dignity of people whilst they were being supported in eating. There was a choice of two hot dinners and both were well presented and looked appetising, with good portions being served to each person. There was a displayed menu to provide information to residents. Care Homes for Older People Page 15 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Management do not always follow the correct practice to ensure residents are kept safe from harm. Evidence: Residents said that they had no complaints but if they did they thought the staff or Manager would quickly get it sorted out. A resident said, there is nothing to complain about but if I needed to do this I am sure that Zelda or the staff would quickly put it right. We saw the complaints record and there were no complaints for the past year. CSCI has also not received any complaints about the service. The complaints procedure was available but did not include details of the Lead Agency, which is the local Social Services Department, and that complainants can choose to contact them in the first instead of the home. We talked to staff to find out how much they knew about protecting people in the home from abuse. Records showed they had received training about safeguarding adults from abuse. They knew of Agencies to report to if the in house procedure failed, though one staff did not know the police could be contacted if the in house process failed. The Manager said she would go through the procedure again with staff to Care Homes for Older People Page 16 of 27 Evidence: ensure they knew all aspects. There was a reference in a residents survey stating that a staff member had inappropriately handled a resident. This had not been fully documented as to the circumstances of this situation and had not been referred to the Lead Agency for possible investigation. The Manager subsequently carried this out to ensure full protection for residents. We looked at the staff recruitment records to see whether all the proper checks had been made on staff before they started employment at Leaholme.We found records which showed two staff had started work at the home before management had received written references to help them reach the judgement that people were safe to start employment, and though the Manager stated she had telephone references, this is not legally sufficient to fully protect residents from unsuitable staff. Pova first protection checks were also not in place for two staff, though the Manager subsequently supplied these. We saw that staff were issued with a contract and had proper ID. Care Homes for Older People Page 17 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Leaholme live in a safe and well maintained environment. Evidence: All residents spoken with said that they liked their bedrooms: I could bring in what I like and they always keep my bedroom clean, one resident said. We saw people at Leaholme living in a clean and well maintained environment. The furnishings in the communal area are homely, and people are encouraged to bring their personal possessions and have them in their bedrooms. There has been redecoration of communal areas in the past year. The Manager said that all residents bedrooms would be redecorated in the next twelve months. Records show that the home is well maintained, and good measures are in place to control infection and keep the home hygienic. There are radiator covers and water valves to protect residents from burn and scalding risks. There were things in the environment to support people with dementia, such as photographs in the entrance hall and on peoples bedroom doors. This could be extended to other things like tactile objects, reminiscence areas, and information Care Homes for Older People Page 18 of 27 Evidence: boards. Care Homes for Older People Page 19 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are many good training initiatives at Leaholme, which will improve the care practice of staff, though domestic input needs to be reviewed to ensure there is sufficient staff to cover all care needs of residents. Evidence: Some residents said that with people with dementia now being accommodated in the home in the past year that staff did not have enough time to spend chatting with them: I know things change but we miss the carers not having enough time to have a good chat with us, one resident said. There was also some concern as to the high staff turnover in the home. We saw that there were enough staff on duty to meet the complex needs of people living at Leaholme, and we were told by staff that although they are busy there is time to help people. We spoke with the Manager about the staffing - including the Manager there are four staff on duty until 2.00pm, and three staff on duty to 8.00pm, with two waking night staff at night. However the Manager cannot be fully counted in the staffing compliment due to her management duties and there are only nine hours domestic time per week in the staff rota, which means that care staff have to do domestic duties, taking them away from residents care. Care Homes for Older People Page 20 of 27 Evidence: The Manager said that there was a problem with staff retention. We saw that staff were being charged for their legal checks, which is ultimately the responsibility of the Company and does assist in helping staff morale. Written references were not always available before staff commenced employment, in contravention of legal duties. We found that staff have been on a number of training events to help update their practice on areas such as Moving and Handling, Fire Safety, Infection Control and Dementia, though there has been no training on residents conditions such as Sight and Hearing Impairment, Stroke, Parkinsons etc. Care Homes for Older People Page 21 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Management maintain a good quality of life for people at Leaholme. Evidence: Both staff and residents said that Zelda, the Manager was very friendly and approachable and efficient. One resident said, Zelda is excellent. She listens to what you have to say and then does something about it. The Manager has the relevant qualifications to be in charge at Leaholme and is to be taking further management training in the near future. . She has been updating staff practice with a series of training events. We heard from staff that the Management listen and act upon their concerns, and we saw evidence that management use different ways of finding out from people who live at the home and their relatives, what their views are about the care given at Leaholme and how this can improve. Care Homes for Older People Page 22 of 27 Evidence: There are risk assessments to ensure safe working practices. The Manager said these were to be reviewed and updated. Fire records were in place regarding the proper testing of systems. We were informed by staff that they felt appropriately supervised to do their jobs. We checked records of money transactions, and were satisfied that the service was managing the personal allowances of people living at the home well. Care Homes for Older People Page 23 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 18 13 All potential safeguarding incidents must be reported to the Lead Agency. To ensure that residents are kept safe from abuse. 17/02/2009 2 29 19 Written references must be received before staff commence employment. To ensure full protection of residents. 13/02/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 8 Potentially serious accidents always need to be referred to medical services and a full record kept of any injury to ensure full protection of residents health. Medication need to be supplied to residents by the person issuing it to ensure that it is taken by the resident. The complaints procedure needs to be updated to include details of the Lead Agency and all staff need to know the full safeguarding procedure in terms of all the relevant Agencies to contact if abuse is suspected. 2 3 9 16 Care Homes for Older People Page 25 of 27 4 19 The provider should undertake an environmental audit of the home to determine how the service can best meet the needs of people living at Leaholme who have dementia. Domestic input needs to be reviewed and increased do that this is available daily so as allow care staff more time to meet all residents needs. It is recommended that the Company, not staff, pay for legal checks and that they consider other methods of staff retention. The staff training programme needs to include training on all residents conditions. 5 27 6 29 7 30 Care Homes for Older People Page 26 of 27 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 27 of 27 - 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!