Inspection on 20/09/06 for Leazes Hall Care Home

This inspection was carried out on 20th September 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

Leazes Hall Care Home 01/12/08

Leazes Hall Care Home 01/02/06

Leazes Hall Care Home 29/11/05

Leazes Hall Care Home 25/01/05

Leazes Hall Care Home 26/10/04

Similar services:

Turret Villa Retirement Home

Moor House

Mendip House

Beaconsfield Court Care Home

Little Sisters Of The Poor

Manor House

Middleton Hall Ltd

Middlesbrough Intermediate Care Centre

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

CARE HOMES FOR OLDER PEOPLE Leazes Hall Care Home Leazes Hall Care Home Leazes Burnopfield Newcastle upon Tyne NE16 6AJ Lead Inspector Mrs Sue Lowther Unannounced Inspection 10:00 20 & 29 September 2006 th th 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 Leazes Hall Care Home DS0000054486.V311027.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. Leazes Hall Care Home DS0000054486.V311027.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Leazes Hall Care Home Address Leazes Hall Care Home Leazes Burnopfield Newcastle upon Tyne NE16 6AJ 01207 271934 P/F No e-mail address 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) Leazes Hall Care Home Limited Mrs Linda Tupman Care Home 50 Category(ies) of Dementia (20), Old age, not falling within any registration, with number other category (50), Terminally ill (5) of places Leazes Hall Care Home DS0000054486.V311027.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Name Individual: The home may accommodate a named individual as set out in a letters to the registered person dated 28 March 2006 which establishes the basis on which the individual’s needs will be met by the home. Where necessary the home’s statement of purpose shall reflect any changes in service provision required for this arrangement. This condition may not apply to anyone else, other than the named individual, who falls outside the registered category. Age Variations: The home may accommodate five individuals aged 45 and upward. Where necessary the home’s statement of purpose shall reflect any changes in service provision required for this arrangement. 1st February 2006 2. Date of last inspection Brief Description of the Service: Leazes Hall is a care home registered to provide care, including nursing care, and accommodation, for 50 older people. Up to 20 of these may require specialist care due to dementia. In addition 5 people under the age of 65 years but over 45 years of age may be accommodated. Leazes Hall Care Home Ltd owns the home. It is located in Burnopfield, a village in northwest County Durham. There are two small shops and a public house close by. It was opened in 1984 and is housed in an extended and adapted two-storey building. All bedrooms are in single use. There are a range of lounge and dining areas located throughout the home. Adequate bathing and toilet facilities, some with specially adapted equipment available for those people with mobility problems. There is a passenger lift to the first floor. The home has extensive and pleasant gardens with fine views over the local countryside. Fees range from £359 to £412 weekly and do not include hairdressing, newspapers, aromatherapy massage, chiropody and toiletries. Leazes Hall Care Home DS0000054486.V311027.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection of Leazes Hall Care Home took place on the 20th and the 29th September 2006. Records were examined and a tour of the building took place. Time was spent talking to service users, staff and relatives. The manager supplied some information on a pre-inspection questionnaire. Nine service users and eight relatives returned surveys to the Commission for Social Care Inspection (CSCI). Information about these is reflected in the report. The inspection focussed on key standard outcomes for service users. What the service does well: What has improved since the last inspection? A new system has been introduced with regard to care planning. This will help staff make sure that each resident gets the support and assistance that is needed. A new patio has been laid and some of the slopes have been removed in the garden. This makes it easier for people with a physical disability to go out by themselves if they are able. Leazes Hall Care Home DS0000054486.V311027.R01.S.doc Version 5.2 Page 6 A new fire alarm system has recently been introduced to ensure the safety of service users, staff and visitors. 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. Leazes Hall Care Home DS0000054486.V311027.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 Leazes Hall Care Home DS0000054486.V311027.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Assessment procedures are in place to ensure that the home can meet all of the needs of the people who go to live there. The home does not provide intermediate care. Therefore assessment of Standard 6 is not required. EVIDENCE: Four care plans examined showed that a full pre-admission assessment had been carried out. The manager said that she visits the prospective service user before admission to the home. The service user and their relatives are involved in this process. This is to ensure that the home can meet the needs of the prospective service user. All of the people who returned questionnaires said that they were supplied with sufficient information before moving into the home. One said “I have lived in the village all of my life and was aware that the home has a good reputation”. Leazes Hall Care Home DS0000054486.V311027.R01.S.doc Version 5.2 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 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Good systems are in place to ensure that health care needs of service users are met. Service users can be confident that their privacy and dignity is protected and that they are treated with respect. EVIDENCE: The manager said that all of the service users have care plans. A new system has been introduced with regard to care planning. Four were looked at during the inspection. These were comprehensive and well written. This will help staff make sure that each resident gets the support and assistance that is needed. Records examined showed that service users receive visits from other healthcare professionals. These include district nurses, doctors, and care managers. Leazes Hall Care Home DS0000054486.V311027.R01.S.doc Version 5.2 Page 10 Medication systems were looked at during this inspection. The home uses a monitored dosage system. All of the medication was signed for on the medication administration records. Service users and relatives said that the staff are polite, friendly and treat people with respect. One relative said, “The staff here are excellent and keep me well informed”. Another said “I am happy with the care my relative receives. Nothing seems to be too much trouble”. One service user said “They look after you well here and see to everything you want”. Another said, “All of the staff are really kind and good”. Most of the people who returned the questionnaires said that they always get the care, support and medical attention that they need. One G.P. who was in the home at the time of the inspection said the staff always contact the surgery promptly and appropriately when medical attention is needed for service users. All of the people spoken to confirmed that their privacy is maintained. Leazes Hall Care Home DS0000054486.V311027.R01.S.doc Version 5.2 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 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. The activities are varied and provide recreation for some of the people living in the home. Family and friends can visit the home at any time and are made to feel welcome. The meals are of a good standard. Menus are varied and service users are given a choice. EVIDENCE: The home employs an activities co-ordinator. Activities take place both inside and outside of the home. The indoor activities include bingo, board games, flower arranging, armchair exercises and reflexology. Outside entertainers visit the home on a monthly basis. The activities organiser said that she tries to spend time with people on an individual basis so that she can find out which activities they like. She keeps written records to identify what each person likes to do. One service user said, “I like the outside entertainers”. Another said “I like the bingo when I am well enough to attend. When I am poorly the activities organiser comes for a chat”. Leazes Hall Care Home DS0000054486.V311027.R01.S.doc Version 5.2 Page 12 Most of the people said that they liked the food and that a choice is always available. One service user said, “ I find the food alright and you get a choice”. Nutritional assessments are undertaken and special diets are prepared when required. Leazes Hall Care Home DS0000054486.V311027.R01.S.doc Version 5.2 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 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Service users can be confident that their concerns and complaints are dealt with appropriately and that safeguards are in place to protect them from abuse. EVIDENCE: Information is available for service users and visitors to the home on how to make a complaint. Service users and families views are obtained through regular contact and an ‘open door policy’. Service users and relatives said that they feel confident in discussing any issues with the manager. One person said, “I tell the manager when I have a problem”. The policies and procedures regarding protection of service users would benefit from an update. The telephone numbers of the people who need to be contacted should be included. This will provide information and guidance to staff. Training in adult protection is provided for all of the staff during their induction and is updated on a regular basis. Leazes Hall Care Home DS0000054486.V311027.R01.S.doc Version 5.2 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 & 26 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. The home is clean and well maintained. It is decorated and furnished to a good standard and provides a homely environment for the people who live there. EVIDENCE: The inspector looked around the home and found it to be light and airy. The communal areas of the home were clean and service users confirmed that their bedrooms are always cleaned to a good standard. The manager told the inspector that since the last inspection a new patio has been laid and some of the slopes have been removed in the garden. This makes it easier for people with a physical disability to go out by themselves if they are able. Leazes Hall Care Home DS0000054486.V311027.R01.S.doc Version 5.2 Page 15 Service users said that they could take their own possessions into the home to make their rooms more pleasant and homely. There were no unpleasant smells apparent on the day of inspection. All of the people who returned questionnaires said that the home is always clean and fresh. Leazes Hall Care Home DS0000054486.V311027.R01.S.doc Version 5.2 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, 29 & 30 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Staff are appropriately recruited, trained and in sufficient numbers to meet the needs of the people who live in the home. EVIDENCE: The home had staff files in place, which provided evidence that the appointment of new members of staff is made through proper recruitment processes. This includes the vetting of staff through the use of Criminal Record Bureau (CRB) checks, Protection of Vulnerable Adult checks (POVA) and written references. The staffing rotas were examined during the inspection. Staff felt that there are sufficient staff to meet the needs of the people who live in the home. Relatives who returned questionnaires said that there are always sufficient numbers of staff on duty. There is a commitment at the home to having a trained workforce with 65 of staff having completed NVQ level two or three training in care. Training has also taken place in fire safety, health and safety, food awareness and protection of vulnerable adults. Certificates to confirm this were seen in staff files. One recently recruited member of staff said, “I found the induction Leazes Hall Care Home DS0000054486.V311027.R01.S.doc Version 5.2 Page 17 to be really useful and comprehensive. I was given all of the information I needed to be able to look after the people who live here”. Leazes Hall Care Home DS0000054486.V311027.R01.S.doc Version 5.2 Page 18 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, 33, 35, 36 & 38 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Service users can be assured that the home is well managed and they are given the opportunity to comment on how the home is run. Policies and procedures are in place to safeguard their health, safety and wellbeing. EVIDENCE: The manager is well qualified, with several years experience in working with older people. She is a qualified nurse and has an appropriate management qualification. The manager said that the surveys are carried out on a yearly basis. The most recent one was in September 2006 but the results were not available. Service user and relatives views are obtained through regular contact and an open Leazes Hall Care Home DS0000054486.V311027.R01.S.doc Version 5.2 Page 19 door policy. The home would benefit from the introduction of service user and relatives meetings. This would give people an opportunity to make their views about the home known on a more formal basis. The manager carries out a quality assurance and monitoring audit on a monthly basis. This covers all aspects of care delivery and environmental issues. Copies of these were available in the home. The registered provider visits the home on a regular basis and also carries out a monthly audit when the managers’ findings are reviewed. Pocket monies are kept in the home for people who request this. Two signatures are obtained and receipts are kept to ensure service users’ financial interests are safeguarded. Records were seen to confirm that care staff are supervised on a regular basis to ensure they are supported in their role. However the manager does not receive regular supervision. The manager confirmed that the home carries out regular health & safety checks. The inspector checked some of the records. Those seen were up to date. A new fire alarm system has recently been introduced to ensure the safety of service users, staff and visitors. Leazes Hall Care Home DS0000054486.V311027.R01.S.doc Version 5.2 Page 20 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 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 4 28 4 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 3 3 Leazes Hall Care Home DS0000054486.V311027.R01.S.doc Version 5.2 Page 21 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. Standard Regulation Requirement Timescale for action 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 OP33 Good Practice Recommendations The home would benefit from the introduction of service user and relatives meetings. This would give people an opportunity to make their views about the home known on a more formal basis. The manager should receive regular supervision. This is needed to make sure that she is supported in her role. 2. OP36 Leazes Hall Care Home DS0000054486.V311027.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Darlington Area Office No. 1 Hopetown Studios Brinkburn Road Darlington DL3 6DS 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 Leazes Hall Care Home DS0000054486.V311027.R01.S.doc Version 5.2 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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