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Inspection on 23/06/06 for Leighton Court Nursing Home

Also see our care home review for Leighton Court Nursing Home for more information

This inspection was carried out on 23rd June 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The residents spoken to said that the staff are kind and caring, and that their privacy and dignity are respected. A range of activities is offered, with both individual and some group activities being available. Ongoing training and development was seen for various grades of staff. The residents are looked after as individuals, and all residents spoken to said that they enjoyed living at home.

What has improved since the last inspection?

The information available regarding residents care needs, such as care planning and multidisciplinary healthcare team involvement was clearly evident and up to date in all files seen. The overall management of the home also evidences ongoing improvement and development, and staff morale and attitude appears good. Residents spoken to said that "things are nice here" and they are "happy". Staff also confirmed this.

What the care home could do better:

Some items of furniture and furnishings could do with being replaced, and consideration should be given to increase storage space in the home.

CARE HOMES FOR OLDER PEOPLE Leighton Court Nursing Home 112 Manor Road Wallasey Wirral CH45 7LX Lead Inspector Julie King Unannounced Inspection 23rd June 2006 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 Leighton Court Nursing Home DS0000020953.V291826.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. Leighton Court Nursing Home DS0000020953.V291826.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Leighton Court Nursing Home Address 112 Manor Road Wallasey Wirral CH45 7LX 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) 0151 638 9910 0151 638 9909 Southern Cross Healthcare Services Limited Paul Dennis Carroll Care Home 48 Category(ies) of Old age, not falling within any other category registration, with number (48) of places Leighton Court Nursing Home DS0000020953.V291826.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. One named adult (female) under the age of 65 years Date of last inspection 19th January 2006 Brief Description of the Service: Leighton Court is owned by Southern Cross Healthcare Services Limited, and is managed by Ms Mandy Eccles, a first level nurse with many years experience in caring for the client group and Company policies and procedures. This care home is registered to provide nursing care for 48 older persons 65 years and over. Leighton Court is a three-storey purpose built nursing home close to Liscard shopping centre and other local amenities. Care and accommodation for service users are provided on the ground and first floor, and the kitchen, laundry, staff areas, treatment room and hairdressing salon are located on the top floor. All floors are served by a lift. Fees are currently local social service rates; privately arranged rates negotiated individually are for non-social funded service users. Leighton Court Nursing Home DS0000020953.V291826.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. As part of a key inspection, this site visit took place over 7.5 hours, during which a full tour of the premises took place, staff and care records were examined. The inspector was accompanied throughout this visit by the acting manager and operations manager, both of whom gave valuable input to the inspection. Some staff on duty plus some residents and relatives were spoken to during this visit. What the service does well: 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. Leighton Court Nursing Home DS0000020953.V291826.R01.S.doc Version 5.1 Page 6 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 Leighton Court Nursing Home DS0000020953.V291826.R01.S.doc Version 5.1 Page 7 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 good. This judgement has been made using available evidence including a visit to this service. The home’s Statement of Purpose and Resident Guide provides enough information for prospective residents so they can be clear about the services the home provides to meet their care needs. EVIDENCE: The provider has updated the Statement of Purpose and Resident Guide to give prospective residents an accurate reflection of the services and facilities provided at Leighton Court. All residents are issued with a contract / statement of terms and conditions on admission, which sets out responsibilities of all parties and what is included in fees, etc. Pre admission assessments provide a holistic assessment of actual and potential needs of each prospective resident; thus allowing a comprehensive care plan to be developed. However it was recommended that the pre admission assessment tool is utilised in more detail to ensure that all prospective resident’s needs are fully identified. Leighton Court Nursing Home DS0000020953.V291826.R01.S.doc Version 5.1 Page 8 Multidisciplinary healthcare team (MDT) input is evident in resident’s care files, and include reference to NHS out-patient’s appointments, opticians, dentistry, and tissue viability nurse specialist (TVNS) input at the home when needed. Trial visits are offered to all prospective residents prior to admission – this is re-iterated in the Statement of Purpose and Service User Guide. It is suggested to the manager that all trial visits are clearly documented in appropriate care files if and when they take place. Leighton Court does not offer intermediate care. Leighton Court Nursing Home DS0000020953.V291826.R01.S.doc Version 5.1 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): 7,8,9,10,11. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a care planning system in place for all residents. This provides staff with the information they need to meet the resident’s needs. Medication management was not compliant with current good practice requirements and guidelines, thus potentially putting residents at risk. EVIDENCE: Recently admitted residents, and those requiring a high amount of care were case-tracked (followed from pre-admission into the home in all aspects to date), and spoken to in order to establish a holistic view of what that resident’s lifestyle is like at Leighton Court. The residents said that they had had the opportunity to meet someone from the care home “for a chat” prior to admission; and that their families were involved. The commercially produced care plans are loosely based on the Roper, Logan and Tierney model of nursing care; and evidence input from the resident, their representative and the multidisciplinary healthcare team as needed. Leighton Court Nursing Home DS0000020953.V291826.R01.S.doc Version 5.1 Page 10 Monthly reviews and evaluations were evident on most care plans seen, and the plans were based on needs identified on the pre-admission assessments. Multidisciplinary healthcare team (MDT) input was evident in all necessary care plans, and some members of the MDT were spoken to for their verbal opinion of care at Leighton Court as part of this inspection; those spoken to did not express any concerns regarding care. Some of the care plans required updating with what was actually being recorded on the daily report records – this was discussed with the manager who assured the inspector that this would be done. Medications were examined as part of this unannounced inspection, and it was evident that the medication management on the ground floor was satisfactory. However the medication management on the first floor did not meet the required standard with gaps in the medication administration records (MARs), key system not always used, old stock in drugs trolley and inaccurate recording on some medications. Residents spoken to said they were “happy living here”, and “the staff are lovely”. Staff appear to have a good rapport with residents and their relatives, and were observed sitting talking to some of the residents and their relatives during the afternoon. Leighton Court Nursing Home DS0000020953.V291826.R01.S.doc Version 5.1 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 using available evidence including a visit to this service. Links with the local community are good, and support and enrich the resident’s lives. Meals in Rose Brae are good, offering choice and variety, and cater for resident’s special dietary needs. EVIDENCE: Residents in the home are asked on admission about their lifestyle, choice of foods, and choices and preferences of the social activities they would like to participate in, such as outings, bingo and manicure therapy. On admission to the home the resident with help from a family member completes an initial care plan, which includes a social history as well as referring to hobbies, food likes and dislikes information, etc. This information is used to plan organised activities for the resident. Visitors are allowed in the home at any reasonable time of day, residents may entertain their visitors in the communal lounges, or in their own bedroom. The gardens are fully accessible and tidy, and are an ideal setting for residents to sit with their relatives, especially in the summer months. Leighton Court Nursing Home DS0000020953.V291826.R01.S.doc Version 5.1 Page 12 Meals evidence a choice and variety, and special dietary needs (such as diabetes) are catered for. Records are kept for the recording of fridge, freezer and cooked food, and the kitchen was tidy and well maintained. Since the previous inspection, all requirements (including environmental health) regarding kitchen equipment have been met. Leighton Court Nursing Home DS0000020953.V291826.R01.S.doc Version 5.1 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): 16,17,18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A complaint and adult protection policy and procedure was in place that helps ensure the safety and welfare of residents. EVIDENCE: The residents, relatives and staff can access complaint policies and procedures as and if necessary. The procedures includes information on ‘whistle-blowing’, in accordance with current Department of Health guidelines. The CSCI has not received any complaints about this service since the previous inspection. Most of the staff have, or are in the process of completing training in adult protection, with the remaining having training planned for the near future. However all staff do receive basic training in the protection of vulnerable adults during induction. Residents are enabled to exercise their right to vote, either via post or in person; and there is no religious or political persuasion in the home. Leighton Court Nursing Home DS0000020953.V291826.R01.S.doc Version 5.1 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,22,23,24,25,26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Most resident’s rooms are personalized, providing residents with an attractive and homely place to live. EVIDENCE: Most areas of Leighton Court have improved since the previous inspection, but a couple of bedrooms still required new floor coverings and replacement furnishings. However immediately after this inspection, and prior to this report being written, the management of the home have totally replaced the floor coverings and soft furnishings in these, and other rooms. The small lounge (Room 31) is in the process of having new chairs, and a designated activities room is in process of development as present. The main lounge ceiling on the first floor requires painting where it has previously been repaired. Leighton Court Nursing Home DS0000020953.V291826.R01.S.doc Version 5.1 Page 15 The bathrooms were clean and tidy, and did not have any communal toiletries or other items as previously. The inspector was informed that numerous areas of the home are still to be upgraded within the next month, and this work will include replacing more chairs, floor coverings, furniture and re-painting as needed. Leighton Court Nursing Home DS0000020953.V291826.R01.S.doc Version 5.1 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 using available evidence including a visit to this service. There is now a consistency of care within the home provided by permanent staff, which helps to offer safety and stability for the residents. EVIDENCE: A selection of staff personnel files were examined as part of the case-tracking process. Most files now contain all the required documents and records, but some are still in process of completion. CRB and POVA evidence was available, as were references, some training information, NVQ training, proof of identification and basic inductions. The manager was able to evidence that most of the staff have now completed mandatory training (training that is required by law to do the job), and some resident specific training (such as care of the resident who has Parkinson’s Disease, etc.) had taken place, with more planned. Leighton Court Nursing Home DS0000020953.V291826.R01.S.doc Version 5.1 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,34,35,36,37,38. Quality in this area is good. This judgement has been made using available evidence including a visit to this service. Quality assurance is in place, thus helping to improve the quality of care given to residents. EVIDENCE: The acting manager has started the process of registration with the CSCI, and is planning to complete her NVQ4 /Registered Manager’s Award soon. Quality assurance is now in place, with regular audits now evident. Residents and relatives comments are also now being collated, and are assisting in further improvement of services provided at the care home. Staff spoken to stated that they had more support now, and enjoyed their training and development experiences; and felt they benefited from having supervision sessions and appraisals. Leighton Court Nursing Home DS0000020953.V291826.R01.S.doc Version 5.1 Page 18 All of the records and documents seen evidenced regular updates, but a few recommendations were discussed with the manager and operations manager, as listed at the end of this report. Certificates for fire, NICEIC (electrical safety), PAT (small appliance test), Gas safety, hoist and lifting equipment were up to date and valid. Leighton Court Nursing Home DS0000020953.V291826.R01.S.doc Version 5.1 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 3 3 N/a HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 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 3 3 3 3 3 3 3 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 3 3 3 Leighton Court Nursing Home DS0000020953.V291826.R01.S.doc Version 5.1 Page 20 Are there any outstanding requirements from the last inspection? YES STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation 15 Requirement The registered person must ensure that all service users care plans are fully completed and relevant at all times. The registered person must ensure that all medications are kept in accordance with current good practice guidelines. Previous requirement of 30.08.05 not met The registered person must ensure the furnishings and floor coverings identified during this inspection are replaced as planned. Timescale for action 31/08/06 2. OP9 13 (2) 31/08/06 3. OP19 23 31/08/06 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 Good Practice Recommendations DS0000020953.V291826.R01.S.doc Version 5.1 Page 21 Leighton Court Nursing Home 1. 2. 3. Standard OP3 OP12 OP28 It is recommended that the pre-admission assessment tool be used fully to ensure that all actual and potential needs of residents are identified. It is recommended that all activities participated in, or offered to service users are clearly recorded in care files. It is strongly recommended that clear evidence of staff training and development is provided in staff files at all times, and that these are always available for inspection at any time. Leighton Court Nursing Home DS0000020953.V291826.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Liverpool Local Office 3rd Floor Campbell Square 10 Duke Street Liverpool L1 5AS 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 Leighton Court Nursing Home DS0000020953.V291826.R01.S.doc Version 5.1 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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