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Inspection on 09/10/08 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 9th October 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

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 home provides a pleasant, homely and well-maintained environment. Service users are stimulated and given every opportunity to continue with their lifestyle preferences. Detailed pre-admission assessments are undertaken to evaluate the needs of the service users and this information is used to prepare the initial plan of care. Care plans are informative and are reviewed and updated regularly. Risks are reduced through robust risk management strategies. Staff are well trained and are given opportunities to further develop their knowledge and skills. Management arrangements ensure that standards of care are maintained and that records are kept appropriately.

What has improved since the last inspection?

The home has a rolling programme of redecoration and refurbishment to ensure that service users are provided with a pleasant and homely environment. Medications are now dealt with in accordance with the homes policy and procedure and are regularly audited to ensure that service users good health is promoted and protected. Staff files now contain full information regarding the training that they have undertaken and the manager has prepared a training matrix to identify training needs and updates.

What the care home could do better:

Some bedrooms do not have armchairs which would deny the service users of using their room during the day if they wished to spend time alone. All bedrooms should be provided with sufficient and appropriate furniture. Carpets which have become worn or faded should be considered for replacement.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Leighton Court Nursing Home 112 Manor Road Wallasey Wirral CH45 7LX     The quality rating for this care home is:   two star good 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: Jeanette Fielding     Date: 0 9 1 0 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 25 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) 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 25 Information about the care home Name of care home: Address: Leighton Court Nursing Home 112 Manor Road Wallasey Wirral CH45 7LX 01516389910 01516389909 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Southern Cross Healthcare Services Ltd care home 48 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The registered person may provide the following category/ies of service only: Care home with nursing - Code N 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 The maximum number of service users who can be accommodated is: 48. Date of last inspection Brief description of the care home 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. 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. Care Homes for Older People Page 4 of 25 Over 65 48 0 Care Homes for Older People Page 5 of 25 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: two star good 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 unannounced key inspection was undertaken in one day over a period of six hours. As part of the inspection process, all areas of the home were viewed including many of the service users bedrooms. Assessments and care plans were inspected together with staff records and certification to ensure that health and safety legislation was complied with. Observation of the interaction between staff and people who live at the home provided further evidence of the actual care given. The care files of five service users were case tracked to evaluate their care. Discussion took place with the manager, nurses, care staff, service users and visitors to the home. The manager completed an Annual Quality Assurance Assessment form prior to the inspection to give additional information regarding the home. Care Homes for Older People Page 6 of 25 Care Homes for Older People Page 7 of 25 What the care home does well: What has improved since the last inspection? What they could do better: 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 8 of 25 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 9 of 25 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. Service users are provided with full information regarding the services and facilities provided by the home to enable them to make an informed decision regarding their care provider. Evidence: The home has produced a detailed Service User Guide to provide current and prospective service users with full information regarding the facilities and services offered by the home. A copy of the guide is displayed in the foyer of the home and additional copies are available from the home on request. The guide can also be made available in Audio format on request. The needs of prospective service users are fully assessed prior to their admission to the home to ensure that these needs can be met. The assessment is undertaken in the service users own home or in hospital, as appropriate, by the manager or one of the Care Homes for Older People Page 10 of 25 Evidence: qualified nurses. A new form is now used to record the information. All health, care and social needs are assessed and any specialist equipment necessary to meet the service users mobility needs are identified to enable such equipment to be provided prior to admission. The care files of service users recently admitted to the home were inspected and were found to contain full information. Prospective service users and their families are encouraged to visit the home prior to admission to view the room available, meet staff and service users and to ask questions. On admission to the home, new service users are presented with a selection of toiletries, flowers and a card to welcome them. The home does not offer intermediate care. Care Homes for Older People Page 11 of 25 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. Care plans are detailed and provide staff with full information to enable them to meet service users needs and preferences and give them a quality lifestyle. Evidence: Comprehensive care plans are prepared for each service user on admission to the home to provide staff with full information regarding the service users needs and preferences. The care plans of five service users were inspected and showed that their care needs had been identified and action plans set in place to address those needs. Risk assessments had been undertaken and risk management plans were put in place to reduce or remove those risks to protect the service users from harm. Visits to and by GPs, Chiropodists, Dentists, Tissue Viability Nurse Specialists, Dietitian and other healthcare professionals was recorded together with information given by these professionals. The records completed by the staff following these visits are detailed and informative and give staff full information. Care plans are reviewed and updated on a regular basis and whenever the service users needs change. The Care Homes for Older People Page 12 of 25 Evidence: photograph of each service user is place on their file for identification purposes. Permission is sought for the use of bedrails and the service user or their representative is requested to sign the assessment for to provide evidence of this permission. One file was found to contain a care plan that was no longer relevant and the manager arranged to have this removed by the named nurse for that service user. Daily reports are completed by the staff and provide evidence of the actual care given. These are clearly written and are informative. The format for care plans has been changed by the company and all files inspected were organised and clear. The home has produced a clear policy for dealing with medications and it was evident that staff follow the correct procedure. Medication records were accurate and up to date. Discussion took place with the manager regarding the recording of creams and lotions applied by care staff and the thickener which is required in drinks by some service users. The manager is looking to implement and new method of recording of these which she hopes will be in place within the next few months. All storage areas were clean and organised and an air conditioning system has now been installed in the medications room to ensure that the room temperature can be regulated. Arrangements are in place for the disposal of unwanted medications. Information sheets about individual medications is held to ensure that staff have full details about any medications that they are required to administer. Service users may meet with their visitors in one of the communal lounges, the private lounge which is set aside for this purpose or in their own bedroom as they wish. One resident confirmed that the staff always respected their privacy and would take them to the small lounge whenever visitors arrived so that they could speak in private. Staff were observed to speak quietly and discreetly to service users referring to personal issues. Care Homes for Older People Page 13 of 25 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. A high number and range of activities are arranged to give stimulation and entertainment to service users to enhance their lives. Evidence: The home employs an extremely enthusiastic activities co-ordinator each weekday from 8 am to 5 pm. A high number and range of activities are provided for service users which includes Coffee Mornings, Bingo, Art and Crafts and Clothes Shows. A dedicated room has been provided for activities. Trips out to local shops are available and some service users enjoy pub lunches, and recently, to the Blue Planet. Two summer fairs were held and one service user said that she had really enjoyed these events. One to one time is spent with service users, particularly those who are unable to participate in group activities. Fund raising to raise money for prizes and trips provides greater opportunities for service users. A lunch club is provided within the home and takes place in the small lounge which is laid out like a restaurant for these occasions. The home provides a library and books in large print are available. Service users are currently making table centres and cards for Christmas and a selection of items were on display in the lounge. Care Homes for Older People Page 14 of 25 Evidence: Clergy visit the home on a regular basis and provide services for all who wish to participate. Visitors are welcome at the home at any time and one relative said The staff always make me feel welcome. Its so nice to be included in everything that goes on in the home, I feel part of it. Service users are encouraged to take their meals in the dining room but may take them in the lounge or their own bedroom as they wish. The dining tables are attractively laid and the meal served looked and smelled appetising. The main meal of the day is served at lunchtime and a choice of meals is offered. A choice of hot or cold meals is provided in the evening. Snacks and drinks are provided between meals and are available at any time on request. Menus provide evidence that a varied and balanced diet is provided and a choice of meals is offered. Staff give assistance to service users who have difficulties in eating their meals and this assistance is discreet and sensitive to both the person they are helping and other peoples feelings. The kitchen is clean and organised and plans are in place to review and upgrade the storage facilities. A new chef is being recruited for the home and an agency chef is currently covering the vacant position. Food stocks are good and fresh foods are used in the preparation of meals as much as possible. Care Homes for Older People Page 15 of 25 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. All staff have been given training on the Protection of Vulnerable Adults to ensure that service users are protected from harm or abuse. Evidence: The home has a robust complaints procedure which is displayed in the foyer of the home and is also detailed in the Service User Guide. Only one complaint has been received by the home in the last twelve months and this was dealt with in accordance with the homes policy and procedure. All staff have undertaken training on the Protection of Vulnerable Adults and were able to demonstrate that they were aware of the procedure to be followed in the event of abuse being suspected. All accidents are recorded and the events surrounding accidents are investigated. Risk assessments are then undertaken and risk management plans are put in place to reduce the risk of reoccurence. The home has a whistleblowing policy and all staff are made aware of their role and responsibility in reporting poor practice to ensure that service users are protected. One relative said that they would be comfortable in raising any concerns that they had with the manager and was confident that these would be dealt with effectively. Care Homes for Older People Page 16 of 25 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. Service users are provided with a clean and pleasant home in which to live and enjoy their lives. Evidence: Leighton Court is a purpose built care home which opened in 1996. It provides service users with single bedrooms, each having en-suite facilities. The home has four lounges, all of which have recently been redecorated. The home is decorated in a homely style and to a good standard. The programme of redecoration and improvement of the home is on-going. Plans are in place to redecorate some of the main bathrooms to improve the home for service users. A programme of overhaul of all extractors in bathrooms and toilets is currently in place. Maintenance issues are addressed as soon as they are identified and the owners have established a Helpdesk for any issues that the Handyperson is not able to deal with. This system has proved to be effective. Bedrooms are personalised with pictures, photographs and items of memorabilia and it is evident that service user, relatives and staff have strived to provide a warm and homely environment. Some bedrooms were not provided with armchairs to offer service users with the choice of spending time in their rooms or for visitors when they Care Homes for Older People Page 17 of 25 Evidence: call. A programme of replacing bedroom carpets is well underway with other bedrooms being identified as priorities for carpet replacement. Most of the bedroom furniture is modern and domestic style and plans are in place to replace furniture which is now becoming worn and faded. A passenger lift provides full access to all areas of the home and ramps are provided at entrances to give full access to service users and visitors who require to use wheelchairs or have mobility difficulties. Aids and adaptations are provided to assist service users and all staff have been given training in the use of equipment provided for this purpose. Car parking facilities are provided at the rear of the home. The home employs a team of housekeeping staff and all areas of the home were clean and fresh and are well presented. At the rear of the home is a garden and plans are in place to improve this area to provide a more pleasant area for service users to spend time in warmer weather. Dedicated laundry staff attend to personal and general laundry. The laundry area is clean and organised with service users personal laundry placed in individual, named, baskets before being put away carefully in their bedrooms. All COSHH information is available and training on the use of products is provided. Care Homes for Older People Page 18 of 25 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users are provided with care by a well trained staff team to ensure that they are given a good level of care. Evidence: The home employs qualified nurses and care assistants to attend to service users needs. The home also employs, housekeeping, laundry, catering and administration staff to ensure the smooth running of the home. Two qualified nurses are on duty at all times and are supported during the morning by eight carers and in the afternoon by six carers. At night, three carers are on duty with an additional carer working the 8pm to midnight shift to provide additional assistance for service users when they are preparing for bed. The home has a robust recruitment policy which has been prepared by the owners of the home, Southern Cross. All prospective staff are required to complete an application form and attend for interview. Two references are taken together with checks with the Criminal Record Bureau and Protection of Vulnerable Adults registers. Gaps in employment history are questioned and a record of the interview is held on their files. All new staff undertake an induction training programme and it is compulsory that they Care Homes for Older People Page 19 of 25 Evidence: attend mandatory training events. Staff files showed evidence of the induction training. A handbook is provided to all staff which details whistleblowing, POVA and other policies. NVQ training continues with 12 staff holding NVQ 2 and two with level 3. An additional 5 carers are currently working towards NVQ qualifications. A detailed training file is held for all staff and the manager has prepared a training matrix to identify training undertaken and to provide dates of planned training and updates. All staff files are audited on a regular basis. The files of five staff were inspected and all were found to be organised, well maintained and up to date. Qualified nurses undertake specific training to ensure that they have the skills and competency to maintain their registration. Two service users spoke very highly of the staff at the home and said that they were kind and caring. They confirmed that the staff were always available during the day and at night and would do anything they could to help them. Care Homes for Older People Page 20 of 25 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. The home is well managed to ensure that services users and staff are protected at all times. Evidence: The registered manager is a qualified nurse who is experienced in the management of care services for older people. She holds the Registered Managers Award and is able to demonstrate that she continues with her training to further develop her knowledge and skills. The manager is supported by a team of well trained staff who spoke highly of her openness and ability to ensure that the care of the service users was the priority within the home. She is also supported by a senior management team that are also employed by Southern Cross who ensure that systems are in place to audit and review the service on a regular basis. Care Homes for Older People Page 21 of 25 Evidence: Staff supervision is given every two months and annual appraisals are undertaken. Staff meetings are held regularly and provide a forum for the dissemination of information. The home holds an ISO quality assurance accreditation and also undertakes its own quality assurance monitoring. Surveys are sent to service users, relatives and other stakeholders to gather their views of the home and the findings are used to make improvements to the service provision. Health and safety of staff and service users is assured through a programme of review and improvement. Checks on fire detection equipment are undertaken and are recorded. Safety checks on the premises and equipment are made and certification of safety is held in the home. All safety certificates were in place an Care Homes for Older People Page 22 of 25 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 23 of 25 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 19 16 Armchairs must be provided in service users bedrooms. To offer a choice of areas where they spend their day. 23/12/2008 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 Care Homes for Older People Page 24 of 25 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 © (2008) 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 25 of 25 - 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. 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