Inspection on 29/10/08 for Leisure Care Homes Limited (Frampton House)

This inspection was carried out on 29th 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 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

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Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Leisure Care Homes Limited (Frampton House) West End Road Frampton Boston Lincs PE20 1BT     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: Alison Jessop     Date: 2 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. that people have said are important to them: They reflect the things 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 24 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.cqc.org.uk Internet address Care Homes for Older People Page 3 of 24 Information about the care home Name of care home: Address: Leisure Care Homes Limited (Frampton House) West End Road Frampton Boston Lincs PE20 1BT 01205724216 01205724216 c-slade@btconnect.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Leisure Care Homes Ltd Name of registered manager (if applicable) Christine Slade Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is 31 The registered person may provide the following categories 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 Date of last inspection Brief description of the care home Frampton House Care Home is a Grade II listed building set in extensive landscaped grounds in the village of Frampton, which is approximately three miles from the town of Boston and close to the village of Kirton, which provides shops and local facilities. There are car parking spaces to the side of the building and a patio area where service users can sit out in fine weather. A summerhouse is also provided in the grounds for Care Homes for Older People Page 4 of 24 care home 31 Over 65 0 31 31 0 Brief description of the care home the use of residents. The home offers accommodation on three floors, the first and second floors being served by a shaft lift. Seventeen rooms offer single accommodation with en-suite facilities and three rooms with en-suite facilities are offered for double occupancy. A copy of the Service User Guide and Statement of Purpose can be obtained from the manager. The current fees for this service range from £351.00 to £450 and £600 for a double room. Care Homes for Older People Page 5 of 24 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 was an unannounced visit and it formed part of a key inspection, focusing on key standards, which have the potential to affect the health, safety and welfare of people who use the service. Throughout this report the terms we and us refer to The Commission for Social Care Inspection (CSCI). The visit lasted approximately six hours and we took into account previous information held by us including the previous inspection report, their service history and records of any incidents that we had been notified of since the last inspection. The main method used to carry out the inspection is called case tracking, this includes following the care of a sample of three people through their records and assessing their care. We spoke to two people who use the service and saw rooms of those people who Care Homes for Older People Page 6 of 24 said we could and spoke to two staff members. We spent two hours in the sitting/dining room with very vulnerable service users to get an impression of what life was like in the home. This inspector made notes every five minutes on the state of being (mood) of the service users, their interaction with their surrounding and other people including staff and interaction with service users. The inspector notes the best interaction observed. Details of this observation are incorporated in the report. The registered manager was present throughout the visit and the general outcomes of the visit were discussed with her. 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.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 24 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 24 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. The home has a robust admission procedure which ensures that peoples needs can be met prior to agreeing admission. Evidence: The manager carries out a comprehensive needs assessment prior to admission. One of the senior carers is currently being trained to do this so that assessments can be carried out in the absence of the manager. This home does not provide intermediate care. Care Homes for Older People Page 10 of 24 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. Residents receive person centred care which promotes their independence. Although there are risk assessments, not all areas of risk are identified and risk management is not always recorded. Evidence: Kind interactions were observed between residents and staff. One resident was being hoisted in the lounge, the carers were laughing with the resident who appeared to be enjoying the experience. During the observation carers were coming in the lounge and speaking to the residents. The manager came in several times and chatted to residents asked them if they would like the TV volume turned up. Carers spoke clearly and slowly to residents and carried out tasks which were at an appropriate pace for the resident. One carer came in and when she entered the room she spoke to a resident whose face seemed to light up and became very happy. During one point of the observation a resident became very agitated and was trying to slide out of the recliner chair. Staff had be Care Homes for Older People Page 11 of 24 Evidence: called and we advised the staff that it would be more appropriate for the resident to be taken out of the chair as she very clearly did not want to be there. The staff took the resident out for a walk around the garden in a wheelchair and they seemed much more settled on return. Another resident also went for the walk and commented on how much she had enjoyed it. The service has recently commissioned a new care planning system. Each resident has a care plan which in parts had not been completed although on speaking to the staff they were aware of the residents needs and are in the process of reviewing all care plans. The manager stated that staff who are currently reviewing all the care plans may require some training in this area. Care plans described peoples likes and dislikes and also said how the residents independence can be promoted. The service is in the early stages of implementing care plans and assessments on the residents Mental Capacity. Training has been attended by the manager and senior carers and is being filtered down to all staff. Risk assessments on nutrition, moving and handling and the use of recliner chairs had not been completed for two residents and for others had been partially completed as they did not fully state how the risk was to be minimised or eliminated. Care Homes for Older People Page 12 of 24 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are provided with the opportunity to participate in activities to suit their differing needs, this ensures that people are suitably stimulated. People who have dementia are provided with comfort through the use of dolls and other items. Evidence: The manager stated that 50 of the activities are provided for groups and 50 percent is provided on a one to one basis. Group activities available include games, exercises and singalong with a physiotherapist, quizzes, card making and entertainment. On the day of the inspection the residents were playing skittles in the lounge. The service has a dedicated activity coordinator. She got to know the residents by working in a caring role initially and has tailored the activities to meet the needs of the residents. The activity co-ordinator was a bubbly, friendly person, she stated this resident cannot communicate very easily so i do an Irish Jig for her and that gets her laughing and smiling. One resident was given a nail manicure in the lounge and the activity coordinator chatted to the resident in a sensitive manner. The resident said that she enjoyed this. Carers also assist with providing activities at the weekend when the activity coordinator is not working. The home has a pet cat which a lot of the residents appeared to take interest in. The manager stated that they are planning to get Care Homes for Older People Page 13 of 24 Evidence: rummage boxes and dolls for those residents who have advanced dementia. A resident was happy to be asked to cut some old pictures out of a newspaper in order to stick in a scrap book which would be used for reminiscence discussions. One resident who has dementia and who became agitated was given a knitted doll to hold. One resident said that she prefers to stay in her room and occasionally attend various clubs and groups outside of the service. She said that she was happy that she was still able to do this. Feedback about the food was very good. Residents said the food is lovely, only one complaint, we get too much of it. Another said we get a good choice of food. We observed staff assisting those residents who cannot eat by themselves, staff assisted them at a steady, sensitive pace. One resident likes to take her time over her meal, she was not rushed to eat and was happy to sit in the dining room finishing her meal when the lunch period was over. Care Homes for Older People Page 14 of 24 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. The service has a robust complaints procedure and residents can feel confident that their safety is protected. Evidence: No formal complaints have been received and the manager records all concerns and grumbles raised and ensures that this is dealt with and the action taken recorded. Several compliments have been received. All residents spoken to said that they feel confident that if they raised a concern or complaint that it would be dealt with immediately. There have been two adult safeguarding alerts. One was in relation to a staff member who was later referred to the POVA list. The service took action to protect the residents from harm. The manager also made an alert to the Adult Safeguarding Team when it was discovered that a resident may have been subject to financial abuse. Care Homes for Older People Page 15 of 24 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. The residents live in a safe, comfortable and pleasant environment. Staff observe good infection control procedures. Evidence: The environment is spacious and well maintained. The residents bedrooms are filled with personal possessions and were very clean. Communal areas are nicely maintained however the ground floor toilets look bare and clinical and are basic cubicles. The temperature in the toilets felt cold. The service has purchased a new standing hoist. There is a new fire alarm system and other new equipment in place such as specialist equipment to get people down the fire escape staircases. The home was exceptionally clean throughout and no malodours were detected. Care Homes for Older People Page 16 of 24 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. Staffing numbers are in sufficient quantity for them to be able to care for the residents. Although staff have regular training this does not always reflect in their practice in moving and handling, this could cause a risk to both residents and staff. Evidence: There are four carers on in the morning, three in the afternoon and two at night. Residents said that they do not have to wait along time to receive help and staff spoken to said they feel that there are adequate staffing levels to meet peoples needs. The manager stated that she occasionally works the night shift in order to find out if the needs of the residents are being met and to supervise the night staff. The manager stated that she liaises with the provider and would request extra staffing if she felt this was required. The service uses the Skills for Care Induction for all new staff. Staff spoken to said they receive adequate training to be able to carry out their jobs safely however we observed one poor moving and handling technique where a resident was lifted out of the chair by taff pulling from under her arms. The manager stated that handling belts are available but these had not been used, this suggests that staff may not be fully aware of safe moving and handling procedures and may require more training. Otherwise staff demonstrated that they receive regular training and specialist courses are also accessed through local colleges. Senior care staff have been given a new staff handbook which is tailored to the seniors role. Care Homes for Older People Page 17 of 24 Evidence: An anonymous concern was raised with CSCI that domestic staff are covering careworkers night shifts. The manager stated that the carers have NVQ qualifications in care and are employed as domestic staff and care workers. The member of staff did not have a contract for a carers role only a domestics role. All staff have been subject to vetting prior to employment, including POVA, Criminal Record Disclosures and satisfactory references. Care Homes for Older People Page 18 of 24 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 by a qualified person who shows commitment to ensuring that a good service is provided. Evidence: The manager has her Registered Managers Award and has attended training courses on new legislation such as the Mental Capacity Act and the Deprivation of Liberty Act. She has also attended an extensive course in Dementia Care, Risk Assessing, Equality and Diversity and Counselling. The service has a quality assurance system that ensures that peoples views are gained. Relatives are also asked for their views of the care home. The manager keeps a log of comments made as she visits the residents on a day to day basis to get their views. The home has a system for managing residents personal finances. Monies are safely Care Homes for Older People Page 19 of 24 Evidence: stored away with limited access by staff. Two residents manage their own personal finances and have access to lockable facilities. Senior staff carry out health and safety checks on the home including fire drills and risk assessing the environment. Care Homes for Older People Page 20 of 24 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 21 of 24 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 7 13 Risk assessments must be carried out and where a risk is identified records must state how the risk is being managed. This must be done in order to maximise the safety of the residents. 08/12/2008 2 30 18 You must ensure that staff 29/12/2008 practice safe moving and handling techniques and you must provide ongoing training in this area. To ensure that staff carry out safe practices when moving and handling residents. 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 9 It is recommended that formal protocols are attached to Medication Administration Records where a GP has Page 22 of 24 Care Homes for Older People requested specialist treatment. 2 19 It is recommended that the ground floor toilets are made more comfortable and homely and to ensure that a comfortable temperature in this area in maintained. It is recommended that where staff have duel roles for example carer & domestic, staff are provided with contracts and job descriptions for each role. 3 29 Care Homes for Older People Page 23 of 24 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.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 24 of 24 - 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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