Inspection on 24/05/07 for Leivers Court Care Home

This inspection was carried out on 24th May 2007.

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

Leivers Court Care Home 10/11/09

Leivers Court Care Home 24/05/06

Leivers Court Care Home 30/11/05

Leivers Court Care Home 29/06/05

Leivers Court Care Home 12/03/05

Leivers Court Care Home 11/05/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Leivers Court Care Home Douro Drive off Kilbourne Drive Arnold Nottingham NG5 8AX Lead Inspector Richard Ramsden Unannounced Inspection 24th May 2007 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 Leivers Court Care Home DS0000036189.V336235.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. Leivers Court Care Home DS0000036189.V336235.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Leivers Court Care Home Address Douro Drive off Kilbourne Drive Arnold Nottingham NG5 8AX 0115 920 9501 0115 920 9501 julie.allsop@nottscc.gov.uk 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) Nottinghamshire County Council Julie Allsop Care Home 38 Category(ies) of Dementia (19), Dementia - over 65 years of age registration, with number (19), Old age, not falling within any other of places category (38), Physical disability (5) Leivers Court Care Home DS0000036189.V336235.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Out of the total number of beds (38), there will be 19 beds for DE 55 and over and/or DE(E) Out of the total number of beds (38), 5 may be used for PD 55 and over Service users shall be within category OP Date of last inspection 24th May 2006 Brief Description of the Service: Leivers Court is a care home that provides personal care and accommodation for 38 older people. There is a 20 place Day Centre attached to the home, which operates over 7 days. The home is owned and managed by Nottinghamshire County Council. Leivers Court is a purpose built single storey building located within a housing estate approximately 1 mile from Arnold town centre. The accommodation is provided in four units, each unit has a fully fitted kitchenette/dining and sitting area, as well as communal toilets and a bathroom or shower room. All of the bedrooms are for single occupancy and have wash hand washbasins; there are no ensuite facilities. There are enclosed garden areas that are accessible to residents. The weekly accommodation charges for those residents who are self funding would be £377.00. A copy of the most recent inspection report is available in the home. Leivers Court Care Home DS0000036189.V336235.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. One Inspector completed this unannounced visit over one day it took approximately 8 hours. It included the inspection of care and other records, a discussion with the manager, one team leader and a member of care staff. The inspector spoke with four residents. Although the inspector was unable to speak with any visitors during the inspection, he had received nine completed relatives/carers satisfaction questionnaires. Four service user satisfaction questionnaires were also received prior to this inspection. A partial tour of the building was completed. Three residents were case tracked, which means that their care plans were examined against the actual care they receive. The inspector also discussed the Commission for Social Care Inspections proposal to reduce some of the restrictions placed on the homes registration categories. Prior to completing this visit the inspector assessed the homes service history and the last two inspection reports. What the service does well: The people living at Leivers Court and their representatives are generally very satisfied with the services provided by the home. They said that staff are always friendly and respectful and ensure that their privacy and dignity is maintained at all times. The observed interaction between residents and staff was of a very good standard. The home is well managed and run in the best interests of the residents. Regular meetings ensure that the people living at Leivers Court are able to voice their opinions about the way in which the home is run. The residents and staff spoken with during the inspection said that the manager is effective and approachable. Leivers Court Care Home DS0000036189.V336235.R01.S.doc Version 5.2 Page 6 Three residents said they are very satisfied with their bedrooms and confirmed that they had been encouraged to personalise them with small items of furniture photographs etc. Everyone spoken with said that the homes kept “spotlessly” clean. Three residents said how much they enjoyed the food provided by the home, they confirmed that there is always plenty of food available and that an alternative will always be provided if they do not want the meals suggested on the menu. One person said the food is “better than a four-star hotel”. All aspects of health and safety that were checked during this visits had been satisfactorily maintained. There are aspects of good practice highlighted in the main body of this report. What has improved since the last inspection? What they could do better: Leivers Court Care Home DS0000036189.V336235.R01.S.doc Version 5.2 Page 7 The registered person must make sure that the preadmission assessment process ensures that the home will be able to meet residents cultural and communication needs. People should not be admitted to the home until a full assessment has been completed and the registered person is confident that, as far as possible, the home can meet all of the residents assessed needs. It would be good practice to prominently display the full programme of activities and entertainment to be provided for the residents. This will enable people to make an informed choice about the activities they would like to participate in. 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. The summary of this inspection report can be made available in other formats on request. Leivers Court Care Home DS0000036189.V336235.R01.S.doc Version 5.2 Page 8 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 Leivers Court Care Home DS0000036189.V336235.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3. The staff are not always ensuring that they can meet the needs of all prospective residents. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Three residents records were assessed as part of this inspection. All of the records contained pre admission assessments, which had been completed by a social worker. It was identified that one of the resident’s first language was not English. However the assessment did not give any information about whether this resident had any specialist cultural or linguistic needs. Leivers Court Care Home DS0000036189.V336235.R01.S.doc Version 5.2 Page 10 The manager had also not checked these aspects of the residents needs, prior to her admission to the home. The manager was advised that she must ensure that the home can meet prospective residents cultural, and linguistic needs prior to their admission to the home. When the inspector spoke with the resident she stated that she was very happy in the home, that she had lived in England for a very long time and that she believes that the homes staff are meeting all of her assessed needs. Leivers Court does not provide intermediate care. Leivers Court Care Home DS0000036189.V336235.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10. Residents individual care plans contain sufficient information to ensure that staff are aware of what support and assistance each resident requires. The homes medication is well managed and residents believe that they are treated with respect. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Three residents care plans were viewed, as part of this inspection, the care plans for two of the residents, appeared to address all the issues highlighted in the assessment process. Where possible residents had been encouraged to sign their care plans to confirm their involvement in the planning and review process. On the whole care plans were being regularly reviewed and updated. However one of the care plans provided to the inspector, did not identify that Leivers Court Care Home DS0000036189.V336235.R01.S.doc Version 5.2 Page 12 the resident was now receiving subcutaneous insulin to control his diabetes. A second copy of the care plan was located which had been updated to show that this person was now an “insulin controlled diabetic”. This care plan stated that that the district nurse was administering the insulin. However the resident was actually administering his own insulin. A third copy of the care plan was located in the residents bedroom, this care plan is used by the staff to assist the resident with their personal care, it had been updated by hand to reflect all of the changes. Although the resident was receiving appropriate care and support, it is important that all copies of current care plans are appropriately updated to accurately reflect the care and support each resident requires. Having care plans with conflicting information can cause confusion for staff and other professionals and could potentially adversely affect the well being of the residents. Records show that residents health care needs are being appropriately met, this was confirmed by three of the residents spoken with during the inspection. A relative stated on one of the surveys provided prior to this inspection that staff cancel residents hospital appointments if their relatives or friends cannot provide an escort. This issue was discussed with the manager who stated that they would always try to provide staff to escort residents to medical appointments, if their family or friends were unable to attend. However she did state that sometimes escort could not be provided due to staff shortages and consequently, to ensure the safety of the residents, appointments may have to be rescheduled. The literature supplied to prospective residents and their relatives clearly states that the home may not always be able to provide escorts for residents’ who have appointments outside the home. All of the residents spoken with said that staff are friendly and respectful and ensure that their privacy and dignity is maintained at all times. The observed interaction between staff and residents was of a very good standard. Leivers Court Care Home DS0000036189.V336235.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15. The lifestyle experienced in the home appears to match the residents’ expectations and preferences. People are encouraged to main contact with family and friends and the food provided appeared wholesome and nutritious. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager was able to demonstrate that the home provides a good range of activities and entertainment to stimulate the residents. Some of the activities and entertainment to be provided, were displayed on a notice board in the main dining room, however this did not detail all the activities to be provided and consequently residents were unable to make an informed choice about which they wish to participate in. Residents confirmed that their visitors are made welcome at any time and that refreshments are always provided. Leivers Court Care Home DS0000036189.V336235.R01.S.doc Version 5.2 Page 14 Individual residents care plans give details of how residents can be encouraged to make decisions about their daily lives. (This is good practice). There are also regular residents meetings where people are encouraged to express their opinions about the way in which the home is run. The lunch on the day of inspection appeared wholesome and nutritious. All of the residents stated that they are very satisfied with the food provided in the home and confirmed that an alternative will always be provided if they do not want the meal suggested on the menu. Leivers Court Care Home DS0000036189.V336235.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18. The home has a robust accessible complaints procedure and staff are ensuring that residents are protected from abuse. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The literature supplied to all residents contains a copy of the complaints procedure. This procedure is also prominently displayed throughout the home. The homes complaints records show that they have received 10 complaints including one forwarded by CSCI. The complaints records were checked at random and had been dealt with appropriately. The reason that the number of complaints appears to have increased since the last inspection is because the manager is now keeping a record of all informal complaints to provide an overview of the nature and frequency of complaints received. (This is good practice). Leivers Court Care Home DS0000036189.V336235.R01.S.doc Version 5.2 Page 16 The residents spoken with, confirmed that they would contact the manager or another senior member of staff if they had any concerns or complaints. They believe that their concerns would be dealt with appropriately. The manager is aware of the local vulnerable adults procedure and a whistle blowing procedure is displayed in the staff room the member of staff spoken with during the inspection was clear about her responsibility to report any incidents of abuse. There have been no allegations of abuse in the home in the last 12 months. Staff records show that they are being provided with training in safeguarding adults. Leivers Court Care Home DS0000036189.V336235.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19,26. The accommodation has been maintained to a good standard it was pleasant and hygienic at the time of this inspection. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A partial tour of the premises was completed as part of this visit. The purpose-built accommodation has been maintained to a good standard. Leivers Court Care Home DS0000036189.V336235.R01.S.doc Version 5.2 Page 18 The residents bedrooms viewed during the visit were comfortably furnished and people had clearly been encouraged to personalise their rooms with photographs, ornaments and small items of furniture. All of the residents spoken with, the stated that they liked their bedrooms and confirmed that they can use them at any time. The call system was tested in one of the bedrooms and was answered promptly by staff. Many areas of the home have been redecorated and some new furnishings have been provided since the last inspection. All of the residents confirmed that the home is always clean and free from offensive odours. The laundry is large and well equipped, copies of the homes infection control policy and the appropriate C.O.S.H data sheets are displayed in the laundry. (This is good practice). One relative stated in the Pre-inspection questionnaire that the laundry services could be improved. The manager accepted that there had been some problems with residents’ laundry being either lost or damaged. She stated that statistically this situation has improved and that she believes it will further improve when, in the near future, a member of staff is employed specifically to complete the resident’s laundry. Leivers Court Care Home DS0000036189.V336235.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30. Sufficient staff are being employed to meet the assessed needs of the residents, the homes recruitment policies and practices are supporting and protecting residents. The registered person was able to demonstrate a commitment to staff training and development. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Two people stated on the relatives/carer surveys that the services to residents would improve if the home were able to employ more staff. The manager stated that she has received authorisation to provide an additional 109 care staff hours each week. The staffing levels have already increased with relief staff covering the additional shifts until permanent staff appointments are made. The rota for the week of this inspection was checked and the additional staffing levels noted. Leivers Court Care Home DS0000036189.V336235.R01.S.doc Version 5.2 Page 20 The residents spoken with said that although staff are always busy they are always available when you need them. All new members of staff complete an appropriate induction training programme. The staff training records show that out of a total of 31 members of care staff 15 have completed NVQ level 2 or above and a further six people were completing this training at the time of this inspection. The home follows Nottinghamshire County Councils recruitment policies procedures, which include aspects of equal opportunities to help to ensure that there is no discrimination. The personal records of two members of staff were assessed as part of this visit. The records had been well maintained and contained all the required information. The manager confirmed that staff do not commence employment until all the required information has been obtained. Leivers Court Care Home DS0000036189.V336235.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38. The home is well managed and run in the best interests of the residents. Where checked to the health and safety of residents and staff are promoted and protected. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered manager is very experienced and has recently completed NVQ level 4 and the registered managers award. Leivers Court Care Home DS0000036189.V336235.R01.S.doc Version 5.2 Page 22 Residents and staff said that the manager is very approachable and that she seeks their views about the way in which the home is run. Quality monitoring systems are in place and the manager has used the information gathered to produce a basic individual development plan for the home. The manager must ensure that the development plan addresses any individual issues highlighted by residents in the quality review process. Staff do manage some residents’ personal allowances, the records were checked at random and were well maintained. The aspects of health and safety, assessed as part of this visit, had generally been well maintained. The records of the homes emergency lighting tests could not be located at the time of this visit. However the manager has located these records and a copy has been faxed through to the Commission for Social Care Inspection. Nottinghamshire county councils health and safety department completes health and safety inspections of the home. Leivers Court Care Home DS0000036189.V336235.R01.S.doc Version 5.2 Page 23 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 2 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 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Leivers Court Care Home DS0000036189.V336235.R01.S.doc Version 5.2 Page 24 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. 1. Standard OP3 Regulation 14 (a) Requirement The registered person shall not provide accommodation to a resident at the care home unless, the needs of the residents have been assessed by a suitably qualified or suitably trained person. The assessment must include details of peoples cultural & linguistic needs where appropriate. Failure to provide the comprehensive assessment could result in people being admitted to the home when an appropriate service cannot be provided. Timescale for action 24/05/07 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 OP7 Good Practice Recommendations All copies of current care plans should be accurately DS0000036189.V336235.R01.S.doc Version 5.2 Page 25 Leivers Court Care Home updated to avoid confusion to the people who are assisting residents with their ‘care’ needs. Any confusion could potentially put residents health & safety at risk. 2. OP12 The registered person should display the full programme of activities & entertainment to be provided for the residents. The will enable people to make an informed choice about which activities they wish to participate in. Leivers Court Care Home DS0000036189.V336235.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT National Enquiry Line: 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 © 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 Leivers Court Care Home DS0000036189.V336235.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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