Inspection on 29/06/05 for Leivers Court Care Home

This inspection was carried out on 29th June 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 24/05/07

Leivers Court Care Home 24/05/06

Leivers Court Care Home 30/11/05

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 Kilbourne Drive Arnold Nottingham NG5 8AX Lead Inspector Richard Ramsden Unannounced 29 and 30 June 2005 10.00am 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 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 C53 C03 S36189 Leivers Crt V235688 290605 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Leivers Court Care Home Address Douro Drive Kilbourne Drive Arnold Nottingham NG5 5AX 0115 9209501 0115 9209501 Telephone number Fax number Email 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 Margaret Todd Care Home 38 Category(ies) of Old Age x 38 registration, with number Dementia over 65 x 19 of places Leivers Court Care Home C53 C03 S36189 Leivers Crt V235688 290605 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 22/03/05 Brief Description of the Service: Leivers Court is a care home providing 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 Social Services. 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 kitchenett/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 wash basins, there are no ensuite facilities. There are enclosed garden areas which are accessible to residents. Leivers Court Care Home C53 C03 S36189 Leivers Crt V235688 290605 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was completed over one-day and lasted for approximately 7 hours. It included the inspection of care and other records, a discussion with the senior staff, as well as speaking with 4 residents and 2 visitors to the home. A partial tour of the building was also completed. What the service does well: What has improved since the last inspection? Some areas of the home have been redecorated since the last inspection and new floor coverings have been provided. Leivers Court Care Home C53 C03 S36189 Leivers Crt V235688 290605 Stage 4.doc Version 1.40 Page 6 The manager has implemented all of the requirements and recommendations made at the last inspection. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Leivers Court Care Home C53 C03 S36189 Leivers Crt V235688 290605 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Leivers Court Care Home C53 C03 S36189 Leivers Crt V235688 290605 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,3,6. The literature supplied to prospective residents does not contain sufficient information to enable them to make an informed decision about whether the home will meet their needs. The needs of each resident are appropriately assessed prior to their admission to the home. The home does not provide intermediate care. EVIDENCE: At the last inspection a requirement was made that a Statement of Purpose/Service User Guide must be provided to residents and prospective residents. These documents are now available but do not contain all the required information. Of the three residents records checked during this inspection, two people had Extended Social Work Assessments, which had been obtained prior to their admission to the home. The other person was admitted to Leivers Court some considerable time ago, prior to the current management team being appointed to the home. The senior staff stated that residents are now never admitted until a Social Work Leivers Court Care Home C53 C03 S36189 Leivers Crt V235688 290605 Stage 4.doc Version 1.40 Page 9 Assessment has been received. This information is used to enable staff to decide whether they can meet the prospective residents assessed needs. Leivers Court Care Home C53 C03 S36189 Leivers Crt V235688 290605 Stage 4.doc Version 1.40 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,9, The care plans produced for each resident must be reviewed more frequently to ensure that staff are always aware what assistance/support each resident requires. The records show that resident’s health care needs are being appropriately met. Staff must improve the way in which medication is managed to ensure the health and safety of the residents. EVIDENCE: Staff have worked hard to produce care plans for all of the residents, which clearly set out how, their personal and care needs should be met. However the care plans had not been reviewed each month. Care plans must be regularly reviewed to ensure that, where necessary, they are updated to reflect the changing needs of the residents. Residents and where applicable their representatives must be involved in the care planning and review process. Two visitors spoken with during the inspection said that their relatives care plan is available in their bedroom and that they can read it at any time. They Leivers Court Care Home C53 C03 S36189 Leivers Crt V235688 290605 Stage 4.doc Version 1.40 Page 11 said that they had attended a formal review, but had never been specifically consulted or informed about any changes to the care plan. None of the residents spoken with during the inspection could remember the staff discussing their individual cares plans with them. Tissue viability risk assessments have been completed for each resident. (This is good practice). The records showing when each resident had received a bath or shower were all recorded on one page. This meant that the records could not be viewed in a way, which respects individual residents confidentiality. A record of contact with health care professionals was included in each resident’s file, this showed that a range of health needs are being attended to. One of the resident’s health care records showed that she had not seen a doctor since being admitted to the home. However this resident had informed the inspector that she had seen a doctor on one occasion, in the home. Contact Sheets confirmed that a doctor had seen the resident on one occasion and that she had attended several hospital appointments but this had also not been recorded appropriately. It is important that these records are accurately maintained. The homes medication was stored securely and the refrigerator temperatures had been recorded each day. The home does not record the temperature in the room where medication is stored. When the receipt of medication records, were checked at random it was noticed that 14 Diazepam had been received for one resident. The records showed that 14 tablets had been administered to the resident and yet there was still 2 tablets remaining in the box. Clearly either the receipt of medication or the administrations of medication records were incorrect. The senior staff could not locate any more Diazepam in stock for this resident, nor could she locate any records to indicate that a prescription had been requested for this resident’s medication. The senior staff stated that potentially it could take up to six days to obtain a repeat prescription and have it dispensed by the chemist. As the resident is prescribed one tablet each day and only two tablets remained this was not considered acceptable. Staff must ensure that residents always receive the medication, which has been prescribed for them. A photograph of each resident should be attached to his or her Medication Administration records. This will help staff to ensure that they are administering the medication to the correct resident. Leivers Court Care Home C53 C03 S36189 Leivers Crt V235688 290605 Stage 4.doc Version 1.40 Page 12 The inspector was advised that all staff who administer medication have received appropriate training. (The training records were checked at random during the inspection.) Leivers Court Care Home C53 C03 S36189 Leivers Crt V235688 290605 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,15. Residents are provided with regular activities, entertainment and some outings. People are encouraged to maintain contact with family and friends. The diet provided for residents is wholesome, well balanced and varied. To ensure that health and safety of the residents the record of foods temperatures must be completed on a regular basis. EVIDENCE: The programme of planned activities and entertainment is displayed in the communal lounge area. One resident spoken with during the inspection said that the home does provide activities in the communal areas but that they choose not to attend. One resident said how much they had enjoyed the recent trip to Skegness. The home does not provide any religious services but some people do watch the services on the television each Sunday. There are two religious services held in the day centre each month that residential clients can attend if they wish to. All of the people spoken with during this inspection, said that they can have visitors at any time and that their visitors are always made very welcome. Two visitors to the home said that the staff are always very friendly and frequently offer them refreshments. Leivers Court Care Home C53 C03 S36189 Leivers Crt V235688 290605 Stage 4.doc Version 1.40 Page 14 The lunch on the day of this inspection appeared appealing and nutritious; there is a choice of food at each meal. There is an eight weekly rotating menu, which provides a good variety of food. The inspector was advised that three people require liquefied diets. Each element of the meal is liquidised separately to preserve flavour and appearance. (This is good practice). Sugar substitute is used in the preparation of puddings and cakes so that people with diabetes can have the same diet as the other residents. The cook stated that she asks each resident every day what food they would like for the following day. She also asks if there is any food they would like which is not included on the menu. (This is good practice). Every resident spoken with during the inspection confirmed how much they like meals provided. One person confirmed that the cook visits her each day to see what she would like to eat. (This is good practice) It was noted during the inspection that the food temperature records were not completed for a total of 18 days in June 2005. To ensure the health and safety of the residents, it is required that these records are kept up-to-date. Leivers Court Care Home C53 C03 S36189 Leivers Crt V235688 290605 Stage 4.doc Version 1.40 Page 15 Leivers Court Care Home C53 C03 S36189 Leivers Crt V235688 290605 Stage 4.doc Version 1.40 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16. Leivers Court has a simple, clear and accessible complaints procedure. The one complaint received since the last inspection had been dealt with appropriately. EVIDENCE: Every resident at Leivers Court has been provided with a copy of Nottinghamshire County Councils Complaints Procedure. This information does need to be updated to ensure that any complainant is aware that the Commission for Social Care Inspection has replaced the National Care Standards Commission. The home had only received one complaint since the last inspection, this was from one of the Day Care service users. The records of this complaint were checked and the issues had been dealt with appropriately. All of the residents and visitors spoken with during the inspection said that the senior staff are very approachable and that they were confident that any concerns they might have would be dealt with appropriately. The home had received many letters of commendation. Leivers Court Care Home C53 C03 S36189 Leivers Crt V235688 290605 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,20,24,25,26. The premises are well decorated and comfortably furnished and at the time of inspection the home was clean and there were no offensive odours. It is not appropriate to store excess furniture in the resident’s communal areas. The radiators in the communal areas and service users bedrooms were found to be unguarded and could potentially be putting vulnerable residents at risk of burning themselves. EVIDENCE: A partial tour of the premises was completed as part of this inspection. The accommodation was well decorated, comfortably furnished and maintained to a good standard. The gardens are attractive and accessible to service users. The residents spoken with all said that they like their bedrooms and confirmed that they were encouraged to bring small items of furniture ornaments etc to personalise their individual rooms. Leivers Court Care Home C53 C03 S36189 Leivers Crt V235688 290605 Stage 4.doc Version 1.40 Page 18 During the tour of the building the inspector noticed that there was a bed, being stored against the wall, in one of the quiet lounge areas used by residents. The manager stated that many of the service users now require specialist “hospital” beds. The home has run out of storage space for the beds that have been replaced. It is not acceptable that this excess furniture is stored in the residents lounge as it is out of keeping and could present a health and safety risk. At the last inspection a requirement was made that the floor covering in onebedroom must be replaced. This room was checked during the inspection and the new carpet had been provided. The room provided a safe comfortable environment with a separate seating area. The radiators and pipe work in the resident’s bedrooms and the communal areas are unguarded. The inspector stated that these would need to be risk assessed to ensure that residents are not at risk of burning themselves. The manager stated that radiator covers are to be provided for all the unguarded radiators. The laundry is well equipped with two industrial washing machines and two industrial tumble dryers. At the time of inspection the laundry was unattended and the door was left unlocked, giving the residents access to this room. This is not acceptable as there may be soiled, or infected linen in this room that would present a health and safety risk to the residents. There was also Sanitizing powder left unattended in this room. The homes Infection Control Policy and COSH data sheets were not available in the laundry. Leivers Court Care Home C53 C03 S36189 Leivers Crt V235688 290605 Stage 4.doc Version 1.40 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,29. The home has sufficient experienced and trained staff to meet the assessed needs of the residents. The staff recruitment policies and practices are generally robust enough to ensure the safety of the residents but copies of staff references must be kept in the home available for inspection. EVIDENCE: The staff rota for the week of this inspection was assessed. There was five care staff on duty each morning and four in the afternoon/evenings. Three waking night staff are on duty every night. The manager stated that she always ensures that there is sufficient staff available to meet the assessed needs of the residents. She stated that she applies for additional funding if extra staff are required. The records of the most recently recruited member of staff were assessed during this inspection. CRB checks were available as were Job Descriptions and Terms and Conditions of Employment. The manager stated that no staff commenced employment until to satisfactory references have been received, however there were no copies of these references available in the home. Leivers Court Care Home C53 C03 S36189 Leivers Crt V235688 290605 Stage 4.doc Version 1.40 Page 20 Leivers Court Care Home C53 C03 S36189 Leivers Crt V235688 290605 Stage 4.doc Version 1.40 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 35. Resident’s financial interests are safeguarded. EVIDENCE: The financial records of three residents were assessed as part of this inspection all of the records had been well maintained. All of the residents, who were asked, said that they were satisfied with the way in which their finances are managed. Appropriate records and receipts are kept of possessions handed over for safekeeping. Leivers Court Care Home C53 C03 S36189 Leivers Crt V235688 290605 Stage 4.doc Version 1.40 Page 22 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 2 x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 1 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 2 COMPLAINTS AND PROTECTION 3 2 x x x 3 2 1 STAFFING Standard No Score 27 3 28 x 29 2 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x x x x x 3 x x x Leivers Court Care Home C53 C03 S36189 Leivers Crt V235688 290605 Stage 4.doc Version 1.40 Page 23 No Are there any outstanding requirements from the last inspection? 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 1 Regulation 4 Requirement It is required that the written information provided to prospective residents includes the following information. A) The qualifications of the homes manager and staff. B) The residents the views of the home. It is required that Care Plans are reviewed at least once each month in consultation with the resident and where appropriate their representative. It is required that residents health care records are always accurately maintained. It is required that:A) a photograph of each resident is attached to their medication administration records. B) the records of administration of medication are always accurately maintained. C) the home always has adequate supplies of medication prescribed for individual residents. It is required that:A) the records of receipt of medication are always accurately maintain. Timescale for action 31st July 2005 2. 7 15 Immediate 3. 4. 8 9 17 (1) 13 Immediate Immediate 5. 9 13 Immediate Leivers Court Care Home C53 C03 S36189 Leivers Crt V235688 290605 Stage 4.doc Version 1.40 Page 24 6. 7. 8. 9. 10. 11. 15 20 25 26 26 29 16(2) 23 13 (4) 13 13 16 19 B) the the homes records, each day, the temperature in the room in which the medication is stored. The room temperature must not exceed 25 C. It is required that the records of food temperatures are updated each day. It is required that excess furniture is not stored in the residents lounge areas. It is required that residents are not at risk of burning themselves on unguarded radiators. It is required that the laundry door is kept locked when there are no staff in situ. It is required that hazardous substances are kept securely at all times. It is required that copies of staff references are kept in the home available for inspection at all times. Immediate 31st July 2005 31st August 2005 31st July 2005 Immediate Immediate 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. 2. Refer to Standard 7 26 Good Practice Recommendations It is recommended that the records that show when each resident has had a bath are recorded on individual pages for every resident, to preserve confidentiality. It is recommended that the appropriate sections of the homes Infection Control Policy are displayed in the laundry. Leivers Court Care Home C53 C03 S36189 Leivers Crt V235688 290605 Stage 4.doc Version 1.40 Page 25 Commission for Social Care Inspection Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Leivers Court Care Home C53 C03 S36189 Leivers Crt V235688 290605 Stage 4.doc Version 1.40 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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