Inspection on 15/11/05 for Life Care Home

This inspection was carried out on 15th November 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Life Care Home 30/10/07

Life Care Home 27/04/06

Life Care Home 25/07/05

Life Care Home 25/05/05

Life Care Home 19/01/05

Life Care Home 13/05/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE Lifecare Home 31 Cressingham Road Reading Berks RG2 7RU Lead Inspector Robert Dawes Unannounced Inspection 15th November 2005 10:00 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 Lifecare Home DS0000011253.V253701.R01.S.doc Version 5.0 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. Lifecare Home DS0000011253.V253701.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Lifecare Home Address 31 Cressingham Road Reading Berks RG2 7RU 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) 0118 9866371 0118 9346872 Mr S S Ahluwalia Care Home 16 Category(ies) of Old age, not falling within any other category registration, with number (16) of places Lifecare Home DS0000011253.V253701.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. That provision is made for one service user aged under 65 years of age, identified in the application form dated 21.2.05, to be resident in the home. 25th July 2005 Date of last inspection Brief Description of the Service: Lifecare is a residential home providing accommodation and personal care for sixteen older people, of both sexes. The home is situated in a residential area a few miles from Reading town centre. There are local amenities and the home is on a local transport route. There are five ground floor and nine first floor bedrooms, accessed by a lift. One ground floor bedroom has en-suite facilities and one of the first floor bedrooms is a double room. Lifecare Home DS0000011253.V253701.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection to check how the home had responded to the requirements made at the previous inspection. It was carried out during the day on Tuesday 15th November 2005. Two inspectors undertook the inspection. They spoke with seven service users, the proprietor, the manager, four members of staff and two visiting professionals. They also toured the premises and looked at records. Fourteen standards were assessed of which five were met, six were almost met and three were not met. Five requirements and five recommendations were made. What the service does well: What has improved since the last inspection? Staff are receiving regular supervision. Communication has improved. Staff are clearer about what they have to do. Service uses’ personal and health care had improved. There are more activities available to service users. Staff are spending more time talking with service users. An Occupational Therapist has assessed each service user to find out if they have the aids and equipment they need. Lifecare Home DS0000011253.V253701.R01.S.doc Version 5.0 Page 6 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. Lifecare Home DS0000011253.V253701.R01.S.doc Version 5.0 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 Outcomes Statutory Requirements Identified During the Inspection Lifecare Home DS0000011253.V253701.R01.S.doc Version 5.0 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 the following standard(s): This section was not assessed at this inspection. EVIDENCE: Lifecare Home DS0000011253.V253701.R01.S.doc Version 5.0 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Numbers 7 and 8. Each service user has an individual care plan that is reviewed every month. But the information and detailed actions, contained in the plans, need to be improved to ensure the service users health, personal and social care needs are met. Service users’ health and personal care has improved but all their assessed needs are still not being met. EVIDENCE: An individual plan is drawn up for each service user and they are reviewed every month. However, in three files the care plans made no reference to serious medical conditions the service users were suffering from. In other files there were no instructions for staff on how to maintain oral hygiene. It was also evident that several staff did not know what was contained in the care plans. Visiting professionals said the personal and health care of the service users has improved. Service users said they have a bath every week. However the inspectors noted several concerns: a) oral hygiene was not always undertaken; Lifecare Home DS0000011253.V253701.R01.S.doc Version 5.0 Page 10 b) two service users were seen to have teeth in poor condition; c) one service user, who suffers from dementia and has a need to wander around the ground floor, was being prevented from doing so by staff putting her frame out of reach and being told repeatedly to sit down; and d) one service user is only assisted to the toilet once or twice a day. Staff must ensure all service users receive proper dental care and oral hygiene; the needs of demented service users are understood and facilitated; and service users are enabled to use the toilet when ever possible. Lifecare Home DS0000011253.V253701.R01.S.doc Version 5.0 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Numbers 12 and 15. Service users’ lifestyles experienced in the home have improved but more consultation and understanding of the service users’ conditions would improve their quality of life still further. Service users are not receiving an acceptable standard of varied, appealing, wholesome and nutritious meals. EVIDENCE: Service users and visiting professionals said there were more activities and staff were spending more time engaging with service users. Visiting professionals said staff would be able to engage with service users in a more meaningful way and be able to help them take part in activities if they had a better understanding of the service users’ conditions, particularly dementia. A Church of England clergyman visits the home to lead a religious service and give communion but service users who are Roman Catholic have not been consulted to determine whether or not this is acceptable to them. Several service users said they would like to go out of the home. The inspector noted service users were not consulted about what television programmes they would like to watch. Service users and staff said the meals were better but the variety and quality of the food could still be improved. From observation, looking at menus and discussion with staff and service users it was noted that: a) the ‘likes and dislikes’ information sheet in the kitchen had not been up dated to include the Lifecare Home DS0000011253.V253701.R01.S.doc Version 5.0 Page 12 recently admitted service user; b) the menu showed little variation of meals i.e. chicken was on the menu four times a week; c) Sunday lunch is always roast chicken followed by fruit crumble and custard (the manager said that service users only want roast chicken but service users spoken to said they would like to see other roast dinners provided such as lamb and beef); d) a high number of processed foods were used which are high in salt, fat and sugar; and e) the cook is primarily a carer and has had no formal training in catering. Lifecare Home DS0000011253.V253701.R01.S.doc Version 5.0 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Number 16. A complaints procedure is in place but service users need to be aware of how to make a complaint. EVIDENCE: The home has a complaints procedure. Service users and relatives are given a summary of these procedures on admission. Staff have been reminded at a recent staff meeting to record all complaints. The manager occasionally has individual talks with service users about how they are being cared for. However none of the service users spoken to were aware of the complaint procedures. Lifecare Home DS0000011253.V253701.R01.S.doc Version 5.0 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Number 22. Service users will have the specialist equipment they require, when the registered person responds to the recommendations of the Occupational Therapist. EVIDENCE: In response to the requirement made at the last inspection, an Occupational Therapist has undertaken individual assessments of all the service users to check the correct equipment and aids are available to them. The manager is responding to the recommendations. Lifecare Home DS0000011253.V253701.R01.S.doc Version 5.0 Page 15 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Numbers 27, 28, 29 and 30. There are sufficient staff on duty during the day but an effective staff team must be on duty at night. No member of staff has achieved a NVQ 2 or above in care. The registered person operates a thorough recruitment procedure. Staff have undertaken a comprehensive training programme in the last year but there are still crucial areas of knowledge and skills that need addressing. EVIDENCE: In addition to the manager, three care staff are on duty during the mornings and two care staff are on duty during the afternoons and evenings. One of the care staff on duty during the mornings cooks the lunchtime meal. A cleaner is also employed. At night there is one member of staff on duty supported by a staff member who lives in the home. The member of staff who lives in the home is expected to be ‘on call’ every night of the year. It was noted that one service user needs two people to enable her to use the toilet. From records seen it is evident that this service user is not using the toilet at night. The service user said she has to wear pads and feels this is a loss of dignity. A member of staff must be on ‘sleep in’ duty who is part of the duty rota and therefore can be guaranteed to be available to support whenever there is a need. Several of the staff interviewed were uncertain about the exact conditions service users were suffering from. They knew those that suffered from Lifecare Home DS0000011253.V253701.R01.S.doc Version 5.0 Page 16 diabetes and short term memory but did not know those that suffered from conditions such as Parkinson’s disease and Korsakoff syndrome. Staff files seen had the necessary documents, information and recruitment checks. No member of staff has achieved a NVQ 2 or above in care. Three members of staff have been enrolled on NVQ courses. Training opportunities have significantly increased in the last year and an outside consultant has undertaken training needs assessment of the staff team. Since the last inspection nine staff have received core training, including moving and handling, and five others have been booked on core training courses. All the staff have received training in how to use the hoists. There is an induction and foundation training programme for new staff. The manager is introducing a system to ensure refresher training takes place. An area that needs to be addressed is staffs’ understanding of the various conditions service users suffer from. Visiting professionals said the knowledge and understanding of these conditions is very variable between staff. As the home has a high number of service users who suffer from a mental health condition such as dementia and korsakoff syndrome, staff need to receive training in order that they can respond, stimulate and engage with service users in a more knowledgeable and positive way. Lifecare Home DS0000011253.V253701.R01.S.doc Version 5.0 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Numbers 31, 32, 35 and 36. A new manager has recently been employed who has yet to be registered by the Commission. The new manager has a clear sense of direction and has aims and objectives to ensure the home meets the needs of the service users. Service users’ financial interests are safeguarded. Staff have started to receive regular supervision. EVIDENCE: The new manager has only been in post for a few months. She is applying to become registered. She should have completed the NVQ4 in care and the Registered Managers’ award by February 2006. Lifecare Home DS0000011253.V253701.R01.S.doc Version 5.0 Page 18 The new manager has reorganised the working arrangements within the home and clarified the duties and responsibilities to be undertaken. Staff said communication has improved and they are working better as a team. Only one recorded staff meeting could be found for this year. The inspector was informed more have taken place. Five service users have their personal money looked after by the manager. Only the manager handles this money. It is kept in a secure facility and records are kept. Records are kept of all possessions brought into the home by the service users. Service users who look after their own money have secure facilities in their bedrooms. Records showed the manager has started to have regular supervision with her staff. She said appraisals would start to take place in the near future. Lifecare Home DS0000011253.V253701.R01.S.doc Version 5.0 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X X X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 1 9 X 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 X 14 X 15 1 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 X X X X 2 X X X X STAFFING Standard No Score 27 1 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 X X 3 3 X X Lifecare Home DS0000011253.V253701.R01.S.doc Version 5.0 Page 20 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP7 Regulation 15 Requirement The service user’s plan must set out in detail the action which needs to be taken by care staff to ensure that all aspects of the health, personal and social care needs of the service user are met. Care staff must maintain the personal and oral hygiene of each service user The registered person must provide, in adequate quantities, suitable, wholesome and nutritious food which is varied and properly prepared. The registered person must ensure that at all times suitably qualified, competent and experienced persons are working at the care home in such numbers as are appropriate for the health and welfare of service users. The registered person must ensure that staff receive training appropriate to the work they are to perform. Timescale for action 31/01/06 2 3 OP8 OP15 12 16 31/12/05 16/12/05 4 OP27 18 09/12/05 5 OP30 18 28/02/06 Lifecare Home DS0000011253.V253701.R01.S.doc Version 5.0 Page 21 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 3 4 5 Refer to Standard OP12 OP12 OP12 OP16 OP27 Good Practice Recommendations Service users who are practicing Roman Catholics are consulted about receiving communion from a Church of England clergyman. Service users should be consulted about what they would like to watch on the television. Every effort should be made to provide opportunities for service users to engage in community activities and recreational trips. Service users should be made aware of how to make a complaint. Staff should know the mental and physical conditions of all the service users. Lifecare Home DS0000011253.V253701.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Berkshire Office 2nd Floor 1015 Arlington Business Park Theale, Berks RG7 4SA 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 Lifecare Home DS0000011253.V253701.R01.S.doc Version 5.0 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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