Inspection on 01/11/05 for Lime Court

This inspection was carried out on 1st November 2005.

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

Lime Court 26/11/08

Lime Court 12/12/06

Lime Court 05/05/05

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Lime Court Lime Avenue Dovercourt Essex CO12 4DE Lead Inspector Brian Bailey Unannounced Inspection 1st November 2005 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 Lime Court DS0000063091.V262867.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. Lime Court DS0000063091.V262867.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Lime Court Address Lime Avenue Dovercourt Essex CO12 4DE 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) 01255 506340 Excelcare Holdings Mrs Catherine Stronach Care Home 38 Category(ies) of Dementia - over 65 years of age (24), Old age, registration, with number not falling within any other category (38) of places Lime Court DS0000063091.V262867.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. Persons of either sex, aged 65 years and over, who require care by reason of old age only (not to exceed 38 persons) Persons of either sex, aged 65 years and over, who require care by reason of dementia (not to exceed 24 persons) The total number of service users accommodated in the home must not exceed 38 persons) Twenty one service user bedrooms with an area of less than 10 sq.m. will be used only following a written assessment. The essessment should include consideration of whether the facilities in the room are suitable for, and acceptable to, the service user, taking into account their mobility needs. The service user plan should reflect the assessment findings 5th May 2005 Date of last inspection Brief Description of the Service: Limecourt is a large purpose built home situated in a quiet residential area at Dovercourt. The home is within easy reach of the sea front and local amenities. Accommodation is provided on the ground and first floor, which is accessed by a passenger lift. There are 30 single bedrooms and 4 shared rooms. The home has a secure central courtyard and garden with patio area that is accessible to service users. Excelcare owns the home and the manager is Catherine Stronach. The home provides 24-hour care to older people with a wide range of dependency levels, who are generally physically and/or mentally frail. Lime Court DS0000063091.V262867.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on Tuesday 1st November 2005 between 9.30am and 4.30pm. This was the second inspection of Limecourt in the inspection year 2005/06. During the inspection, the manager, staff, six residents and two visitors gave their views about the home. The majority of residents were seen during the inspection. A tour of the building included a check of some bedrooms, bathrooms and the lounges, dining room and the kitchen. Records checked included the home’s statement of purpose, residents’ finances, staff training, medication, activities, some aspects of health and safety, Quality Assurance system and the midday meal was observed. Of the standards assessed at this inspection three requirements have been made that will require attention. What the service does well: The home continues to present as a comfortable and clean environment for residents with numerous touches that contribute to its homely appearance despite its size and layout. Residents spoken to were complimentary about the home, staff and facilities. When asked about what they considered the home does well, residents said “everything” although a few residents commented on the need to have more activities. They liked the food and opportunity to make choices at meal times and being able to come and go as they pleased. The food at the midday meal was well presented and appetising. Staff were observed as cheerful and attentive and demonstrated that they were careful when assisting residents with mobility difficulties. The administration of medication was well organised and residents’ finances looked after by the home for safekeeping was accurate and up to date. The manager was in the process of assessing whether changes can be made to the internal layout of the building to improve facilities for residents. Lime Court DS0000063091.V262867.R01.S.doc Version 5.0 Page 6 What has improved since 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. Lime Court DS0000063091.V262867.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 Lime Court DS0000063091.V262867.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): 2 Residents and their relatives benefit from being fully aware of the conditions of their residency at the home. EVIDENCE: Evidence was available to show that a new statement of the terms and conditions for use between the home and residents had been produced. The statement includes the requirements of the National Minimum Standards and details those items considered to be extra to the fees, such as toiletries, newspapers and hairdressing. The manager was in the process of issuing these to replace agreements provided by the previous owner. Lime Court DS0000063091.V262867.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): 9 Residents are safeguarded by a well maintained system for administering medication. EVIDENCE: Medication is administered from a monitored dosage system by designated senior staff only who have been assessed as competent. The medication is kept in a lockable trolley and cupboard. The medication administrative record sheets were up to date and packets dated on the day of opening. Staff said controlled drugs were kept in a separate locked cupboard and a register is used to record medication administered, but these were not checked on this occasion. Lime Court DS0000063091.V262867.R01.S.doc Version 5.0 Page 10 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): 12, 13 and 14. Residents’ levels of independence and the availability of care staff determine the opportunities for residents to feel fulfilled and stimulated. The recruitment of an activities coordinator will benefit all residents. EVIDENCE: Although there was no evidence of activities taking place during the inspection, four residents spoke about the activities, entertainment and outings they enjoy but all wanted there to be more activities provided. The residents were not aware that the home was trying to recruit an activities coordinator but felt they would all benefit from such an appointment. Three residents spoke of how much they enjoyed going out for a meal together to celebrate a birthday. A church service is held monthly and outings in October included visits to garden centres. Staff stated that residents had been involved in planting bulbs in readiness for next spring. The manager spoke of the importance that the “Friends of Limecourt” play in the running of the home and of their contribution to the facilities available. Whilst it is clear that activities take place, it is residents that are less dependent on staff that are more able to occupy themselves and residents with higher dependency needs that require more involvement and stimulation. Lime Court DS0000063091.V262867.R01.S.doc Version 5.0 Page 11 Residents said how much they liked friends and relatives to visit them. A relative spoke of visiting the home on a regular basis and considered the staff care for residents well and had no concerns or complaints. A discussion was held with residents about the opportunities for choice they had each day. One person, who was at the home for a period of respite care, spoke of not having to change their routines about what they did each day. They were able to get up in the morning when they liked and to retire to their bedrooms whenever they wanted. A choice of meals was always available, which was evident at the midday meal. A resident spoken to said the staff were attentive to their needs and were kind and patient. Lime Court DS0000063091.V262867.R01.S.doc Version 5.0 Page 12 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): 18. Adequate systems and procedures are in place to protect residents from abuse although further training is required. EVIDENCE: These standards were assessed at the previous inspection. However, although all staff has received in-house training on the protection of vulnerable adults and information was readily available, the manager acknowledged the need to obtain further training provided by the Essex Vulnerable Adults Committee and to check their website for information. Four residents spoken to said they felt safe at the home and considered they were well cared for by kind staff. Residents knew the name of the manager and said they would speak to her if they had a complaint. Lime Court DS0000063091.V262867.R01.S.doc Version 5.0 Page 13 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): 19, 20, 24 and 26. Residents benefit from living in a clean, well decorated and furnished property, but facilities in the dining room and odour control in one bedroom need to be improved. EVIDENCE: Limecourt is a large purpose built home that is well maintained and decorated and furnished to a good standard. There is a passenger lift that provides access to the first floor, but the long corridors present difficulties for some residents that wish to be independent and use the dining room and lounges on the ground floor. A tour of the building concluded that with the exception of one bedroom where there was poor odour control, other bedrooms seen, lounges, dining rooms, kitchen and laundry were clean and pleasant smelling. Lime Court DS0000063091.V262867.R01.S.doc Version 5.0 Page 14 The home has an attractive internal courtyard that is safe and accessible to residents. Many areas of the home including residents’ bedrooms were homely and comfortable in appearance. The home has sufficient bathrooms and toilets for residents although none of the rooms have en-suite toilets. It was noted that a dining table used by a resident with a wheelchair was not entirely suitable as the resident appeared to find it difficult to sit close enough when eating a meal. The manager agreed to consult an Occupational Therapist to consider the most appropriate solution. Staff were of the opinion that the carpet in the dining room was a major problem to keep clean owing to the constant spillage of food. Lime Court DS0000063091.V262867.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): 27, 28 and 30. Residents benefit from being supported by an experienced team of staff, of whom, the majority have obtained National Vocational Qualifications. EVIDENCE: Staff rosters were available that showed that there were five staff on duty plus a shift leader during the morning and afternoon/evening shifts. In addition there was a cook, domestics and the manager. Records showed that of the twenty eight care staff employed, a total of seventeen had obtained a National Vocational Qualification at level 2, one staff member was in the process of taking the qualification and three were planning to take it. In addition, five staff had NVQ at level 3. This means that the home has achieved the National Minimum Standards target of 50 of care staff having obtained the qualification by the end of December 2005. Evidence was available to show that new staff are required to undertake an induction course that meets the required standard and that a range of training is provided. Recent courses included diabetes, medication, falls prevention and pressure care. Lime Court DS0000063091.V262867.R01.S.doc Version 5.0 Page 16 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): 33 and 35. Obtaining the views of residents and other interested people about the home and the services provided would ultimately benefit residents assuming the home is able to address any issues raised. Residents benefit from a system that safeguard their finances effectively. EVIDENCE: The home has a Quality Assurance system and the most recent survey was carried out in August, which included obtaining feedback on the services provided from GPs, district nurses, hairdresser, relatives and residents. The returned questionnaires were in the process of being analysed and the manager was hopeful that the results would be published in the near future. A discussion was held with the manager as to how the results would be used and that these should be included in the annual review of the home’s performance. Lime Court DS0000063091.V262867.R01.S.doc Version 5.0 Page 17 Three residents’ finances looked after by the home for safekeeping were checked. Records were well maintained and accurate and all expenditure was in accordance with those items considered to be extra to the fees, such as hairdressing, newspapers, chiropody and toiletries. A requirement at the last inspection for all staff to receive fire training had been addressed and further training was to be provided. Lime Court DS0000063091.V262867.R01.S.doc Version 5.0 Page 18 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 3 X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 X 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 x 17 X 18 3 3 3 X X x 2 X 2 STAFFING Standard No Score 27 3 28 3 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X 3 X X X Lime Court DS0000063091.V262867.R01.S.doc Version 5.0 Page 19 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 OP12 Regulation 16 Requirement The home must provide a range of activities on a regular basis that involves all residents, particularly those with high dependency levels. The registered person must review whether the dining tables are appropriate for wheelchair users. The carpet in the bedroom identified to the manager, must be cleaned more effectively or replaced with a suitable floor covering. Timescale for action 31/12/05 2 OP20 23 31/12/05 3 OP26 23 31/12/05 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 OP15 Good Practice Recommendations The provider should consider how the layout of the home could be improved to meet the needs of residents with dementia. Lime Court DS0000063091.V262867.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ 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 Lime Court DS0000063091.V262867.R01.S.doc Version 5.0 Page 21 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!