Inspection on 02/08/05 for Linden Court

This inspection was carried out on 2nd August 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

Linden Court 07/06/06

Linden Court 26/04/05

Linden Court 11/01/05

Linden Court 27/05/04

Linden Court 19/02/04

Linden Court 28/07/03

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 Linden Court Church Walk Watton Norfolk IP25 6ET Lead Inspector Ruth Hannent Unannounced 2 August 2005 nd 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. Linden Court I55 s38862 lindencourt v242577 020805 stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Linden Court Address Church Walk, Watton, Norfolk, IP25 6ET 01953 881753 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) Norfolk County Council Mrs Pamela Christine Millard Care Home 36 Category(ies) of Old age, not falling within any other category registration, with number (36) of places Linden Court I55 s38862 lindencourt v242577 020805 stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: The home can accomodate up to 36 Older People not falling in any other category Date of last inspection 26th April 2005 Brief Description of the Service: Linden Court is a care home providing personal care and accommodation for up to 36 older people.It is a Local Authority Home situated in the town of Watton, close to local shops, church and other amenities.The home was opened in the mid 1960’s and consists of a two-storey building with an additional two-storey extension. There is a shaft lift for service users and staff to gain access to the first floor as well as being able to make use of the main staircase if appropriate.All the bedrooms at the home are of single occupancy of various sizes. There are no rooms at the home that have en-suite facilities but there are a number of toileting and bathing facilities that are near to the rooms and communal areas.The home has extensive gardens that are well maintained and accessible for the service users as well as a small courtyard that is accessible through the dining area. Linden Court I55 s38862 lindencourt v242577 020805 stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection which took place over four hours with the majority of the day spent with the Senior Carer who was the responsible person for that part of the day. Six residents were spoken to along with the manager who arrived at the end of the inspection. A tour of the building took place. Some care plan records were looked at along with the medication administration procedure. What the service does well: What has improved since the last inspection? What they could do better: The internal fabric of the building could be better maintained. The Home needs to improve on the administration of medication. Menu’s should be clearer and in a print format that is easy to read for residents to be able to understand and make the choice of what they would like to eat. Stimulation for individual people should to be seen and evidenced. Linden Court I55 s38862 lindencourt v242577 020805 stage 4.doc Version 1.40 Page 6 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. Linden Court I55 s38862 lindencourt v242577 020805 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 Linden Court I55 s38862 lindencourt v242577 020805 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) These standards were not inspected on this occasion. EVIDENCE: Linden Court I55 s38862 lindencourt v242577 020805 stage 4.doc Version 1.40 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 standard(s) 7, 8, 9 and 10 Clear and comprehensive details are written in care plans for all residents. The documentation to ensure health needs are met are clear and precise. Medication procedures need reviewing to ensure safe administration of medicines takes place. Residents are treated with respect but to allow full privacy locks for bedroom doors are required. EVIDENCE: In total four care plans were looked at. The details in the care plans are written to include all the needs of the individual person. It was noted that one person has good and bad days and is sometimes up and about and on others prefers to stay in bed. On talking to this person it was clear that she still had this choice and on the day of the inspection wished to stay in bed. On talking to another lady who was taking a late breakfast in the dining room with the assistance of a carer had clear instructions on her care plan of this need. She was smiling and appreciative of her late rising. The format of the care plans are slowly improving making the reading of the documents more manageable Linden Court I55 s38862 lindencourt v242577 020805 stage 4.doc Version 1.40 Page 10 for the new staff. It was also noted on one care plan how a lady needs very milky drinks. On talking to a staff member this is the only way this lady will take a drink and all staff know exactly how she likes it. This was confirmed by the lady herself. Within each care plan is a medical record form that notes any health concerns. Recorded was the resident who was unwell, how many times the doctor had visited with dates and what medication was required. Throughout the lunchtime period the administration of medication was observed. All medication is transported up and down stairs in a locked trolley with most medication stored in a monitored dosage blister pack. Each person has a recording chart and medication was issued as instructed. The swallowing of the medication was not seen. The MAR chart was then signed by the staff member as a recording that the medication had been ingested. This occurred many times throughout the process and is not a safe procedure. (Requirement). The medication trolley is also not always in vision of the staff member and was left unlocked when she was moving in and out of the room to deliver medication. One resident who appears to have short term memory passed the trolley to go to the bathroom when the trolley was unlocked and unobserved. This practise is also unsafe. (Requirement) The staff were carrying out their duties and conversations were heard that were respectful and offering choice. One lady was kindly asked where she would like to be. When escorted to her room she was asked if she wished the door to be left open or closed. The resident was spoken to later and although the staff take her to her room to be private she has no way of locking her door if she wished. (Outstanding requirement) Linden Court I55 s38862 lindencourt v242577 020805 stage 4.doc Version 1.40 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 standard(s) 12, 13 and 15 The stimulation and activities offered needs to improve to ensure all residents are encouraged to continue to pursue their interests. Friends and families are actively encouraged to be involved in the community of Linden Court. The meals served are enjoyed and are wholesome but the choice available is not always evident EVIDENCE: The care plans have clear details of the interests and lifestyles enjoyed by the residents. Although this is written in their care plans the continuity of stimulation and activities is not evident for all residents once they move in to Linden Court as no records were seen on individual activities. Motivated residents were seen knitting, talking and smoking but many were sitting around the room with the television playing and no one watching. The activities programme for August was not in place but at least six activities had taken place over the month of July. The recent barbeque was talked about by some of the residents with great enthusiasm with one lady saying she got up and danced which she hadn’t done for a long time. The individual stimulation is not in place for those less motivated with no evidence found on daily records to show this is happening. (Outstanding Requirement) The manager stated Linden Court I55 s38862 lindencourt v242577 020805 stage 4.doc Version 1.40 Page 12 she is allocating the responsibility of stimulation and activities to a senior staff member who has a particular interest in this area of care. Residents who were spoken to told of their families and friends who visit as often and at whatever time they wish. The families were invited to the barbeque and many attended with good feedback given to the staff on the event. On talking with five of the residents about the choice of meals it was difficult for them to say they were offered a choice. One lady knew the menu was on the wall but the print was too small and she couldn’t see it. Her daughter had to read it and told her the choice. The meal that was served upstairs did not have the vegetable curry available which was the alternative and although the Manager has heard staff in the past ask the residents what they would like residents could not remember being asked. (Recommendation) Linden Court I55 s38862 lindencourt v242577 020805 stage 4.doc Version 1.40 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 standard(s) 16 The Home has a complaints procedure that is actively used, taken seriously and acted upon in the best interest of the resident, relatives and friends EVIDENCE: The Home has a full complaints procedure and the Manager explained the Home is dealing with a complaint at present. On discussion, in the handling of this concern, it was clear the Manager was actively trying to resolve the problem and also trying different strategies to ensure the concern does not arise again. A meeting was being held the evening of the inspection with the people involved and plans of how to take the issues forward to gain a positive outcome was discussed. Linden Court I55 s38862 lindencourt v242577 020805 stage 4.doc Version 1.40 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 standard(s) 19 and 26 Although the home is safe the environment is not homely and comfortable in some areas. The home is very clean and tidy. EVIDENCE: The Home is safely maintained with records of health and safety checks in place. The fire extinguishers were dated for servicing in 2006 and the hoists were serviced in October 2004 with all equipment holding a service date sticker. On testing the water in two areas the hot was running at hand hot which is suitable for washing safely. The building is tired and old in certain areas. The toilets and bathrooms have flaking paint and some of the bedrooms are plain and lacking in home comforts. The bedroom seen had badly papered walls a sink in the corner had no vanity unit and the metal window frames are cold looking with red tiled window ledges. (Recommendation). Linden Court I55 s38862 lindencourt v242577 020805 stage 4.doc Version 1.40 Page 15 All areas seen were clean, tidy and there was no unpleasant odours detected. The commodes were all washed and returned to the rooms and toilets had been freshly mopped and cleaned. The laundry was managing the washing accrued and it was noted that any soiled items are transported to the laundry via plastic bags for good practise in infection control. Linden Court I55 s38862 lindencourt v242577 020805 stage 4.doc Version 1.40 Page 16 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, 28 The ability of the staff observed and the numbers on duty ensure the needs of the residents are met. The staff need to be encouraged to gain the NVQ2 qualification to ensure the numbers are increased of suitably qualified staff. EVIDENCE: On the day of the inspection one senior, four care staff, three cleaners, one cook and one kitchen assistant were on duty to serve 30 residents. This was sufficient numbers for the residents needs on this occasion. Agency staff are being used at present due to sickness/annual leave and vacancies but the Manager is interviewing again this month and hopes to increase the care staff numbers shortly. The Home has not managed to increase the number of staff who hold the qualification of NVQ2 and this still remains at 48 since the last inspection. The Manager explained that the difficulty lies in trying to encourage long standing staff that this is a qualification that is now required. (Recommendation). Two staff have struggled with getting their work assessed due to assessor not being available or off sick. Linden Court I55 s38862 lindencourt v242577 020805 stage 4.doc Version 1.40 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 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) These standards were not inspected on this occasion. EVIDENCE: Linden Court I55 s38862 lindencourt v242577 020805 stage 4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x x x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 1 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 x 15 2 COMPLAINTS AND PROTECTION 2 x x x x x x 3 STAFFING Standard No Score 27 3 28 2 29 x 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 x x x x Linden Court I55 s38862 lindencourt v242577 020805 stage 4.doc Version 1.40 Page 19 yes 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 22 Regulation OP23 Requirement The registered person must ensure the passenger lift is changed to allow a wheelchair and staff member to travel between floors safely (OUTSTANDING REQUIREMENT x 2) The registered person must ensure all bedrooms are fitted with locks for residents privacy. (OUTSTANDING REQUIREMENT x 2) The registered person must ensure suitable social interests and stimulation is provided and recorded on the daily records (OUTSTANDING REQUIREMENT x 1) The reistered person must ensure residents are seen ingesting their medication before the staff member signs the MAR chart The registered person must ensure the medication trolley is kept locked if out of vision of a staff member. Timescale for action .30th November 2005 2. 24 OP23 30th November 2005 30th September 2005 3. 12 OP26 4. 9 OP13 Immediate and ongoing Immediate and ongoing 5. 9 OP13 Linden Court I55 s38862 lindencourt v242577 020805 stage 4.doc Version 1.40 Page 20 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 15 Good Practice Recommendations It is recommended that the choice of meals and the menus be made clearer and in suitable print for residents to make and remember the choice of meal they have ordered. It is recommended that the Home updates some areas within the home that are looking shabby and outdated. It is recommended that the Management and Senior Staff team encourage the care staff to gain the NVQ 2 qualification. 2. 3. 19 29 Linden Court I55 s38862 lindencourt v242577 020805 stage 4.doc Version 1.40 Page 21 Commission for Social Care Inspection 3rd Floor, Cavell House St Crispins Road Norwich NR3 1YF 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 Linden Court I55 s38862 lindencourt v242577 020805 stage 4.doc Version 1.40 Page 22 - 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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