Inspection on 26/04/05 for Linden Court

This inspection was carried out on 26th April 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 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 02/08/05

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 Announced 26 April 2005 09:15 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 Version 1.10 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 Version 1.10 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 11/01/05 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 has en-suite facilities but there is 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 Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over 6 hours with the Manager in attendance throughout. The pre inspection questionnaire, menu’s for the month and copies of the 4 week rota’s were ready to be included as part of the inspection. (These documents were taken away and looked at after the inspection but information within them have been included in this report). In all 8 residents were spoken to. With a meal taken with all the people who live at Linden court. A tour of the building with the Manager and again without the Manager took place. All staff on duty, including kitchen and cleaning staff were seen going about their tasks. 3 staff members were spoken to in more detail and in private. Visitors were seen coming and going and 2 were spoken to for information. What the service does well: What has improved since the last inspection? What they could do better: The residents need to be stimulated throughout the day on a regular basis. The care staff who are the key workers need to be more involved in developing the care plans which incorporate background information to build a picture of the person to ensure the personal needs of the resident are met. Linden Court Version 1.10 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Linden Court Version 1.10 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 Version 1.10 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) 3 This Home does not have care needs information prior to admission for all potential residents, which means that care needs might not always be met. EVIDENCE: On looking at some paperwork for people who had been admitted to Linden Court it was noted that only planned admissions had the relevant information before hand to assess if the Home could meet the needs of the individual. People who had needed an emergency placement could not have a pre assessment form completed, but it was noted that relevant paperwork was faxed through to the Home as soon as possible giving clear details of need. Linden Court Version 1.10 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 and 9 It is clear that the Home holds relevant information that ensures the health and care needs of the people who live there are met appropriately EVIDENCE: The home is working towards improving the recording of information on a comprehensive format that will give clear guidance to staff on the care required for residents. This was seen in 4 care plans on the day of inspection. The recording of care practice and the support offered by the health professionals was seen in 3 care plan files. On talking to people who live at Linden Court and checking the care plans and daily records for these people it was clear that needs were being met. Records of visits by the GP and district nurse were seen along with visits documented for the chiropodist. No resident at this present time take responsibility for their medication although this is an option that is discussed with the person and family as part of the care plan. Each room was seen with a lockable drawer if a person wishes, and has also been assessed as able to manage this part of their need. The Home has a clear medication procedure as part of Norfolk C.C. policies and procedures. Linden Court Version 1.10 Page 10 Linden Court Version 1.10 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 This Home needs to find ways to stimulate and encourage residents to be more active throughout the day. The meal served on the day of inspection was healthy and nutritious. EVIDENCE: Throughout the inspection long conversations were held with 5 residents. It was clear that the expectations of these people were being addressed and all the people were happy with the support they get from the staff. One person said “It is the best home in Norfolk”. A concern shared with the Manager was the lack of stimulation for the residents. This was observed on walking around the building. Many of the residents were seen in the lounge sitting in a big circle at the edge of the room asleep, with the television on but no one listening or watching it. Occasional activities do happen but are more on an adhoc basis carried out by the care staff or when entertainment is paid for or the Church offers communion. (Requirement) 4 relatives visited during the inspection with the Inspector talking to 2 who visit every week. They both felt the care offered was suitable but wished a way could be found to motivate their mother. They are always made to feel welcome and able to talk to staff about any concerns. A meal was taken with the residents in their dining room that offered choice of both the main course and dessert. It appeared attractive and was enjoyed by Linden Court Version 1.10 Page 12 those sitting in the room. Four residents needed assistance with their meal and 2 staff members sat down to do this task, giving encouragement to those people throughout. A wipe board in the dining room showed the meals for the day and relatives could see this typed information on the notice board at the entrance to the Home. Linden Court Version 1.10 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) 18 It is clear that staff understand how residents should be protected from abuse. EVIDENCE: The staff are trained and know where the policy on vulnerable adults is held in the office. The 2 staff spoken to are both aware of the whistle blowing procedure and feel they could talk to the Manager or senior if they were concerned about any care practice that could be seen as abusive. Linden Court Version 1.10 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) 19,20, 25 and 26 The environment is comfortable and safe but need some areas decorated and soft furnishings put in place for the privacy of the residents. EVIDENCE: Linden Court is beginning to look shabby in certain areas of the building. Metal window frames are in need of paint and areas around these metal frames are cracked and need some maintenance work done on them. (Recommendation) The decorators were painting the outside of the Home on the day of inspection which gives the exterior a fresher look. A new carpet throughout the hall and corridors has much improved these communal areas giving a nice environment for people to move about in. Two bedrooms were noted to have frosted glass panels in the top half of the doors which does not allow full privacy to the people who live in those rooms. (Requirement) Also noted was the lack of window blinds or curtains on a few Linden Court Version 1.10 Page 15 bathroom and toilet windows, which again is not offering privacy to the person using that facility. (Requirement) Records seen and labels on equipment show that the servicing had taken place of the fire extinguishers and hoists dated 20/10/04 and the pre questionnaire completed by the manager showed all servicing of equipment throughout the building was within the last 12 months except the Fire Officer visit which is now due. The homes lift still needs to be replaced as required in the last inspection to allow better access between the two floors. This lift can not accommodate a wheelchair and staff member comfortably. (Requirement) There is plenty of areas for people to relax, make a drink and entertain visitors that is comfortable and pleasant. The home has a nice well-established garden with seating which is used by residents in the warmer weather. No unpleasant odours were detected. The laundry, sluice areas and clinical waste are all dealt with appropriately with clear infection control guidelines to ensure these high risk areas have procedures that are correctly followed. It was noted in the laundry that light and dark flannels are used for personal washing with disposable cloths available for some tasks when the cloth needs to be thrown away. A recent outbreak of gastro enteritis was managed and over within a week with good infection control procedures followed by all staff. Linden Court Version 1.10 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) 27,29 and30 The staff are recruited, trained and competent ensuring the residents are well cared for. EVIDENCE: The rota’s for the past 4 weeks were looked at and the hours calculated showed the staffing levels to be higher than the required 11 hours per resident per week. This is a good ratio and with the competences seen while the inspection took place should ensure a good service is offered. As the staff went about their duties it was noted the conversations and approach to the residents was respectful and caring Two care staff were spoken to in detail. Both had many years of experience, attended all the training required and one had nearly completed her NVQ2. Records of training were seen in staff files where some of the photocopies of the certificates were held. The home at present relies on the personnel department of the County Council to ensure that the recruitment procedure is appropriate and all paperwork CRB checks and references are handled centrally. Once the recruitment has taken place photocopies of the paperwork is then sent to the Home for the individual staff files. On talking to the staff it was clear that regular statutory training is kept on a rolling programme including moving and handling, first aid, fire awareness, food hygiene and adult protection. Some certificates were seen. 48 of the staff have now gained the NVQ2 qualification with a further 5 staff part the Linden Court Version 1.10 Page 17 way through. New staff work along side experienced staff as part of their induction with training planned over the first few months of employment. Linden Court Version 1.10 Page 18 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) 31,32,33,36 and 38 Linden Court is managed by a person who is able to cover her duties fully and competently with an open and inclusive manner. EVIDENCE: The Manager has been at Linden Court for three years with many years of experience within the caring field. The residents feel able to approach her if they have any concerns and many of them will attend a residents meeting which are held every 2 months to air their views. Throughout the day of the inspection the Manager spoke to families, friends, staff and residents in a professional manner. Clear leadership was shown which was echoed by the staff on talking to the Inspector. A quality assurance monitoring system has been undertaken in March with an excellent return (95 ) on the questionnaires that were sent out. Included Linden Court Version 1.10 Page 19 were health professionals, relatives and friends, staff and residents. 2 comments were read at random stating “My father found it hard to settle, staff persisted with kindness and understanding. I am extremely fortunate that father is in capable hands.” Another was “not so happy with the courtesy of the staff”. The Manager is already planning to discuss this with the family. This information is now being collated and will be shared with everyone who was involved. The manager has a supervision file for each staff member and these one to one meetings will happen as near to 6 weekly as possible. A copy of 2 staff members supervision notes were seen and the records were kept in a locked drawer. The Home is managed to ensure safe working practices are followed by a good training programme to suit the needs of the staff. Records and regular recording practice is in place as seen on equipment stickers and in record logs. Throughout the building taps in bathrooms and hand wash basins were turned on at random and all were felt to be at a suitable temperature. All people who visit the home sign in and out of the visitors book which is open with a pen in the entrance lobby. All visitors who came and went throughout the day were seen to record in the book their visit. The building risk assessments are held in the main office and accessible to all staff for information. Residents have a personal risk assessment if required , kept in their own care plan folder. The accident recording was seen and the last 10 incidents discussed. The Manager has dealt with the accidents and near misses in the appropriate way with clear recording practice and follow up intervention where necessary.. Linden Court Version 1.10 Page 20 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. Where there is no score against a standard it has not been looked at during this inspection. 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 2 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 2 3 x x x x 2 3 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x 3 3 3 4 x x 3 x 3 Linden Court Version 1.10 Page 21 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 large enough to carry a wheelchair plus a member of staff safely. (THIS IS AN OUTSTANDING REQUIREMENT).. The registered person must ensure all bedrooms are fitted with locks for residents privacy. (THIS IS AN OUTSTANDING REQUIREMENT).. The registered person must ensure that suitable social interests and stimulation is provided and recorded as part of thei residents care plan. The reistered person must ensure that all windows have a blind or curtain in the bathrooms and toilets to allow privacy for all users. The registered person must ensure the two bedrooms with glass panels in the doors are removed or covered to allow privacy. Timescale for action June 30th 2005 2. 24 OP23 June 30th 2005 3. 12 OP16 July 31st 2005 4. 24 OP16 July 31st 2005 5. 24 OP16 June 30th 2005 Linden Court Version 1.10 Page 22 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 Good Practice Recommendations Linden Court Version 1.10 Page 23 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. 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