Inspection on 06/04/05 for Little Court Nursing Home

This inspection was carried out on 6th 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

Little Court Nursing Home 27/06/07

Little Court Nursing Home 10/01/06

Little Court Nursing Home 02/09/04

Little Court Nursing Home 11/05/04

Little Court Nursing Home 26/11/02

Similar services:

Springfield House

Sutton Lodge Nursing Home

The Shelley

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Little Court Nursing Home Roopers, Speldhurst Tunbridge Wells Kent TN3 0NY Lead Inspector Maria Tucker Unannounced 6 April 2005 10:05 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. Little Court Nursing Home H56-H06 S26188 Little Court V220100 060405 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service Little Court Nursing Home Address Roopers, Speldhurst, Tunbridge Wells, Kent. TN3 0NY 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) 01892 863414 01892 861454 Mr Peter Francis Gregory Mr Peter John Hart CRH Care Home 28 Category(ies) of Old Age (28) registration, with number of places Little Court Nursing Home H56-H06 S26188 Little Court V220100 060405 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: 1 Care is given to one service use with a d.o.b. 22 October 1939 Date of last inspection 06 April 2005 Brief Description of the Service: Little Court Nursing Home is a care home with nursing, it is a large old house standing in its own grounds with new buildings attatched. The home is arranged on two floors, there is a passenger lift. Twenly rooms are for single occupancy and there are four double rooms. Ten rooms have en suite. Car parking on site is abailable albeit limited. There are ample car parking spaces on surrounding roads. Little Court provides accommodation for twenty-eight older persons. The home utilises a staff roster that gives 24-hour care cover, with a Qualified Registered Nurse on duty at all times and waking night staff. The home also employs staff for catering, domestic and maintenance purposes. The public transport bus service stop is within 800 yards and High Brooms railway station is approximately five miles away. Tunbridge Wells is the nearest large toem and it has all the usual facilities. The home is a non smoking establishment. Little Court Nursing Home H56-H06 S26188 Little Court V220100 060405 Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Little Court provides an individual service based upon the service users needs, which are identified through assessments made and a good care planning system. The manager and staff were open to the inspection and freely discussed any issues raised and good practice. The staff on duty during the inspection consisted of the manager, 2 registered nurses (RGN); 4 care assistants; 1 cook and 1 kitchen assistant. The home is limited in space for service users and staff, which is compounded by the lack of an office and a visitor’s room. The proprietors have stated for 2 years that a conservatory would be built and the completion for this was agreed by them with the inspector to be December 2004. No conservatory has been built and no contact made to the CSCI in respect of any delays. What the service does well: What has improved since the last inspection? What they could do better: The home is limited for space and this has an impact upon the service users choice dignity and respect, as they are restricted in where they are able to meet visitors. There is no office, which is needed so that meetings such as supervision can be held without interruption and the current arrangements of an office area that impinges in the service users lounge would be eliminated. Little Court Nursing Home H56-H06 S26188 Little Court V220100 060405 Stage 4.doc Version 1.20 Page 6 The proprietors should be meeting the National Minimum Standards Care Home Regulations and working more in partnership with the CSCI. 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. Little Court Nursing Home H56-H06 S26188 Little Court V220100 060405 Stage 4.doc Version 1.20 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 Little Court Nursing Home H56-H06 S26188 Little Court V220100 060405 Stage 4.doc Version 1.20 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 3, 5, 6. Without a full version of the Statement of Purpose and Service Users Guide the service user and their representatives do not have a full picture to understand fully the service provided. Service Users and their representatives are supported in the choice of home based on the assessments made by professionals and the home ensuring that their needs are identified and can be met in the home. EVIDENCE: The last inspection report detailed the items to be included in the Statement of Purpose and Service Users Guide. The Manager has been working on these documents with the Elderly Nurse Specialist as evidenced from detailed notes with comments and suggestions shown to the Inspector from discussions between them had been held. A recently admitted service user stated that the staff from the home had visited them to undertake an assessment prior to them being admitted; that their Care Manager had written and signed on their behalf their care plan and that their representative had been included in this process. The registered nursing input was determined from a Health assessment the Inspector discussed this with the service user and a Qualified Nurse at the home. The home does not provide intermediate care. Little Court Nursing Home H56-H06 S26188 Little Court V220100 060405 Stage 4.doc Version 1.20 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, 10 The care plans provide sufficient details so that the health care needs can be met. Specialist professional support is sought when required so that the standard of care and nursing received by the service user is individually tailored and their health needs are maintained and promoted. Service users privacy and dignity is not respected and cannot be met if they chose to meet health and social care professionals in a private room other than their own room. For service users who share a room a private consultation in their own room are further restricted as to who and when the room is occupied. EVIDENCE: The inspector discussed with two service users their care needs and their preferences. These were followed through from looking and discussing the care plans with the named nurse and in a separate discussion with the manager. One service user expressed a preference for supper, which was stated in the care plan. Care plans are reviewed by staff monthly. An assessment identified the need for exercises to increase mobility. There was a record in the notes of these having taken place and the service user demonstrated what the exercises were and how they helped them and staff in promoting and maintaining what they can do and the support needed from care staff. The care plans included a range of assessments including risk assessments. Various health professions work with the home in supporting and assisting with Little Court Nursing Home H56-H06 S26188 Little Court V220100 060405 Stage 4.doc Version 1.20 Page 10 specialised care these included a physiotherapist and hospice link nurse. One service user currently has a pressure sore, which is being monitored and treated. The home has equipment for the promotion of tissue viability. During the inspection a visiting Doctor was seeing service users in their rooms with a qualified staff member. Staff were observed throughout the inspection to treat the service users with dignity and respect. A staff member who undertakes cleaning stated that she works around the service users when they are in their room and cleans other areas at a suitable time for the service users. A telephone in a service users room for their personal use was said by the service user to have been provided by the home and that they pay for their own calls. Screening was seen to be provided in shared rooms. The home does not have any separate private rooms for the service users to meet with health and social care professionals. Little Court Nursing Home H56-H06 S26188 Little Court V220100 060405 Stage 4.doc Version 1.20 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) 13, 14. Service users receiving visitors are compromised by the lack of a visitor’s room and the option of receiving guests and holding meetings such as a review in a suitable private room. The service users are able to maximise their personal autonomy and choice as they are consulted by staff and supported with decisions. EVIDENCE: Service users visitors were in the home during the inspection. Service users spoken with said that they had regular visitors. There is no private room for service users to receive visitors. A visiting professional support staff who was escorting a relative to visit stated that “visiting is very difficult in the lounge as sometimes other residents interfere and it is cramped”. The inspector observed this. Service users who were seen in their own room stated that it was their choice to stay there and that at times they did choose to use the lounge or dinning area. The rooms had plenty of personal possessions, which the service users stated they had bought in from home. One service user said that they chose to go to bed after 9pm. A service user told the inspector that they have chosen to no longer manage their own financial affairs that a relative supports them in this. The manager had a copy of the Draft Mental Incapacity Bill. Little Court Nursing Home H56-H06 S26188 Little Court V220100 060405 Stage 4.doc Version 1.20 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 standard(s) 16, The manager and staff are proactive in meeting the service users needs, which has resulted in complaints being very limited. Service users are consulted as to if everything is ‘alright’ and subsequent action of any requests, making them feel listened to and respected. EVIDENCE: The complaints book was inspected and found to contain 1 complaint that had been followed through and managed appropriately. Service users spoken with stated that they would say if they had a complaint. The inspector asked several service users if they had any complaints or anything that they feel they would differently or improved. A service user said that their tea was not as warm as they would have liked it that morning but it was usually. The comment made a representative about lack of privacy for visiting is being addressed in this report and subsequent actions by the CSCI. Little Court Nursing Home H56-H06 S26188 Little Court V220100 060405 Stage 4.doc Version 1.20 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 standard(s) 20, 22, 23, 24 The service users needs in respect of their personal choices and private accommodation have not been addressed restricting and limiting their opportunities. EVIDENCE: The home has not completed a full schedule of accommodation required in the statement of purpose. The communal space of a dinning room and the lounge does not cater for all service users. A suitably qualified person, including a qualified occupational therapist, has not made an assessment of the premises and facilities. Call systems have not been replaced. The furnishings for the individual rooms have not been assessed as to if all items as listed in 24.2 are required. Little Court Nursing Home H56-H06 S26188 Little Court V220100 060405 Stage 4.doc Version 1.20 Page 14 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, 30 The home have a good level of staff and skilled work force who continue to update their knowledge base and competences providing a high level of expertise and care in meeting the service users needs. EVIDENCE: Regular staff training takes place with Kent Care Training Associates LTD. The NVQ assessor detailed to the inspector some training undertaken and ongoing. Staff spoken with said they were supported in meeting their training needs and offered ample training. The manager is registered to do the NVQ level 4 award. The home have a range of staff including qualified nurses, care staff, cook, kitchen assistant, laundry person, cleaner and a staff who provides entertainment. Little Court Nursing Home H56-H06 S26188 Little Court V220100 060405 Stage 4.doc Version 1.20 Page 15 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 The home is run openly and efficiently, which enables the needs of the service users to be met. EVIDENCE: The manager has not got the NVQ level 4 in management, but holds the RGN and RMN qualifications, has considerable experience in the running of the home. Other agencies and professions are consulted for advice and support demonstrating openness to joint working. Little Court Nursing Home H56-H06 S26188 Little Court V220100 060405 Stage 4.doc Version 1.20 Page 16 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 2 x 4 x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 1 14 3 15 x COMPLAINTS AND PROTECTION x 2 x 2 2 2 x x 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 Standard No 16 17 18 Score 3 x x 2 3 x x x x x x Little Court Nursing Home H56-H06 S26188 Little Court V220100 060405 Stage 4.doc Version 1.20 Page 17 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 OP 1 Regulation 4 Schedule 1(5) (8) (11) (15) (16) 5 Schedule 1 (1) (2) (3) Requirement The registered person shall compile a Statement Of Purpose. The registered person shall supply a copy to the Commission and make a copy available on request for inspection by every service user and any representative of a service user. The registed person shall produce a written guide to the care home which shall include a summary of the statement of purpose. The registered person shall make suitable arrangements to endure that the care home is conducted in a manner which respects the privacy and dignity of service users. Timescale for action Completed versions to be recieved by the CSCI by 6th June 2005 2. OP 10 12 (4) (a) 3. OP 13 23 (2) (i) A letter from the responsible individual confirming the date for completion to be recieved by the CSCI by the 6th June 2005 The registered person shall A letter having regard to the number and from the needs of the service users responsible ensure that (i) suitable facitlites individual are provided for service users to confirming Version 1.20 Page 18 Little Court Nursing Home H56-H06 S26188 Little Court V220100 060405 Stage 4.doc meet visitors in communal accommodation, and in private accommodation which is seperate from the service users own private rooms. 4. OP 20 23 (1) (a) (2) (f) 5. OP 23.5 23 (1) (a) (2) (a) (f) 6. OP 31 9 (1) (2) (i) the date for completion to be recieved by the CSCI by the 6th June 2005 The registered person shall A letter having regard to the number and from the needs of the service users responsible ensure that the physical design individual and layout of the premises meet confirming the date the needs of the service users and that the size and layout of for completion the rooms occupied or used by service users as not all service to be users can be accommodated in recieved by the CSCI the dinning room and lounge. by the 6th June 2005 A letter The registerdd person shall having regard to the number and from the needs of the service users responsible individual ensure that the physical design and layout of the premises meet confirming the date the needs of the service users and that the size and layout of for rooms occupid or used by service completion to be users are suitable for their needs, in that a detailed recieved by assessment must be undertaken the CSCI as to whether room 24A is fit for by the 6th purpose for the service users. June 2005 A person shall not manage a Completion care home unless he has the of the NVQ qualifications necessary for Registered managing the care home. Managers Award by 1st January 2006. Little Court Nursing Home H56-H06 S26188 Little Court V220100 060405 Stage 4.doc Version 1.20 Page 19 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. Refer to Standard OP 23 OP 24.2 OP 22.1 Good Practice Recommendations it is recommended that an assessment be undertaken as to whether bedrooms 15 and 16 are large enough for the occupying service users identified care needs to be met. It is recommended that where practicable service users bedrooms be furhished as detailed by standard 24.2. It is strongly recommended that the call system be updated and replaced. Little Court Nursing Home H56-H06 S26188 Little Court V220100 060405 Stage 4.doc Version 1.20 Page 20 Commission for Social Care Inspection The Oast, Hermitage Court Hermitage Lane Maidstone Kent ME16 9NT 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 Little Court Nursing Home H56-H06 S26188 Little Court V220100 060405 Stage 4.doc Version 1.20 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. 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