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Inspection on 10/03/06 for Littlecoates House Care Home

Also see our care home review for Littlecoates House Care Home for more information

This inspection was carried out on 10th March 2006.

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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Littlecoates House exceeded four of the National Minimum Standards. Standards 24,26,31 and 32. The service users all receive a full assessment of their individual needs before they are admitted in to the home. Visitors are welcome at the home at any reasonable time. The service users and visitors spoken to by the inspector were very positive in relation to the quality of the services that are provided in the home. The service users confirmed to the inspector that the quality of the meals at the home was always very good and that there was always a choice if meal provided at all mealtimes. Staff receive appropriate protection of vulnerable adults training through their induction and through training provided by the local authority. The home provides a very comfortable environment of the service users and the home exceeded the standard for the furniture and fittings provided in individual service users bedrooms. The manager of the home is a qualified nurse and has also completed the Registered Managers Award. Service users, visitors and staff confirmed to the inspector that the management of the home is open, positive and responsive. This standard was exceeded. All of the homes health and safety requirements were met. This included up to date records for the service and maintenance to the fire and moving and handling systems. There were also safety certificates for the gas and electrical systems at the home. Care staff receive all of the mandatory training that is required by regulation and specialist training in relation to the needs of the service users including dementia care. The homes self-medication policies and procedures are appropriate to meet the needs of the service users.

What has improved since the last inspection?

All prospective staff to the home had received appropriate safety vetting clearances before they commenced work at the home. This supports the safety and welfare of the service users.

What the care home could do better:

Care staff working at the home must receive a minimum of six formal recorded supervision periods per year (pro-rata). A minimum of 50% of the homes care staff must achieve the minimum of NVQ 2 in care.

CARE HOMES FOR OLDER PEOPLE Littlecoates House Care Home Littlecoates Road Grimsby North East Lincs DN34 4NN Lead Inspector Stephen Robertshaw Unannounced Inspection 10th March 2006 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 Littlecoates House Care Home DS0000002792.V272093.R01.S.doc Version 5.1 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. Littlecoates House Care Home DS0000002792.V272093.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Littlecoates House Care Home Address Littlecoates Road Grimsby North East Lincs DN34 4NN 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) 01472 343833 01472 354743 CKB Building Services Limited Mrs Christine Mary Rhodes Care Home 46 Category(ies) of Dementia - over 65 years of age (16), Old age, registration, with number not falling within any other category (30) of places Littlecoates House Care Home DS0000002792.V272093.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. The DE(E) units policies and procedures must relate specifically to the needs of service users with dementia. The garden area of the home must be developed to meet the needs of service users with dementia care needs and to include stimulation to the individuals involved. This must be completed by 20 April 2005 Risk assessment to be provided if bedroom doors are to be locked denying access to the service users Staff should not be rotated between the rest of the home and the dementia unit such that there is a greater than 10 turnover of staff in the dementia unit, over a 2 month period The staff employed by the unit must undertake appropriate recognised specialist training in relation to dementia care and care of the elderly. 2nd December 2005 Date of last inspection Brief Description of the Service: Littlecoates House is situated on the outskirts of Grimsby. It is close to local amenities including shops, post-office, doctor’s surgeries, chemist, golf club, public houses and Grimsby college. The accommodation for the service users is provided over one storey. All entrances, fire exits, and inner doors are wide enough for wheelchair users to access. All of the service users individual rooms include en-suite facilities. Car parking is provided to the rear of the building, and there is a risk assessment covering the building and the grounds. The gardens are well kept and there is an enclosed patio area in the centre of the home. This has recently been developed to include an enclosed garden. Smoking in the home is restricted to certain areas. Littlecoates House is registered for the care of Older People. This includes up to 16 placements for elderly service users with dementia related needs. Training records in the home identified that staff receive training in relation to dementia care. Littlecoates House Care Home DS0000002792.V272093.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection of Littlecoates House was unannounced and took place on 10th March 2006. The inspection was over a period of approximately six and a half hours. The management and staff working at the home exceeded four of the National Minimum Standards. There was only one recommendation and one requirement made by the inspector. Service users and visitors to the home that were spoken to by the inspector were very positive in relation to the services and the environment that are provided at the home. Staff interviews, personnel and training files showed that they receive the appropriate safety vetting before they have any contact with the service users and after commencing work at the home they receive appropriate training to make sure that they can meet the needs of the service users. What the service does well: Littlecoates House exceeded four of the National Minimum Standards. Standards 24,26,31 and 32. The service users all receive a full assessment of their individual needs before they are admitted in to the home. Visitors are welcome at the home at any reasonable time. The service users and visitors spoken to by the inspector were very positive in relation to the quality of the services that are provided in the home. The service users confirmed to the inspector that the quality of the meals at the home was always very good and that there was always a choice if meal provided at all mealtimes. Staff receive appropriate protection of vulnerable adults training through their induction and through training provided by the local authority. The home provides a very comfortable environment of the service users and the home exceeded the standard for the furniture and fittings provided in individual service users bedrooms. The manager of the home is a qualified nurse and has also completed the Registered Managers Award. Service users, visitors and staff confirmed to the Littlecoates House Care Home DS0000002792.V272093.R01.S.doc Version 5.1 Page 6 inspector that the management of the home is open, positive and responsive. This standard was exceeded. All of the homes health and safety requirements were met. This included up to date records for the service and maintenance to the fire and moving and handling systems. There were also safety certificates for the gas and electrical systems at the home. Care staff receive all of the mandatory training that is required by regulation and specialist training in relation to the needs of the service users including dementia care. The homes self-medication policies and procedures are appropriate to meet the needs of the service users. 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. Littlecoates House Care Home DS0000002792.V272093.R01.S.doc Version 5.1 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 Littlecoates House Care Home DS0000002792.V272093.R01.S.doc Version 5.1 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): 2,3 and 4 Service users are given the opportunity to visit the home before moving there on a more permanent basis. EVIDENCE: There were forty-one service users living at the home at the time of the inspection and the inspector observed the care file information in relation to three of them. All of the files observed included terms and conditions of the service users residency at the home and serviced users that were funded through care management also had terms and conditions of their placements provided through the local authority. The terms and conditions included what services were provided for the fees and who was responsible for paying the fees. Records observed in the home showed that the service users have a full assessment of their needs completed before they are admitted in to the home. This makes sure that the home can meet their needs and its registered to do so. The assessments were a combination of the homes pre-admission Littlecoates House Care Home DS0000002792.V272093.R01.S.doc Version 5.1 Page 9 assessment and assessments completed by the funding care management teams. Service users spoken to by the inspector stated that the home met all of their needs and that the staff were very helpful to them. The service users were very happy and content with the services available to them at the home. Care files had recorded information that supported that the service users healthcare needs are met through appropriate professionals that are based in the community. Staff interviews and records of staff training supported the evidence that the home can meet the assessed needs of the service users. The home does not provide intermediate care to service users. Littlecoates House Care Home DS0000002792.V272093.R01.S.doc Version 5.1 Page 10 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): 7,8,9 and 11 The health and personal care needs of the service users are met at the home. EVIDENCE: The inspector observed the individual care plans for three of the service users. These were all closely associated to the needs identified in their original assessed needs. All of the care plans that were observed by the inspector has been signed in agreement with them by the service user or their representative. The care plans had also been evaluated on a minimum of a monthly basis to ensure that the service users needs were continuing to be met. Littlecoates does not provide nursing care to the service users, however the records in the home showed that the relevant healthcare professionals that are based in the community met the service users healthcare needs. This included contact with GP’s, dentists, opticians, chiropodists and district nurses. The inspector observed medication being administered to the service users and all legislation and good practice guidelines were observed to be followed. All of Littlecoates House Care Home DS0000002792.V272093.R01.S.doc Version 5.1 Page 11 the records were up to date and were accurately recorded. This included the controlled medication that was prescribed to service users. All of the staff that administer medication to the service users had received accredited medication training. The temperature of the medication room and the medication fridge were recorded on a regular basis. The medication room was well organised and securely locked. Service users stated to the inspector that the staff were always very supportive when they gave them their medication. Staff interviewed by the inspector were all aware of the homes policies and procedures for the receipt, disposal and administration of medication. All of the care plans observed by the inspector included the last wishes of the service users in the event of their deaths as required by National Minimum Standard 11. Littlecoates House Care Home DS0000002792.V272093.R01.S.doc Version 5.1 Page 12 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): 12,14 and 15 The service users lives are very flexible and the home provides a good choice of activities for them. EVIDENCE: Service users case files showed when they had been involved in activities and this was also indicated in their daily diary notes. Service users were observed taking part in an afternoon activity and appeared to be enjoying the event. Service users spoken to by the inspector stated that they have a choice whether or not to become involved in the daily activities that are held at the home. Records of service users meetings supported that the service users are given the opportunity to determine the type and frequency of activities at the home. Individual assessments of needs and care plans identified service users likes and preferences in relation to activities. The service users confirmed to the inspector that they have choice in their daily lives. This included the times to rise from and go to bed, what to wear, what to eat and where to socialise with their peers and friends. The service users are provided with a choice at all meal times. The inspector ate lunch with several of the service users. The meal was well presented and Littlecoates House Care Home DS0000002792.V272093.R01.S.doc Version 5.1 Page 13 was very tasty. The service users stated that the quality of the meals provided was always very good. Direct observation by the inspector identified that service users are given appropriate support to eat their meals and that the atmosphere was very relaxed and unhurried. A tour of the kitchen found it to be very clean and organised. There were plentiful supplies in the homes food stores and the kitchen was very clean. The cook had a clear record of any special nutritional needs for individual service users. Littlecoates House Care Home DS0000002792.V272093.R01.S.doc Version 5.1 Page 14 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): 17 and 18 The service users welfare is protected from abuse at the home. EVIDENCE: All new staff appointed to work at the home receive appropriate security vetting before they have any contact with the service users. Protection of vulnerable adults training is provided by the local authority and the staff attend these sessions when approved for the course. Staff interviewed by the inspector were aware of what can constitute as abuse and how to report alleged or suspected abuse. There had been no reports to the POVA team in relation to suspected abuse at the home since the last inspection. Individual service users care files identified that they are included on the electoral register where appropriate and staff offer support to service users to vote at national and local elections. The files also identified when other individuals were responsible for the service users finances including court of protection and power of attorney. Littlecoates House Care Home DS0000002792.V272093.R01.S.doc Version 5.1 Page 15 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): 21,23,24,25 and 26 A very comfortable and homely environment is provided to the service users at the home. EVIDENCE: A tour of the premises by the inspector confirmed that the home was clean, tidy and was free of any offensive smells. The accommodation is all provided on one level and the toilets and bathrooms are well spaced around the building close to the service users bedrooms and the communal areas. The individual bedrooms include en-suite facilities. Several service users invited the inspector to look at their rooms. These had all been personalised to their own tastes and preferences including introduction of small items of furniture, pictures and personal ornaments. The service users stated to the inspector that they were very happy with the standards of their personal rooms and the communal areas. Visitors to the home also commented on the cleanliness and general good appearance of the environment in the home. Littlecoates House Care Home DS0000002792.V272093.R01.S.doc Version 5.1 Page 16 Littlecoates continued to exceed National Minimum Standards 24 and 26. The standard for the service users private accommodation was exceeded. The quality of the furniture and fittings provided by the home was very good. The tour of the premises by the inspector evidenced that a homely environment is provided and the furniture, fittings and lighting were domestic in character. Records maintained in the home evidenced that the heating, lighting and water supply are well maintained and are serviced on a regular basis. All of the hot water pipes and radiators have been provided with low temperature surfaces. The standard of decoration throughout the home is to a very high standard and service users confirmed to the inspector that they were very happy with the presentation of the home. The laundry was well organised and the washing machines were programmable to disinfection and sluicing standards. Service users and visitors to the home stated that the service users always received their own clothes back from the laundry and they were never dressed in other people’s clothes. Littlecoates House Care Home DS0000002792.V272093.R01.S.doc Version 5.1 Page 17 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 29 The staff receive appropriate training to meet the needs of the service users. EVIDENCE: The management of the home confirmed to the inspector that the minimum staffing levels for the home are determined through using the residential forum formula. Service users and visitors to the home stated to the inspector that there were always enough staff available to meet their needs and that when the call system was used there was a quick response from the staff. The staff and management of the home are all positive in relation to NVQ training and the home is working towards its commitment of 50 of the care staff to have achieved NVQ 2. Ten staff have already completed the award and a further nine staff are registered on the award and are working towards it. Staff training records showed that all of the staffs mandatory training is met and is updated as required by regulation. The inspector observed the staff personnel and training files for three of the staff that were employed at the home. These all included their terms and conditions of employment and evidenced that an equal opportunities procedure was followed in their employment at the home. This included an application, interview, references and appropriate safety vetting before the staff were allowed contact with the service user group. Littlecoates House Care Home DS0000002792.V272093.R01.S.doc Version 5.1 Page 18 Regular staff meetings are held at the home and these are all fully recorded. Staff interviewed by the inspector confirmed that they receive in excess of three days paid training per year and if they attend the home for training on their off duty then they are paid appropriately. Littlecoates House Care Home DS0000002792.V272093.R01.S.doc Version 5.1 Page 19 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): 31,32,36 and 38 The management of the home ensures that the service users welfare is maintained and they are protected from possible abuse. EVIDENCE: The manager of the home is a qualified nurse and has completed the Registered Managers Award. National Minimum Standards 31 and 32 were exceeded. The manager is not responsible for any other home. The staff working in the home that were interviewed by the inspector all understood the clear lines of responsibility and accountability at Littlecoates. The inspector spoke to service users and visitors and interviewed management and staff to confirm that the management of the home is open, positive and inclusive. Records of staff and service user meetings showed that their opinions are sought in the development of the service that are provided at the home. Littlecoates House Care Home DS0000002792.V272093.R01.S.doc Version 5.1 Page 20 The staff personnel files did not include supporting information that the care staff receive the minimum formal recorded supervision that is required. However staff confirmed to the inspector that informal supervision is constantly available at the home. The inspector observed that all of the appropriate health and safety certificates were in position. This included appropriate insurance cover for the home and up to date safety certificates for the electric and gas supplies to the home. The records for the fire systems maintenance checks were seen to have been appropriately carried out. This included the fire alarm system, fire fighting equipment and the emergency light system. Littlecoates House Care Home DS0000002792.V272093.R01.S.doc Version 5.1 Page 21 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 3 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 X 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 3 18 3 X X 3 X 3 4 3 4 STAFFING Standard No Score 27 3 28 2 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 4 X X X 1 X 3 Littlecoates House Care Home DS0000002792.V272093.R01.S.doc Version 5.1 Page 22 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 OP36 Regulation 19 Requirement The registered person must ensure that all care staff working in the home receive the minimum of six formal recorded supervision periods per year (pro-rata). Timescale for action 01/06/06 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 OP28 Good Practice Recommendations The registered person must ensure that a minimum of 50 of the homes care staff have achieved NVQ 2 or equivalent. Littlecoates House Care Home DS0000002792.V272093.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Hessle Area Office First Floor, Unit 3 Hesslewood Country Office Park Ferriby Road Hessle HU13 0QF 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 Littlecoates House Care Home DS0000002792.V272093.R01.S.doc Version 5.1 Page 24 - 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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