Inspection on 02/12/05 for Littlecoates House Care Home

This inspection was carried out on 2nd December 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Littlecoates House Care Home 24/06/09

Littlecoates House Care Home 26/06/07

Littlecoates House Care Home 05/06/06

Littlecoates House Care Home 10/03/06

Littlecoates House Care Home 07/01/05

Littlecoates House Care Home 08/07/04

Littlecoates House Care Home 23/02/04

Similar services:

Snydale Care Home

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Hawkhills

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Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

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

CARE HOMES FOR OLDER PEOPLE Littlecoates House Care Home Littlecoates Road Grimsby North East Lincs DN34 4NN Lead Inspector Stephen Robertshaw Unannounced Inspection 2nd December 2005 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Littlecoates House Care Home DS0000002792.V272075.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Littlecoates House Care Home DS0000002792.V272075.R01.S.doc Version 5.0 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 (38) of places Littlecoates House Care Home DS0000002792.V272075.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The DE(E) unit`s 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. 7th January 2005 3. 4. 5. 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. All 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. 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.V272075.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and took place on the 2nd December 2005. The inspection was over approximately seven hours. The manager of the home and the proprietor were both present and were very forward with any information requested from them. The service users spoken to by the inspector spoke very highly of the services that they received at the home. What the service does well: What has improved since the last inspection? Littlecoates House Care Home DS0000002792.V272075.R01.S.doc Version 5.0 Page 6 All staff working at the home now receives the minimum of six formal recorded supervision periods per year. The management have increased the staffing levels at the home and have included an additional fourteen new staff positions since the last inspection. The staff are receiving the mandatory training that id required. The homes quality assurance and monitoring system is now completed and is effective. An up to date electrical systems safety certificate was open to inspection. The homes self-medication policies and procedures have been updated and improved. 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.V272075.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Littlecoates House Care Home DS0000002792.V272075.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3 and 4 The home does not provide intermediate care to service users. Service users are provided with the opportunity to visit the home before they make a decision to move there on a more permanent basis. Their needs are fully assessed to ensure that the home can meet all of their needs. EVIDENCE: The homes statement of purpose was updated this year to include the manager now having achieved the Registered Managers Award. The statement of purpose included all of the information as required by NMS 1.2. At the time of the inspection there were forty-five service users living at the home. The inspector observed the case files for four of the current service users. These all included terms and conditions of the service users residency at the home. These had been updated to include the room to be occupied and all of the other information required by NMS 2.2. Littlecoates House Care Home DS0000002792.V272075.R01.S.doc Version 5.0 Page 9 The individual case files observed by the inspector all included comprehensive assessments of the service users needs. The assessments were a combination of the homes pre-admission, care management and specialist mental heath team assessments. Where service users were involved with the Care Management Approach this was identified in their assessments and the appropriate co-ordinator was identified. Discussions with service users, interviews with staff working at the home and interviews with visitors supported the evidence that the home has the capacity to meet the needs of the service users group. The home does not provide nursing or intermediate care to service users. Littlecoates House Care Home DS0000002792.V272075.R01.S.doc Version 5.0 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): 7,8,9,10 and 11 The health and personal care of individual service users is supported and maintained at the home. EVIDENCE: The inspector observed the care plans for four of the service users living at the home. All of their needs had been identified but the care plans provided limited information as to how the needs must be met. The care plans for all of the service users included an assessment of their individual nutritional needs. The home does not provide nursing care but the records in the home supported that service users healthcare needs are met through healthcare workers that are based in the community. This included GP’s, district nurses, community psychiatric nurses, occupational therapists and psychiatrists. The care plans have all been evaluated on a minimum of a monthly basis. Service users confirmed that when they have medical appointments or visits they are always able to see them in private unless they request that a member Littlecoates House Care Home DS0000002792.V272075.R01.S.doc Version 5.0 Page 11 of staff to support them. Visitors to the home also suggested that this was always the case when service users are visited by healthcare staff at the home. On the day of the inspection the medication in the home was generally stored, recorded and administered appropriately to legislation and good practice guidelines. There was one medication that had been administered from a monitored dosage system that had not been recorded. A recent regulation 37 was submitted to the commission in relation to the homes medication. A member of staff had administered the wrong medication to a service user. The appropriate procedures were followed to ensure their safety. Since the last inspection the home policies and procedures for medication have been updated and improved. There were no controlled drugs in the home at the time of the inspection. The home has a separate medication fridge and the temperatures of the fridge and the room are recorded on a daily basis. All of the care plans observed by the inspector included the last wishes of the service users in the event of their deaths. Littlecoates House Care Home DS0000002792.V272075.R01.S.doc Version 5.0 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): 13 and 14 The service users are encouraged to maintain and develop opportunities that they have to engage in activities in the home and in the community. They also have choices made available to them throughout their daily lives at the home. EVIDENCE: The standard for visitors to the home (NMS 31.1) was exceeded. The inspector spoke to visitors to the home and they stated that they were always made to feel welcome when they visited the home and were offered appropriate food and beverages. The visitors also confirmed that they are able to visit the home at any reasonable time. A service user who was very ill at the time of the inspection and their relatives had been offered accommodation at the home as they lived to far away to visit on a regular basis. Littlecoates House Care Home DS0000002792.V272075.R01.S.doc Version 5.0 Page 13 The visitors also stated to the inspector that when they visited the home there were always plenty of activities for the service users and that they had been invited to join in the activities. One visitor stated to the inspector that their relative had previously been in the home but left when the nursing unit was closed. She said that since that time she has not been happy with the care that he received in the other homes so when she was aware that the home had re-registered to include dementia care she arranged for her father to return to Littlecoates and she has been happy with his care since arriving back there. The inspector ate lunch with several of the service users. An alternative meal was available to all of the service users and the presentation was very good. The service users stated that the quality of the meals at the home was always very good. The mealtime was also unhurried. The staff were observed offering appropriate levels of support to individual service users to ensure that they could eat their meals. The inspector also looked around the homes kitchen. It was kept very clean and was well organised. There were plentiful supplies in the homes food stores and they were all within their best eat by dates. Littlecoates House Care Home DS0000002792.V272075.R01.S.doc Version 5.0 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): 16,17 and 18 The service users are protected from potential abuse at the home. EVIDENCE: The home records all complaints and niggles that are raised with it. There had been a small number of complaints made directly to the home and were dealt with through the homes complaints procedure. All of the complaints had been resolved at the first stage of the homes complaints procedure and the outcomes were recorded. Individual service users case files showed that they are included on the electoral register and identified if they were not responsible for their personal finances. If they were involved in the Court of Protection or Power of Attorney this was identified in their care plans. The staff receive protection of vulnerable adult training that is provided by the local authority. New staff to the home also receive protection training through their induction. Littlecoates House Care Home DS0000002792.V272075.R01.S.doc Version 5.0 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): 19,20,21,23,24 and 26 The environment at the home is appropriate to meet the needs of the service users. EVIDENCE: The layout of the home is suitable for its stated purpose this evidence was supported through the inspectors tour of the premises. Service users and visitors spoken to by the inspector stated that they were very happy with the environment that was provided at Littlecoates. There are a variety of communal areas around the home that the service users can choose to use to socialise. The lighting and furniture in the communal areas were domestic in character. Littlecoates House Care Home DS0000002792.V272075.R01.S.doc Version 5.0 Page 16 The toilets and bathrooms well spaced throughout the home and were close to all of the communal and bedroom areas. The toilets and bathrooms were maintained very well and were free of any offensive smells. 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 standard for the service users private accommodation was exceeded. The quality of the furniture and fittings provided by the home was very good. Service users spoken to by the inspector stated that they were very happy with the decoration of their individual rooms. All of the service users rooms had been personalised to their own tastes and preferences. A tour of the premises by the inspector found the home to be very clean and tidy and was free of any offensive smells. All appropriate actions had been implemented to ensure the control of any infection at the home. Littlecoates House Care Home DS0000002792.V272075.R01.S.doc Version 5.0 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): 27,28,29 and 30 The homes employment procedures for new staff do not ensure the safety of the service users. EVIDENCE: The service users and visitors stated to the inspector that there are always enough staff working at the home to meet the needs of the service users and that the staff are always very polite and helpful. The manager uses the residential forum to determine the staff levels at the home. The manager and staff of the home have a strong commitment towards NVQ training at the home. The home employs forty-six care workers. Ten of these have completed NVQ 2 in care and a further fifteen staff are registered on and are working towards the award. Thirty-one of the care staff had also completed the basic food hygiene course. Additionally the home employs ten ancillary staff and two of the domestic staff had completed an NVQ 1 in domestic and cleaning support. Littlecoates House Care Home DS0000002792.V272075.R01.S.doc Version 5.0 Page 18 The staff personnel files provided evidence that the home is employing staff to work at the home before they had received appropriate POVA first or Criminal Record Bureau clearances. This practice must stop immediately as this could place vulnerable service users at risk of abuse. The remainder of information held in the staff personnel files were appropriate including two references and personal identification documents and records of the interview process. Regular staff meetings are held at the home and this are all fully recorded. The home has a staff training plan and individual staff have a training schedule included in their personnel files. The home would benefit from developing an overall plan that identified when mandatory training has been completed by individual staff members and when it needs refreshing. 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. Littlecoates House Care Home DS0000002792.V272075.R01.S.doc Version 5.0 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): 31,32,33,35,3637 and 38 The management and administration resources support the needs of the service users living at Littlecoates. EVIDENCE: The manager of the home is a qualified nurse and this year has successfully completed the Registered Managers Award. The manager also updates her training and knowledge through joining in the training that has been commissioned for the care staff. There are clear lines of responsibility and accountability in the home. The home has also recently appointed a new deputy manager and they will be enrolling of the NVQ 4 in care. Littlecoates House Care Home DS0000002792.V272075.R01.S.doc Version 5.0 Page 20 The service user and visitors spoken to by the inspector and staff interviewed by the inspector all confirmed that the management approach to the home is open, positive and inclusive. Records of staff and service user meetings evidenced that the management of the home consult these groups to gain their opinion in relation to the services that are provided in the home. Staff meetings were also evidenced to include specialist healthcare workers being invited in to the home to advise and train the care staff on specific issues. Staff supervision has improved since the last inspection and all staff working at the home now receive at least the minimum requirement of six formal recorded supervision periods per year. The quality assurance and monitoring system in the home has now been fully developed to include questionnaires being sent out to target groups, the returned papers being analysed and an action plan created. The results were then published around the building and were discussed in service user and staff meetings. Service users monies are very well controlled at the home this standard was exceeded. The written records were accurately recorded and double signatures were included for all transactions. Individual service users care plans identified if they were not responsible for their own finances and if not recognised who was responsible for them. All of the records held by the home were stored in accordance with the Data Protection Act 1998. The records were also all up to date and were accurately recorded. Previous inspection reports indicted that the home did not have a Legionella certificate. This was in fact an error as the home does not have holding tanks for water and therefore a certificate is not required. Hot water temperatures at the outlets are randomly monitored on a monthly basis and the whole system is monitored every three months to ensure that they remain close to 43°C and to maintain the safety of the service users. Current gas and electrical system safety certificates and insurance certificates were observed by the inspector and were up to date and appropriate to the needs of the home. All of the appropriate fire safety checks were maintained and recorded. The home had an up to date fire risk assessment. Littlecoates House Care Home DS0000002792.V272075.R01.S.doc Version 5.0 Page 21 The records for the service and maintenance of the home moving and handling equipment were all up to date. Littlecoates House Care Home DS0000002792.V272075.R01.S.doc Version 5.0 Page 22 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 3 3 3 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 4 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 3 3 X 3 4 X 3 STAFFING Standard No Score 27 3 28 2 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 3 3 X 4 3 X 3 Littlecoates House Care Home DS0000002792.V272075.R01.S.doc Version 5.0 Page 23 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 OP29 Regulation 18 Requirement The registered person must ensure that all staff employed by the home receive a minimum of a POVA first or Criminal Records Bureau clearance before they commence working at the home. Original timescale of 28 February 2005 was not met. Timescale for action 03/12/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard OP9 OP28 Good Practice Recommendations The registered person must ensure that all medication administered in the home is accurately recorded. The registered person must ensure that a minimum of the homes care staff have achieved NVQ 2 or equivalent by 31st December 2005. Littlecoates House Care Home DS0000002792.V272075.R01.S.doc Version 5.0 Page 24 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.V272075.R01.S.doc Version 5.0 Page 25 - 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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