Inspection on 19/12/05 for Liversage Court Residential Care Home

This inspection was carried out on 19th 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Liversage Court Residential Care... 02/05/08

Liversage Court Residential Care... 10/05/07

Liversage Court Residential Care... 23/05/06

Liversage Court Residential Care... 24/05/05

Liversage Court Residential Care... 27/01/05

Liversage Court Residential Care... 24/08/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Liversage Court Residential Care Home Liversage Street Derby Derbyshire DE1 2LD Lead Inspector Jo Wright Unannounced Inspection 09:15 19 December 2005 th 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 Liversage Court Residential Care Home DS0000001986.V268277.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. Liversage Court Residential Care Home DS0000001986.V268277.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Liversage Court Residential Care Home Address Liversage Street Derby Derbyshire DE1 2LD 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) 01332 291241 01332 205201 The Liversage Trust Charity Patricia Blurton Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (40) of places Liversage Court Residential Care Home DS0000001986.V268277.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 6 Day Care places Date of last inspection 24th May 2005 Brief Description of the Service: Liversage Court is a purpose built two-storey building, located in a cul-de-sac close to the city centre of Derby. Liversage Court provides 40 single en-suite bedrooms over the two floors. Residents enjoy easy access around the building, and can access the first floor either by the stairs or the shaft lift. Lounge areas are located on both floors, with a spacious dining area on the ground floor. Residents also have access to well-maintained, secure landscaped gardens that have extensive patio areas with water features. Liversage Court is within easy access to the entire city centre amenities. Liversage Court Residential Care Home DS0000001986.V268277.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection and the duration of the visit was approximately 5 ½ hours. Time was spent speaking with staff and residents, and observing the daily routine. Records such as care plans (as part of the case tracking process, which is used to help determine how the home meets the needs of individual residents) were examined in depth during this inspection. Other records such as staff files, medication records and service certificates were examined. An assessment was made with respect to the requirements made at the last inspection of this service. The manager was present at the inspection, and the findings the inspection were discussed with her. What the service does well: What has improved since the last inspection? Care plans are now being reviewed and updated monthly, following discussion with the individual resident. Staff clearly record any changes to care in the care plans. Continued improvements have been made to the leisure and social activities provided for people living at the home. A dedicated member of staff organises activities five afternoons a week, and spends time both with individual residents as well as small groups of residents. Records supported that day to day activities were taking place, as well as regular entertainment. Liversage Court Residential Care Home DS0000001986.V268277.R01.S.doc Version 5.0 Page 6 An additional lounge area has been created since the last inspection. This lounge provides a quiet area for residents, where they can sit and talk with each other, read or listen to music. One bathroom has also been upgraded, and a specialist bath installed. 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. Liversage Court Residential Care Home DS0000001986.V268277.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 Liversage Court Residential Care Home DS0000001986.V268277.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, 3 and 4 (Standard 6 is not applicable) The admission procedure ensured that a proper assessment was carried out prior to admission, and provided potential residents and relatives with assurances that the care needs could be met. EVIDENCE: A structured admission process was in place, which ensured that accommodation was only offered to people whose needs could be met at Liversage Court. This was achieved through providing information about the home to potential residents and relatives, so they can make an informed choice about the suitability of the home, and assessing people needs before offering accommodation at the home. Residents were also reassessed following admission to hospital, to ensure that the home could continue to meet their needs. The resident files seen during this inspection supported that the admission process had been followed. Care plans had been developed from the assessment of needs. Residents spoken with stated that they felt well cared for, and that the staff were able to meet their needs. Liversage Court Residential Care Home DS0000001986.V268277.R01.S.doc Version 5.0 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 the following standard(s): 7, 8, 9 and 10 There was a clear and consistent care planning system in place, which adequately provided staff with the information they need to satisfactorily meet residents’ needs. Inconsistent use of the systems for checking hand written entries on medication charts potentially placed residents at risk. EVIDENCE: People spoken with talked very highly about all of the staff team, and said that ‘they felt well cared for’. People spoken with reported that staff were attentive to their needs and treated them with respect. The files for two residents were looked at during this inspection. Progress had been made towards meeting the requirements made in the previous inspection report. Care plans promoted individuality and independence, and provided clear instructions for staff on how this may be achieved. Residents had been involved in planning the care as well as reviewing the support provided every month. Changes to care were clearly recorded and the care plans updated. The daily logs provided detailed information about the daily lives and activities Liversage Court Residential Care Home DS0000001986.V268277.R01.S.doc Version 5.0 Page 10 of the people living in the home. Appropriate risk assessments were in place and had been updated. Attention was paid to individual’s health care needs and referrals were made to community nursing services as required. People spoken with confirmed that they had access to their GP and other health care services such as the chiropodist, optician and dentist. As several requirements relating to medication were made in the previous inspection report, a review of the medication charts was carried out. It was noted that hand written entries were still not always checked and countersigned by second member of staff. Liversage Court Residential Care Home DS0000001986.V268277.R01.S.doc Version 5.0 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 the following standard(s): 12 and 15 A range of activities suitable for the resident group was being provided, meeting the leisure and recreational interests of residents. Residents were provided with meals that they enjoyed, offering them a balanced and varied diet. EVIDENCE: The routines at the home were relaxed and the atmosphere welcoming. Residents spoken with were very positive about living at Liversage Court and commented that they enjoyed living there. Residents made good use of all areas of the home, including their bedrooms. Visiting was unrestricted and a number of residents regularly went out with their families. Independence was encouraged and one resident routinely went for a walk each day. Dedicated staff time was provided to enable activities to be provided each weekday. This member of staff was able to clearly describe her role and responsibilities, and discussed both the group and individual activities that she organises for residents. Records of organised activities and who attended were maintained. Entertainers also visited the home on a regular basis. Residents commented that they enjoyed the meals provided, and they were offered choice and variety. The meal time observed during this inspection was Liversage Court Residential Care Home DS0000001986.V268277.R01.S.doc Version 5.0 Page 12 unhurried, with staff providing support and assistance as required. The menus have recently been altered, to reflect the preferences of the current resident group. The kitchen area was satisfactory at the time of this inspection. Levels of food stocks were satisfactory. The Environmental Health Officer visited in June 2005, and it was reported that the recommendations made in the report had been attended to. Liversage Court Residential Care Home DS0000001986.V268277.R01.S.doc Version 5.0 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 the following standard(s): 16 and 18 The home has a satisfactory complaints procedure with evidence that residents feel that their views were listened to and acted upon. Not all staff were unaware of the external organisations involved in the protection of vulnerable adults, which potentially put service users at risk of not being protected from abuse. EVIDENCE: Systems were in place for raising and dealing with complaints. Residents spoken with were aware of the complaints procedure and were confident that their concerns would be listened to and acted upon. Neither the manager nor the Commission had received any complaints about the care and services provided at the home during the previous 12 months. Robust systems, which link into the local authority procedures, were in place to manage any incidents of abuse to people living the in the home. There have been no recent referrals made under these procedures. Staff training was provided through videos as part of the induction and the management team have attended training provided by the local authority. Discussion with staff indicated that although they had a good understanding of the internal policies, not all staff were aware of the external agencies involved in the protection of vulnerable adults, which potentially puts residents at risk. Liversage Court Residential Care Home DS0000001986.V268277.R01.S.doc Version 5.0 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 the following standard(s): 19 Through ongoing investment, the home continues to provide a comfortable and safe environment for those living there and visiting. EVIDENCE: Liversage Court was well maintained and decorated. An additional lounge has been created since the last inspection, and was well used by residents. There has been ongoing redecoration in the lounge and corridor areas, as well as all of the bathroom and shower areas. The facilities in one bathroom have been upgraded from domestic style bath to a fixed hoist bath. Liversage Court Residential Care Home DS0000001986.V268277.R01.S.doc Version 5.0 Page 15 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 Staffing levels were in keeping with the needs of the residents living at the care home. Residents were supported by staff competent and qualified in the role that they perform. EVIDENCE: Residents benefit from a stable staff team at Liversage Court. Staff turnover has been low, and the majority of staff have worked at the home for a number of years. Staffing levels have been maintained through the use of agency staff, and residents and staff commented that staffing hours were sufficient to meet the needs of the current resident group. The staff team as a whole had been provided with the required training to ensure that they were competent to do their jobs. Over 50 of care staff had achieved NVQ Level 2 or equivalent. Newly appointed staff complete the required induction and foundation training. Newly appointed staff would benefit from additional management input and oversight to ensure that the training is completed on time. Robust systems were in place for the recruitment of new staff. Two out of the three staff files checked contained all of the required information. The information missing in the other file had been seen and checked by the home as it was required for the CRB check, but copies had not been taken and placed on file. This was discussed with the administrator at the time of this Liversage Court Residential Care Home DS0000001986.V268277.R01.S.doc Version 5.0 Page 16 inspection. Criminal record bureau checks were in place for all staff except one; the POVA check had been received for this member of staff and she continued to work under supervision. Liversage Court Residential Care Home DS0000001986.V268277.R01.S.doc Version 5.0 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 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, 37 and 38 The manager was supported by the staff team and provided clear leadership throughout the home with staff demonstrating an awareness of their roles and responsibilities. EVIDENCE: The manager has been registered with the Commission for Social Care Inspection, and has completed a management qualification. A representative of the Trustees continues to carry out monthly visits to the home and the reports sent to the local office of the Commission. Staff spoken with commented that in their opinion, Liversage Court was ‘a very professional home’, and that they enjoying working at the home and caring for the residents. Staff spoke about good team work, and that the manager was approachable and would deal with any issues appropriately. Staff were able to clearly describe their role and responsibilities as key workers. Liversage Court Residential Care Home DS0000001986.V268277.R01.S.doc Version 5.0 Page 18 Systems were in place to consult residents and staff about the quality and services provided at Liversage Court. The representative of the Trustees regularly speaks with residents as part of the monthly visit, and satisfaction surveys for both residents and staff were carried out annually. The results of the surveys were on display in the home. The most recent resident survey was carried out in October 2005, and although generally positive, also identified areas that residents considered could be improved. The administrator stated that action had been taken to address these areas. Robust systems were in place for the safe keeping of residents monies. The records and the money held on behalf of several residents were cross referenced and found to be accurate. The standard of record keeping at the home was good, with systems in place to ensure that records were keep up to date and were accurate. Systems were in place for induction and foundation training, and ongoing mandatory training. A sample of service/maintenance records was examined (including equipment, gas and electricity services) and there was confirmation that equipment and services are properly maintained. Systems were in place for monitoring and maintaining a safe hot water temperature. Liversage Court Residential Care Home DS0000001986.V268277.R01.S.doc Version 5.0 Page 19 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 X 3 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 X X X X X X X STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 X 3 3 Liversage Court Residential Care Home DS0000001986.V268277.R01.S.doc Version 5.0 Page 20 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 OP9 Regulation 13(2), 17(1) Requirement If the Medication Administration Chart (MAR) chart is handwritten or altered by a member of staff this must be dated by them and checked and dated by a second member of staff. (Previous timescales of 31/10/04 and 31/08/05 not met) All staff must be fully aware of the external organisations involved in the protection of vulnerable adults and how to make a referral through the local authority procedure. Staff files must contain all of the required information in accordance with Schedules 2 and 4. Timescale for action 31/03/06 2 OP18 13(6) 31/03/06 3 OP29 17(2) Sch 2&4 31/03/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Liversage Court Residential Care Home DS0000001986.V268277.R01.S.doc Version 5.0 Page 21 1. OP30 Newly appointed staff would benefit from additional management input and oversight to ensure that the induction training is completed on time. Liversage Court Residential Care Home DS0000001986.V268277.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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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