Inspection on 27/10/05 for Londesborough Court Care Home

This inspection was carried out on 27th October 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Londesborough Court Care Home 28/06/06

Londesborough Court Care Home 21/06/05

Londesborough Court Care Home 19/10/04

Londesborough Court Care Home 25/06/04

Similar services:

Snydale Care Home

Abbey The

Hawkhills

Larchfield Manor

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 Londesborough Court Care Home Londesborough Road Market Weighton East Yorkshire YO43 3AZ Lead Inspector Diane Wilkinson Unannounced Inspection 27th October 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 Londesborough Court Care Home DS0000019691.V260970.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. Londesborough Court Care Home DS0000019691.V260970.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Londesborough Court Care Home Address Londesborough Road Market Weighton East Yorkshire YO43 3AZ 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) 01430 873954 01430 873954 Londesborough Health Care Limited Position Vacant Care Home 30 Category(ies) of Dementia (1), Dementia - over 65 years of age registration, with number (30), Old age, not falling within any other of places category (30) Londesborough Court Care Home DS0000019691.V260970.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21st June 2005 Brief Description of the Service: Londesborough Court Care Home is a privately owned care home that is situated in the small town of Market Weighton. The registered providers own another care home in the nearby town of Beverley. The home is registered to care for and accommodate thirty older people, including those with dementia. The property consists of a large old house and a modern extension. The accommodation is provided on two floors, and the second floor is accessed via a passenger lift. The home is located within pleasant grounds and is close to local amenities such as churches, hairdressers, shops, cafes and public houses. The home is close to a bus route and has ample parking space for visitors and staff. Londesborough Court Care Home DS0000019691.V260970.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over a period of 7 hours, including preparation time for the inspector. A complaint received by the Commission for Social Care Inspection was investigated on the same day. The inspection consisted of a tour of the premises and examination of records, including care plans. The inspector spoke to two service users (one to one), to a staff member and to the proposed registered manager. What the service does well: What has improved since the last inspection? What they could do better: There are some strong odours in service users’ bedrooms and this must be addressed by the home. Daily records should be maintained to ensure that care plans are always an up to date reflection of the care needs of service users. Londesborough Court Care Home DS0000019691.V260970.R01.S.doc Version 5.0 Page 6 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. Londesborough Court Care Home DS0000019691.V260970.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 Londesborough Court Care Home DS0000019691.V260970.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): None EVIDENCE: Londesborough Court Care Home DS0000019691.V260970.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): 8 Current recording systems do not always evidence that the health care needs of service users are met. EVIDENCE: A complaint was investigated as part of the unannounced inspection – one aspect of the complaint was that a service user’s mobility and general health deteriorated whilst having respite care at the home. It was found that staff did not keep relatives and health professionals sufficiently informed of the service user’s deterioration and that appropriate changes were not made to the plan of care. Daily recording should take place to ensure that records are constantly updated and that there is a record of all care that actually takes place. Other service users’ care plans examined by the inspector evidence that health care needs are met. There are appropriate risk assessments in place as well as assessments of dependency levels. Nutritional screening takes place via recording a person’s weight, and food and fluid intake charts are used when this is an area of concern. Some service users with deteriorating illnesses are cared for in bed and arrangements for pressure care are recorded Londesborough Court Care Home DS0000019691.V260970.R01.S.doc Version 5.0 Page 10 appropriately. Pressure care equipment is provided for these and other service users. Continence care and the equipment provided are satisfactory. At the last inspection the inspector and the proposed registered manager had a discussion about whether or not trained nurses needed to complete accredited medications training. The inspector confirmed that they do. The proposed registered manager stated that she would ensure that this training commences by the end of 2005. Londesborough Court Care Home DS0000019691.V260970.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): 13 and 15 Services users are encouraged and supported to maintain contact with family and friends and to take part in the local community. Meal provision at the home is good but there are sometimes insufficient staff on duty to ensure that mealtimes are a safe and pleasurable experience for service users. EVIDENCE: There is evidence that service users are encouraged and supported to maintain contact with family and friends and to access the local community. Most service users are visited regularly by relatives and friends. Records show that service users are supported to take walks in the local area and are accompanied by staff when this is appropriate. Meals are prepared elsewhere and transported to Londesborough Court. They are kept hot until lunchtime and the temperature is checked prior to them being served to ensure that they are at the correct temperature for serving. There are two choices of main meal on offer and the inspector observed that the meals were well presented. Some service users have their meals in their bedroom; some of these service users choose to do so and others are too poorly to eat in the dining room. Diabetic diets are catered for, and some service users have a ‘soft’ diet. The inspector was informed that the home is being nominated for a ‘Healthy Food’ award. Londesborough Court Care Home DS0000019691.V260970.R01.S.doc Version 5.0 Page 12 On the day of the inspection the serving of lunch was very slow – some people had finished their first course before others had been served. The kitchen assistant was absent from work due to illness and care staff were serving lunch. Only one member of staff was available to serve food and assist service users in the dining room – this person had to stop serving lunch to assist a service user who wanted to go to the toilet. Londesborough Court Care Home DS0000019691.V260970.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): 18 Service users are protected from abuse by the policies and procedures that are in place, and by the training offered to staff. EVIDENCE: There are appropriate policies and procedures in place on the protection of vulnerable adults from abuse. Two care staff have undertaken training on the protection of vulnerable adults from abuse and staff also cover this topic on Induction training and NVQ training. The proposed registered manager attended a seminar on this topic and the notes she obtained were photocopied and a copy was given to all staff. The proposed registered manager informed the inspector about an issue that had arisen at the home and how she had dealt with it. The inspector was satisfied that it had been dealt with effectively. Staff have also attended training sessions on how to deal with aggression from service users. Londesborough Court Care Home DS0000019691.V260970.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): 24 and 26 Bedrooms have been personalised by service users to an extent chosen by them. The home is clean and hygienic with the exception of two bedrooms where the presence of odours needs to be addressed to create pleasant surroundings for service users. EVIDENCE: Some bedrooms are fitted with locks and keys – the home should aim to have locks and keys available on all bedrooms doors so that new and existing service users can immediately be provided with a key (unless a risk assessment suggests otherwise). This work is due to commence in the New Year. One service user who has specifically requested a lock and key is to be provided with one. Bedrooms have been personalised to meet the wishes and needs of service users – some service users have brought small items of furniture into the home. Lockable storage is available for service users who require this provision. Londesborough Court Care Home DS0000019691.V260970.R01.S.doc Version 5.0 Page 15 Laundry facilities are sufficient to meet the needs of the service users living at the home. A laundry assistant is employed. Domestic staff are employed but there are strong odours in two bedrooms – other areas of the home were clean and hygienic on the day of the inspection. The presence of strong odours needs to be addressed by the home. Londesborough Court Care Home DS0000019691.V260970.R01.S.doc Version 5.0 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission 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 30 Training records evidence that staff have the skills and knowledge to enable them to meet the needs of service users. EVIDENCE: There is a staff rota in place that records the roles of all staff on duty, including domestic and laundry staff. There are usually four staff on duty in the mornings and three staff on duty in the afternoons/evenings (this is reduced to 3/3 on weekends), and there are two ‘waking’ night staff. Dedicated domestic staff and laundry staff are employed. The proposed registered manager informed the inspector that the home usually covers staff absences, but on the day of the inspection the rota was not fully covered. The home were advised to consider training domestic staff to take on the role of kitchen assistant to cover staff absences. The home is on target to achieve the requirement for 50 of care staff to achieve NVQ Level 2 in Care by the end of 2005. Some staff have already achieved this award. There is a training and development schedule in place that records training achieved by staff and the training needs of staff. Training certificates are retained for individual staff members, and individual staff records include details of training undertaken and training needs. New staff at the home undertake the home’s own induction programme – this meets Skills for Care specifications. Londesborough Court Care Home DS0000019691.V260970.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, 33, 35 and 38 The home is managed effectively and the manager is well supported by the staff team. There are quality assurance systems in place that enable service users and others to affect the way in which the home is operated. Financial procedures protect monies held on behalf of service users. The arrangements in place at the home protect the health, safety and welfare of service users. EVIDENCE: The proposed registered manager has now achieved the registered manager’s award (NVQ Level 4). She is awaiting CRB clearance and the interview with the Commission for Social Care Inspection to complete the registration process. The proposed registered manager keeps her practice up to date by attending training courses and by accessing the internet. The home has achieved the Investors in People award and the local authority quality scheme Part 1 – they are currently working towards Part 2. Surveys Londesborough Court Care Home DS0000019691.V260970.R01.S.doc Version 5.0 Page 18 are completed by service users, relatives and health and social care professionals and the results of these are published via the home’s newsletter and on the notice board. An annual service review is produced and there is a document entitled ‘Business Objectives for 2005/6’. Staff meetings and quality audits take place on a regular basis. Policies and procedures are updated to reflect current good practice guidelines. Monies held on behalf of service users are held securely. There were some minor discrepancies involving missing receipts or receipts that did not record the actual item purchased, and the proposed registered manager was advised that more care must be taken with this aspect of financial management. Copies of these accounts are sent to relatives when money is needed for service users. Lockable storage is available for service users on request. There are appropriate policies and procedures in place that are designed to protect service users from financial abuse. In-house fire tests are satisfactory (there is a weekly fire alarm and emergency lighting test) and the fire alarm system has been tested by a qualified contractor. The electrical installation has been tested and gas appliances were serviced in October 2005. The passenger lift and mobility/bath hoists were serviced in April 2005. Portable appliances are tested on an ongoing basis. The testing of water temperatures in bedrooms and bathrooms takes place on a regular basis to control the risk of scalding, and a test to detect the presence of Legionella was undertaken in June 2005 – this was negative. Accident records were examined by the inspector and these cross reference to records in care plans. A discussion took place about reporting incidents to the Commission for Social Care Inspection under Regulation 37 of the Care Homes Regulations 2001 to clarify the manager’s responsibility in legislation. The home has produced a written statement of the policy, organisation and arrangements for maintaining safe working practices, including risk assessments and significant findings. Appropriate health and safety training is undertaken by staff. Londesborough Court Care Home DS0000019691.V260970.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 X X X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 X 8 2 9 X 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 3 14 X 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 X X X X X 2 X 2 STAFFING Standard No Score 27 3 28 2 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 X X 3 Londesborough Court Care Home DS0000019691.V260970.R01.S.doc Version 5.0 Page 20 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. Standard Regulation Requirement Timescale for action 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 OP8 Good Practice Recommendations Daily records should be maintained. The changing needs of service users should be recorded and care plans updated accordingly. Relatives and health professionals should be included in this process. Enough staff must be allocated to meal provision to ensure that service users are assisted appropriately and that mealtimes are safe and congenial for service users. The inspector recommends that lockable storage is provided in all bedrooms, and that locks and keys are provided for all bedroom doors. Every effort must be made to prevent unpleasant odours in the home. The proposed registered manager should complete the registration process as soon as possible. 2. 3. 4. 5. OP15 OP24 OP26 OP31 Londesborough Court Care Home DS0000019691.V260970.R01.S.doc Version 5.0 Page 21 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. 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