Inspection on 28/06/06 for Londesborough Court Care Home

This inspection was carried out on 28th June 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.

Other inspections for this house

Londesborough Court Care Home 27/10/05

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 Terry Downey Key Unannounced Inspection 28th June 2006 09:00 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.V299949.R01.S.doc Version 5.2 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.V299949.R01.S.doc Version 5.2 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 court@amserve.com Londesborough Court 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.V299949.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 27th October 2005 Brief Description of the Service: Londesborough Court Care Home is registered to provide residential, social and personal care for 30 people with dementia over 65 years of age. The property is a large detached house set in its own grounds, and has a conservatory and popular patio area. The accommodation is provided on two floors, and access is available via a passenger lift. There is ample car parking space for staff and visitors. The home was formerly a nursing home but was registered as a care home in 1994. The registered provider is Londesborough Court Ltd and the manager is Ms Meg Kennedy who has applied to be registered. The home has an information pack and service user guide to inform prospective residents about the home. On 28th June 2006 the fees for the home ranged from £340 - £400. . Londesborough Court Care Home DS0000019691.V299949.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection consisted of a review of the information held on the homes file since the previous inspection, information submitted by the home in the Pre Inspection Questionnaire, and a 8 hour unannounced site visit to the home on 28th June 2006. At the time of the site visit the manager, Ms M Kennedy was available to assist with the inspection and was very helpful. The site visit included observation of care practices, discussion with 14 residents, 8 members of staff, a visiting mental health care worker, a National Vocational Qualification Assessor, 4 visitors, and the hairdresser who had been visiting the home for almost a year. A survey form had also been completed by a GP who visits the home regularly. The visit also included a check on the requirements from the previous inspection, a tour of the premises and a check on the records kept by the home. The inspection showed that the residents were well cared for in a clean, well maintained, home. There is a core of well trained, and committed staff, and a manager and deputy who work hard to improve the residents’ quality of life. What the service does well: What has improved since the last inspection? The kitchen has been up graded which makes it a better place to work and more efficient way of organising the meals. Londesborough Court Care Home DS0000019691.V299949.R01.S.doc Version 5.2 Page 6 Some systems have been streamlined to enable staff to spend more time with the residents. The manager has been up dating her knowledge by use of the internet and passing this on to the staff to ensure that they are all aware of the current legislation and best practice. 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. Londesborough Court Care Home DS0000019691.V299949.R01.S.doc Version 5.2 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.V299949.R01.S.doc Version 5.2 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): 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents and their representatives have the information required to choose a home which meets their needs . EVIDENCE: Case tracking confirmed good practice. A senior care worker had visited prospective service users at home and undertaken an initial assessment of their care needs. One of the service users whose care was case tracked had visited the home before deciding to move there. A staff member had showed her around and explained how the home was run and what would be available. She had been told how the home could meet her needs and had spent time with other service users and talked to them about what it was like living there. Another service user spoken to said he had all the information he felt he required before coming to the home The service user guide was looked at and is written in plain language and is clear about the service being offered. The assessment process and information given to prospective residents means that Londesborough Court Care Home DS0000019691.V299949.R01.S.doc Version 5.2 Page 9 they can be confident that their diverse needs will be met. Information was available to staff to ensure they could meet the social, emotional and care needs of new service users. The written contract and terms and conditions of residence were on each service user’s file. The current fees were included and clearly laid out. This means that service users have the information they need about the service they will receive and how much it will cost them. Londesborough Court Care Home DS0000019691.V299949.R01.S.doc Version 5.2 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. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Care planning is good but the way the medication was being given out could put the residents at risk.. EVIDENCE: Care plans contained the information required to help the staff meet the needs of the individual resident and the information was up to date, and monthly reviews are carried out. Four residents were case tracked and they indicated that their personal care needs were met appropriately. There was evidence that residents are part of the process and that they sign to agree the contents of the care plan. Staff had an understanding of the needs of the residents and were seen to be patient and kind when interacting with them. All residents have frequent contact with the manager, the deputy, and care staff which ensures that appropriate care is provided. Care plans include health care requirements and service users felt that if they needed to see a doctor or attend an appointment this was arranged quickly. The GP and two Community Nurses were surveyed but only one reply was received from the GP which Londesborough Court Care Home DS0000019691.V299949.R01.S.doc Version 5.2 Page 11 considered that there had been a problem, now resolved, and good communication exists between the Practice and the home. It was possible to speak to four visitors, an NVQ assessor, a worker from the local mental health team, and the hairdresser, who all considered that the residents were well looked after. The home’s medication procedure is good but was not being followed on the day of the inspection. Medication was being put into pots on trays to be taken to a resident by another member of staff other than the one in charge of dispensing the medicines. This practice may put residents at risk. The manager considered that this was not the usual practice, and not how staff had been trained. Staff have had training in the administration of medication and the pharmacist visits the home to check the system, and provide useful information for the staff. Relevant staff have had accredited training and the storage and record keeping was good. None of the residents self medicate. Londesborough Court Care Home DS0000019691.V299949.R01.S.doc Version 5.2 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): 12,13,14,15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service The social and recreational activities meet the residents’ expectations and they eat a healthy and varied diet. EVIDENCE: The evidence indicated that the level of social activities is appropriate for the residents. All the residents said that they enjoy the entertainers who visit the home, some had individual activities such as reading, crosswords, and cross stitch, they also enjoy the music and regular sing songs with the staff, so they did not want more activities. The residents were clean, and well dressed, and clearly well cared for. A Methodist minister visits the home but none of the residents go out to services, as they would be expected to organise their own transport. Residents said that the food is good and they have sufficient choice. Two meals were observed during the inspection and both were enjoyed by the residents, and were well presented and served. Some residents have asked for a cooked breakfast and this is being considered by the home. The kitchen is well equipped and cleaning rotas ensure that cleanliness is maintained. The temperatures of the cooked food is taken to ensure that it is fully prepared, and good records are kept. Londesborough Court Care Home DS0000019691.V299949.R01.S.doc Version 5.2 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): 16,18. Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Residents are protected from abuse because staff are trained, work closely together and are well managed. EVIDENCE: A complaints procedure was available to all service users and this was included in the service user guide. Some service users remembered they had the guide and the procedure but others did not think they had seen it. They all felt safe, listened to, and able to speak to the staff and manager if they were not happy about anything to do with their care. Staff had a good understanding of service users’ rights as citizens. The evidence indicated that residents are protected from abuse, the staff had done a training course in adult abuse and the senior staff were aware of the procedure. The recruitment procedure is good and ensures that only suitable people are employed in the home. Londesborough Court Care Home DS0000019691.V299949.R01.S.doc Version 5.2 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): 19,26. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Good maintenance and cleaning rotas ensure that the home is satisfactorily maintained. EVIDENCE: The home was clean but quite untidy in places. There was a large pile of towels in the bathroom because there was no storage cupboard; in one resident’s bedroom incontinence pads were stored under the hospital bed. The manager explained that there was a lack of storage but also said that if pads were stored centrally they would not be as accessible and could not ensure that each resident got their own pads. The decorations and furnishings were satisfactory. Some of the beds and bedroom furniture were suffering from wear and tear. The kitchen had recently been refurbished and there was a rolling programme in place for decorations. There were good cleaning rotas in place and the cleaner/handyman considered that he had sufficient Londesborough Court Care Home DS0000019691.V299949.R01.S.doc Version 5.2 Page 15 equipment and time to do the work. He also had the support of another part time cleaner. There was an efficient system of notifying him that minor repairs were required around the home. Londesborough Court Care Home DS0000019691.V299949.R01.S.doc Version 5.2 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): 27,28,29,30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents benefit from a core of well trained and committed staff. EVIDENCE: The rota showed that there were sufficient staff on duty and this was confirmed during the inspection. Staff were observed assisting the residents and also having time to spend talking to them. The residents also said they felt that there were enough staff and that they were always helpful. The staff do work 12 hour shifts which is not considered good practice. The home has also adopted the policy of employing overseas staff. The manager explained that she had trouble employing local people who were prepared to train or to work the later shifts. She said the staff she has at present are are very reliable, good carers, and work hard. The language barrier did not seem to be a problem and all the residents comments about the staff were positive. The problems arise with writing and understanding the training, but the staff are very supportive of one another, and as much training as possible is done by demonstration, and the home, and the staff feel that they are overcoming the difficulties. Staff files were examined and showed that a safe recruitment procedure is followed to ensure that only suitable people are employed. A good induction and training programme is then in place to ensure that staff are equiped to carry out their jobs well. This training includes the protection of Londesborough Court Care Home DS0000019691.V299949.R01.S.doc Version 5.2 Page 17 vulnerable adults and ‘dementia care’ as well as the mandatory training to meet service users basic needs, such as manual handling and health and safety. Staff were clear about their role, knew what was expected from them. There was an indication that some of the established staff were reluctant to take on the training and this needs to be addressed as well the National vocational Training which is well short of the 50 recommended figure. Londesborough Court Care Home DS0000019691.V299949.R01.S.doc Version 5.2 Page 18 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): 31,32,33,35,37,38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Good management arrangements ensure that the home is run to meet the needs of the residents. EVIDENCE: The manager is on maternity leave but still works regularly in the home and has able deputies who can stand in. Residents and visitors spoken to knew the management structure of the home, and felt that the home was well organised. Some of the residents felt that they were well consulted and asked for their opinions about improving the home. Staff considered that they were well supported by the management and that they worked well together as a team. Staff had regular supervision which was clearly recorded. Londesborough Court Care Home DS0000019691.V299949.R01.S.doc Version 5.2 Page 19 The quality assurance systems in place are very effective and the manager is proactive in addressing quality issues within the home. The views of service users, staff members, relatives and professionals visiting the home are sought on how the service can be improved. The manager was committed to promoting equality and diversity in the service and meeting service users individual needs. The owners of the home visit regularly and talk to residents and staff but do not complete a written report of their visit and this must be addressed. Londesborough Court Care Home DS0000019691.V299949.R01.S.doc Version 5.2 Page 20 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 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 1 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 3 2 3 Londesborough Court Care Home DS0000019691.V299949.R01.S.doc Version 5.2 Page 21 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. 2 Standard OP9 OP37 Regulation 13 26 Requirement Timescale for action 28/06/06 The medication procedure must be followed at all times to ensure the safety of the residents. The registered provider must 31/08/06 carry out an unannounced visit to the home at least once per month and prepare a written report on the conduct of the home. 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 OP28 OP30 Good Practice Recommendations A minimum of 50 of the staff should be trained to NVQ level 2 It is not considered good practice for staff to work 12-hour shifts. 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