Inspection on 18/03/08 for Loose Court

This inspection was carried out on 18th March 2008.

CSCI found this care home to be providing an Good service.

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

Loose Court 26/04/10

Loose Court 23/02/10

Loose Court 19/11/09

Loose Court 03/04/07

Loose Court 27/10/05

Loose Court 03/05/05

Loose Court 15/12/04

Loose Court 18/05/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Loose Court Loose Court Rushmead Drive Maidstone Kent ME15 9UD Lead Inspector Paul Stibbons Unannounced Inspection 11:00 18 March 2008 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 Loose Court DS0000023872.V359578.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. Loose Court DS0000023872.V359578.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Loose Court Address Loose Court Rushmead Drive Maidstone Kent ME15 9UD 01622 747406 01622 749948 debbiecarson@btconnect.com 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) Regal Care Homes vacant post Care Home 39 Category(ies) of Dementia - over 65 years of age (39) registration, with number of places Loose Court DS0000023872.V359578.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Care is restricted to provide older person residential care to 7 persons not diagnosed with dementia. 3rd April 2007 Date of last inspection Brief Description of the Service: Loose Court was a domestic house until 1982, when it changed to a care home for the elderly. The house has had purpose built extensions. The accommodation comprises of two lounges and integral conservatory, a library/snoozlem room and dining area. There are 39 bedrooms of which 31 are for single occupancy and 4 are twinned rooms. There is a lift to access the first floor bedrooms, as well as stairs for those more ambulant. Some internal/external doors have keypad locks for the security and safety of residents. The home has a small-enclosed garden. The care home is currently registered as a residential care home for 39 Dementia- over 65 years. With a condition restricted to 7 persons who care is Older Person not falling into any other category. The home is approximately 50 yards from the main Loose Road where local bus services are available to the town centre of Maidstone approximately 4 miles away, where there are two main line railway stations. Loose Court’s current fee range is £401.26 to £590.00 per week. Additional charges are made for Hairdressing £7.20, Chiropody £12.00, one to one escorts £7.50 per hour, personal toiletries and newspapers vary pending on personal choices. A copy of the last inspection report can be seen in the main hallway of the home. Loose Court DS0000023872.V359578.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This unannounced inspection took place over a period of 4 hours. An Annual Quality Assurance Assessment (AQAA) completed by the home was returned to the CSCI prior to the inspection. A tour of the building was conducted and a variety of records and documents were examined. The Area manager and homes manager were present throughout the inspection and some residents and members of staff were spoken with. What the service does well: What has improved since the last inspection? The home is introducing Regal Care homes documentation and policies. Care plans are being reviewed and information added including, weight records, food journals, life histories and likes and dislikes of individuals. Redecoration of some bedrooms and communal areas. Increase in number of NVQ qualified staff. The requirements of previous inspections have been addressed. Loose Court DS0000023872.V359578.R01.S.doc Version 5.2 Page 6 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. The summary of this inspection report can be made available in other formats on request. Loose Court DS0000023872.V359578.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 Loose Court DS0000023872.V359578.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. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4,5,6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents have sufficient information on which to make an informed decision as to whether the home can meet their expectations. Comprehensive assessments of individual need are conducted prior to admission followed by a trial period to ensure the suitability of the home for both parties. People living in the home have the security of a written contract of terms and conditions with the home. Loose Court DS0000023872.V359578.R01.S.doc Version 5.2 Page 9 EVIDENCE: The home understands the importance of having sufficient information when choosing a care home. It has innovative ways of helping prospective individuals to choose a home that will meet their needs and preferences. It has developed clear information to help them understand what specialist services the home can provide. Prospective residents are provided with a homes brochure, a Statement of Purpose and Service Users Guide. The statement of purpose that is provided is specific to the individual home and the resident group they care for. It clearly sets out the objectives and philosophy of the service supported by a service user’s guide that can be provided in a simplified version and includes pictures to aid understanding. Care plans viewed evidence that admissions are not made to the home until a full needs assessment has been undertaken. For people who are self-funding and without a care management assessment, a skilled and experienced member of staff always undertakes an assessment. The assessment is conducted professionally and sensitively and involves the individual and their family or representative, where appropriate. Where the assessment has been undertaken through care management arrangements the service insists on receiving a summary of the assessment and a copy of the care plan. Prospective residents are given the opportunity to spend time in the home, this could be a brief visit, a meal, or whole day. There is a four-week trial period for all new admissions. New residents are provided with a statement of terms and conditions or a contract. This sets out in detail what is included in the fee, the role and responsibility of the provider, and the rights and obligations of the individual. Loose Court DS0000023872.V359578.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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health care needs of people living in the home are fully met and set out in an individual plan of care. People living in the home are treated with respect and dignity and their right to privacy is upheld. People living in the home are protected by the homes policies and procedures for dealing with medication. Loose Court DS0000023872.V359578.R01.S.doc Version 5.2 Page 11 EVIDENCE: Staff members understand the importance of residents being supported to take control of their own lives and use pictorial formats where possible to encouraged individuals to make their own decisions and choices. Three care plans viewed each included comprehensive risk assessments, which are reviewed regularly. The management of risk is positive in addressing safety issues while aiming for improved outcomes for people. Where there are limitations, the decisions have been made with the agreement of the person or their representative and are accurately recorded. The home ensures that residents or their representatives are consulted regularly to gather information about their satisfaction with the home through quality assurance questionnaires that are sent out 3 monthly to visitors, other health professionals, residents and staff. A random selection of responses were viewed with generally positive feedback about the home. The home has introduced specific charts to monitor weight and food intake to ensure appropriate action is taken where necessary. Medication was stored appropriately and records viewed were complete. As recommended in the last inspection the home has now put in place guidelines for PRN medication. It is recommended that a hand wash dispenser is fitted in the medication room. Observation of interactions between staff and residents evidenced a mutual respect. Loose Court DS0000023872.V359578.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People living in the home have the opportunity to participate in a range of activities to meet their social and recreational interests. People living in the home are supported in maintaining family contact. People living in the home enjoy a varied diet according to their choosing. EVIDENCE: Residents are able to enjoy a full and stimulating lifestyle with a variety of options to choose from. Activities observed during the visit included reading, puzzles, knitting and a music man where some residents joined in. The home has sought the views of the residents and considered their varied interests when planning the routines of daily living and arranging activities both in the Loose Court DS0000023872.V359578.R01.S.doc Version 5.2 Page 13 home and the community. Routines are very flexible and residents can make choices in major areas of their life. The home is currently developing life histories and likes and dislikes within the care plans to identify recreational interests. The service is developing effective methods using pictorial formats, which focus on involving residents in all areas of their life, and actively promotes the rights of individuals to make informed choices. This includes developing and maintaining family and personal relationships. The homes cook demonstrated a good knowledge of individual likes and dislikes and menus are planned in advance enabling residents to see forthcoming choices for meals. Residents make their choice of meal on the day. The home is again developing pictures of meals to assist residents in their choices. For those individuals who need support during mealtimes, including those who have difficulty swallowing or chewing, staff members give assistance. They are discrete and sensitive to the feelings of both the person they are helping and also to others present. Mealtimes are flexible and relaxed, staff are patient and helpful, and allow individuals the time they needed to finish their meal comfortably. Loose Court DS0000023872.V359578.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16,17,18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Systems are in place to enable people living in the home or their representatives to raise any concerns or complaints with management or staff. People’s legal rights are protected and they are protected from abuse. EVIDENCE: The service has a complaints procedure that is clearly written and easy to understand. It is available on request in a number of formats (including pictorial and a complaints box) to help anyone living at, or involved with, the service to complain or make suggestions for improvement. The complaints procedure is supplied to everyone living at the home and is displayed in a number of areas within the service. Residents and visiting relatives spoken with understand how to make a complaint and are clear about what will happen if a complaint is made. The home keeps a full record of Loose Court DS0000023872.V359578.R01.S.doc Version 5.2 Page 15 complaints and this includes details of the investigation and any actions taken. Unless there are exceptional circumstances the service always responds within the agreed timescale. The home has received one complaint that was resolved since the last inspection. Residents are supported in taking part in the election process if they wish and can access advocacy services through Age Concern. The policies and procedures for safeguarding adults are available and give clear specific guidance to those using them. Staff members spoken with demonstrated understanding of when incidents need external input and who to refer the incident to. The manager states that not all staff are up to date with training around safeguarding vulnerable adults but this is being addressed. Loose Court DS0000023872.V359578.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,22,24,26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ benefit from living in a safe, well-maintained environment with adequate personal and communal space to meet their needs. People living in the home have comfortable bedrooms and benefit from having their own possessions around them. Residents’ benefit from, living in clean, pleasant and hygienic conditions, that are free of any offensive odours. Loose Court DS0000023872.V359578.R01.S.doc Version 5.2 Page 17 EVIDENCE: The home provides a physical environment that is appropriate to the specific needs of the people who live there. The well-maintained environment provides specialist aids and equipment to meet their needs. The home is a very pleasant, safe place to live. A maintenance person is employed to monitor and maintain the building and redecoration of some bedrooms and communal areas has taken place in the last 12 months. There are plans to replace some carpets and communal furniture in the next 12 months and develop a sensory garden. Bedrooms viewed had personal possessions on display reflecting the lifestyles and interests of individuals. The shared areas provide a choice of communal space with opportunities to meet relatives and friends in private. The bathrooms and toilets are fitted with appropriate aids and adaptations to meet the needs of the people who use the service, and are in sufficient numbers and of good quality. Domestic and laundry staff are employed to ensure the home is clean, pleasant and hygienic. Cleaning chemicals are kept in secure storage areas and the home has environmental and fire risk assessments in place. The home is well lit, clean and tidy and smells fresh. The management has a good infection control policy. Not all staff members have received training in infection control and the manager states this is being addressed. Loose Court DS0000023872.V359578.R01.S.doc Version 5.2 Page 18 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. 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’ needs are met by sufficient numbers and skill mix of staff on duty, and they are in safe hands at all times. People living in the home are protected by the homes recruitment policies and practices. EVIDENCE: People can have confidence in the staff who care for them. Rotas viewed indicated well thought out and creative ways of making sure that the home is staffed efficiently, with particular attention given to busy times of the day and changing needs of the people who use the service. Inductions viewed for new staff consisted of a 3 day initial induction followed by a skills for life common induction programme. Loose Court DS0000023872.V359578.R01.S.doc Version 5.2 Page 19 The service recognises the importance of training, and tries to deliver a programme that meets any statutory requirements and the NMS. The manager is aware that there are some gaps in the training programme and plans to deal with this. Staff members undertake external qualifications beyond the basic requirements. Managers encourage and enable this and recognise the benefits of a skilled, trained workforce. NVQ qualifications are supported and currently 50 of staff members have either achieved the award or working towards the award. A working with dementia course is arranged for 14/04/08. There is a good recruitment procedure that clearly defines the process to be followed. This procedure is followed in practice with the home recognising the importance of effective recruitment procedures in the delivery of good quality services and for the protection of individuals. Staff files viewed evidence that appropriate checks are carried out. Loose Court DS0000023872.V359578.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,35,36,38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident’s benefit from living in a home that is run in their best interests and the leadership and management approach of the home. The health, safety and welfare of people living in the home is promoted and protected. Loose Court DS0000023872.V359578.R01.S.doc Version 5.2 Page 21 EVIDENCE: Discussions with the manager demonstrated a clear understanding of the key principles and focus of the service, based on organisational values and priorities. They work to continuously improve services through evaluation of regular quality assurance audits. They provide an increased quality of life for residents with a strong focus on equality and diversity issues and promoting human rights, especially in the areas of dignity, respect and fairness. There is a strong ethos of being open and transparent in all areas of running of the home. The AQAA contains clear, relevant information that is supported by a wide range of evidence. The AQAA lets us know about changes they have made and where they still need to make improvements. It shows clearly how they are going to do this. The data section of the AQAA is accurately and fully completed. Good financial systems are in place to protect and assist residents with personal monies held by the home. The home does not act as appointee for any residents. This is managed by relatives or power of attorney. The home works to a clear health and safety policy. Records viewed were complete and included water temperatures, fire logs and equipment servicing. Safeguarding is given high priority and the home provides a range of policies and guidance to underpin good practice. Loose Court DS0000023872.V359578.R01.S.doc Version 5.2 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 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 3 X 3 X 3 X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 3 X 3 Loose Court DS0000023872.V359578.R01.S.doc Version 5.2 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. 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 OP9 Good Practice Recommendations It is recommended the commission pharmacy inspectors prior to any work commencing view the plans for new medication storage for advice and approval. Ongoing from the last inspection, this is proposed to address in the homes extension and refurbishment plans now approved by Maidstone Planning Dept. 2. OP26 It is recommended that the laundry area have access that is not through dining area. Before final work commences on laundry access, consideration should be given to consultation with the Health Protection Unit for advice on effective clean and dirty area management of laundries in care homes. Ongoing from the last inspection, this is proposed to Loose Court DS0000023872.V359578.R01.S.doc Version 5.2 Page 24 address in the homes extension and refurbishment plans now approved by Maidstone Planning Dept. Loose Court DS0000023872.V359578.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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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