Inspection on 27/10/05 for Loose Court

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 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

Loose Court 26/04/10

Loose Court 23/02/10

Loose Court 19/11/09

Loose Court 18/03/08

Loose Court 03/04/07

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 Lynnette Gajjar Announced 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 Loose Court DS0000023872.V259372.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. Loose Court DS0000023872.V259372.R01.S.doc Version 5.0 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) Jewel Homes Limited Mrs Debra Carson Care Home 39 Category(ies) of Dementia - over 65 years of age (39) registration, with number of places Loose Court DS0000023872.V259372.R01.S.doc Version 5.0 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 May 2005 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, library/snoozlem and dining area, with 39 bedrooms of both single (31) and twinned rooms (4). There is a lift to access the first floor bedrooms, as well as stairs for those more ambulant. Some internal/esternal 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 directors and manager have expressed and evidenced a high commitment to residents involvement in any changes to the care home and to provide the support, environment and trained staff in order to meet the care needs of their residents. The home is run by a registered manager with the support of the welfare officer, senior carers, carers, kitchen, domestic, administration and maintenance staff and 2 part-time leisure therapists. 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 DS0000023872.V259372.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection, the second in the year running from April 1st 2005 to March 31st 2006. The visit lasted from 09.30am until 15.45pm. The home currently has 38 residents and is running with one vacancy that is due to be filled in the coming week. The visit was spent talking directly with residents privately and collectively, care and ancillary staff, welfare officer and the registered manager, visiting relatives and district nurses. Due to the nature of the service, it is difficult to reliably incorporate accurate reflections of the service users in the report. Some judgements about quality of life and choices were taken from direct conversation with residents and observation followed by discussion with care staff. Additional information was obtained through receipt of the manager’s preinspection questionnaire, a tour of the premises and conducting a case tracking exercise, by reading the files and care plans of the four residents and two care staff and two ancillary staff, as well as some policies and records maintained by the home. Documentation was on the whole in good order and the recommendations from the previous inspection had been implemented. Questionnaires feedback was also received from a further 10 relatives/carers, 8 GP and 1 care manager. Overall relatives and professionals are very satisfied with the service received. Some comments received: “ On the whole I find Loose Court very friendly and always thinking of the residents and give them the care and love they need, but I feel there should be more staff at weekends” “It’s always very friendly and the staff are always there to answer problems my mother is always looked after alright” “I have complete confidence in the staff at Loose Court. They are kind, friendly and very helpful” What the service does well: Loose Court DS0000023872.V259372.R01.S.doc Version 5.0 Page 6 Loose Court provides a welcoming and homely environment, is decorated and furnished to a good standard and is clean, bright and airy. This home offers a friendly and personal care service to the residents, encouraging active participation in daily routines and the running of their home and accessing local community facilities. The home offers a stimulating, relaxed and comfortable home for their residents. Residents spoke today of feeling safe, expressed confidence in the care staff and manager to listen to them and “feel good” in themselves. Personal health care needs are well supported. Residents are encouraged to maintain regular contact with external agencies and professionals to managed their health care and personal preferences. Relatives and district nurses strongly commended the staff on their caring but also the good communication about their relatives / residents care. The home continues to benefit from a stable and highly motivated care team with a developmental and experienced manager. Care staff work in a way that promotes a relaxed atmosphere. What has improved since the last inspection? What they could do better: With the completion of the approved building works will offer residents and staff safer and more easily accessible facilities in the home for accessing closer Loose Court DS0000023872.V259372.R01.S.doc Version 5.0 Page 7 toilets, safer access and management of the laundry service and medication storage. Residents and staff would benefit from clearer and more specific guidelines in the administration of PRN medication, such as what exactly the medication is prescribed for and visual triggers and indicators of when medication is to be administered. 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. Loose Court DS0000023872.V259372.R01.S.doc Version 5.0 Page 8 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.V259372.R01.S.doc Version 5.0 Page 9 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): 1,3,4,5,6 Residents and their families are given all the information they need to make an informed choice about whether to live at Loose Court. EVIDENCE: The homes statement of purpose and service user guide gives clear information about the services provided. The home undertakes full pre-admission assessments before offering a visit to the home. This enables staff and residents to get a clearer understanding of the services offered and if the home is able to meet their care needs. Further development of understanding of dementia care for care staff has enabled this process to be simplified and welcoming. One resident reflected: “ My daughter looked around a lot of homes and said to me – I have found just the right home Mum- I came the next day for the afternoon and tea and decided I liked so much, so stayed and here I am, the girls are lovely, nothing is too much for them and always so happy.” The home does not provide intermediate care. Loose Court DS0000023872.V259372.R01.S.doc Version 5.0 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Individual health, social care needs and personal choices are well supported through discussion, and informed decision-making. Residents are treated with genuine respect and dignity by care staff. EVIDENCE: Four individual care plans were tracked. Staff maintain care plans to ensure personal, consistent, safe care and support is given. These can be developed further with individual information particularly in relation to social interaction and personal preferences. Much of which, staff were verbally able to share with the inspector. Risk assessments format are simple, detailed and easy to follow, offering a good baseline for guidelines to promote individual independence through minimised risk. Photographs are in the process of being transferred to the new care plan files. Records are stored securely. The health and personal care needs of residents are well supported with regular contact with specialists and external professionals. District nurse visiting today expressed satisfaction with the open and good communication with care staff and working together to address the care required for residents. Interaction between residents / relatives and staff is good showing genuine respect, friendship and appropriate familiarity with each other. Loose Court DS0000023872.V259372.R01.S.doc Version 5.0 Page 11 “ Mum has settled well, I asked her to considered coming home to live with me and my wife but she said – I quite like it here now Thank You. The staff are great, only problem are with appointments but these tend to be the hospitals fault not the home, very friendly good staff, no concerns at all, we are very happy with mums’ care” Residents discussed getting together formally through residents committee meetings, what they would like to do, daily routines and chores, activities and issues for the home. Minutes were also evidenced. Safe medication practice is in place with regular monitoring and auditing by the manager and welfare officer. Residents and staff would benefit from more detailed guidelines of what PRN medication is given for and specific triggers or indicators for administration, particularly for those who may be more confused. Medication storage will be greatly improved with the planned new clinical/ medication room. Loose Court DS0000023872.V259372.R01.S.doc Version 5.0 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14, Residents are given encouragement and support to make choices about aspects of their daily lives, including a range of local social and recreational interests. EVIDENCE: Continued support from staff enables individuals to access local amenities and surrounding area including shopping, walks, and trips out, one lady discussing fondly two summer outings to Herne Bay for Fish ‘n’ chips and lunch out at a golf club. Resident’s families are in regular contact, with an open door visiting policy. A steady flow of visitors was observed through out the day with fondness and familiarity with staff. There is a high regard from families towards the staff team and care provided. Residents are supported to visit or meet relatives outside the home. All feedback cards received from relative stated they were satisfied with the overall care given. (See summary) The home has recruited two part-time leisure therapist, spending time from 24pm and 6-9pm in supporting residents in leisure activities both in groups and individually. The home has purchased a number of leisure activities / games promoted by the Alzheimer’s Association. One leisure therapist is trained in Loose Court DS0000023872.V259372.R01.S.doc Version 5.0 Page 13 beauty therapy and massage, which is well received, by a number of resident, particularly the hand massages. Themed nights are popular. Residents today engaged in games of dominoes and cards, various threading and weaving and fine dexterity movement activities, including skittles. Residents also commented fondly of the ‘music man’ who comes every fortnight to entertain them. A number of residents chose not to join in but sat reading newspapers, snoozing or chatting to each other. Others were engaged in responsibilities of laying tables for meal times, polishing cutlery (at their choice) and being involved in the daily routines of the home. Residents were observed to be stimulated and comfortable in their home. Loose Court DS0000023872.V259372.R01.S.doc Version 5.0 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Systems are in place to enable those living and visiting the home to raise concerns or complaints with staff. However not all relatives were familiar with this process. Protection from abuse is promoted through staff training and understanding of actions they may need to take. EVIDENCE: Copies of the complaint procedure are available in the home in formats easily understood by those living there, but also given to relatives at the time of admission. Four comment cards received from relatives indicated they were unfamiliar with the process. The manager will through the next mail out to relatives ensure all are given a copy of the procedure for their reference. Complaint records evidenced one formal complaint has been received and resolved amicably by all concerned. Due to the nature of the service and those living here, using this system can be limiting. Residents were able to indicated through discussion, who they would talk to if they were unhappy about something. Residents can also rely on others such as relative/ advocates to identify concerns and raise them on their behalf. Staff spoken with continue to showed a good understanding of how to protect and prevent abuse, including reporting under the latest local procedures. With up dated training this year. There are no current adult protection alerts relating to this home. Loose Court DS0000023872.V259372.R01.S.doc Version 5.0 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,23,24,25,26 Residents live in a warm, nicely decorated, safe and clean home, which will be enhanced further with facilities being installed later this year. EVIDENCE: The home continues to be presented to good standard of hygiene and cleanliness. The development of the snoozalem room has proven to be successful. Communal rooms have water ioniser and aromatherapy units in use at all times giving of a subtle fresh smell. Risk assessments for specific oils used both stimulating and relaxing and safety of use have been undertaken. Security keypads have been installed to minimise the risk of residents entering stairwells, external doors and rooms holding equipment and chemicals. The registered manager detailed proposals to start the final part of building work to include a separate entrance to laundry room, larger medication storage room and additional toilets of the communal conservatory. Planning permission has been approved. Minor areas were identified during this visit but in hand with the manager to be fully addressed by the maintenance staff. Loose Court DS0000023872.V259372.R01.S.doc Version 5.0 Page 16 Installation of new doorway has been put in to develop a safe reception area, where reception staff will be in place from 31st October 2005. The garden has been completed, with special safety surface installed to this area and the car park has been re-surfaced. For further independence and to minimise the risk of falls, immediate exploration of the raised doorframe (off the conservatory external doorway) should be undertaken, particularly for those with limited mobility and reliant on Zimmer frames or wheelchairs. Loose Court DS0000023872.V259372.R01.S.doc Version 5.0 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Service users benefit from the support of a confident and skilled staff team. Resulting in good morale and enthusiasm to improve the service users whole quality of life. EVIDENCE: The home continues to encourage and support care staff to completed their NVQ 2 and 3 in care. The home currently has nine of twenty-two staff holding NVQ 2 or 3 in Care. All staff has undertaken a thorough and comprehensive recruitment and induction programme including all core training. Detailed training matrix is in place. Staff feel supported by the manager and welfare officer. Care staff spoken with and directly observed evidenced clear and good understanding of different individual care needs. There are clear roles and responsibilities to enable a smooth and efficient service being delivered, with good communication between staff. Which will be further enhanced with the reception staff. Residents reacted fondly towards individual staff and their help. Comments shared included:” She’s my darling”, “They’re alright”, “They’re all lovely aren’t they, all the helpers” Staff were seen to support individuals with dignity but with respectful two-way familiarity. Loose Court DS0000023872.V259372.R01.S.doc Version 5.0 Page 18 Rosters are covered with various short shift patterns to cover key areas of the day. Weekends due to the welfare officer being off duty have additional carers hours rostered. Most staff are part-time enabling annual leave and sickness to be covered by familiar regular staff increasing their hours for that period. Offering consistent care and support. Loose Court DS0000023872.V259372.R01.S.doc Version 5.0 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,34,35,36,38 Residents living here have their personal preferences, support and care needs encouraged through the registered managers open leadership and the promotion of a safe home and working environment. EVIDENCE: The registered manager has worked with this service user group for a number of years and has completed NVQ 4 in Care and Management. The manager also has responsible individual responsibility for other homes within the organisation. Residents and staff expressed a high regard for their management approach to the home. Resident’s continue to feel the registered manager and welfare officer are approachable and staff said they felt well supported. Regular quality assurance questionnaires are circulated to residents and relatives. Loose Court DS0000023872.V259372.R01.S.doc Version 5.0 Page 20 The registered manager and welfare office continue to demonstrated through discussion and practice, a very clear understanding of the needs of current residents and current issues. 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. Relatives or power of attorneys manages this. Monitoring health and safety in the home is to a good standard. Minor areas were identified and undertaken before the inspection had concluded. Equipment is serviced as required to maintain a safe home and facilities. Risk assessments are completed for individuals and staff activities in the home and care duties. Staff evidenced a clear understanding of accident/incident Loose Court DS0000023872.V259372.R01.S.doc Version 5.0 Page 21 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 3 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 4 13 3 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 3 3 X 3 3 3 2 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 4 4 4 3 3 3 X 3 Loose Court DS0000023872.V259372.R01.S.doc Version 5.0 Page 22 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. 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 that care plans are developed further to detail residents using PRN medication with clear guidance to triggers to look for, to indicate how much PRN Medication is required particularly for those who are easily confused. 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. It is recommended that during the next mailing to relatives this includes the homes complaint procedure and information to ensure all are aware of formal process to raise concerns. It is recommended that raised doorframes leading to the DS0000023872.V259372.R01.S.doc Version 5.0 Page 23 2 OP9 3 OP16 4 OP19 Loose Court 5 OP26 garden are risk assessed and the access made safe for residents (using highlighters or flushing floor to frame). It is recommended that the laundry area has access that is not through dining area. Before final work commences on laundry access, consideration should be given to consutlation 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 address in the homes extension and refurbishment plans now approved by Maidstone Planning Dept It is strongly recommended that all residents have their own nail care products and manicure sets. It is recommended that all minor repairs indentified today are completed within reasonable timescales. 6 OP38 Loose Court DS0000023872.V259372.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Loose Court DS0000023872.V259372.R01.S.doc Version 5.0 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!