CARE HOMES FOR OLDER PEOPLE
Loxley Chase 3a & 5 The Crescent Linthorpe Middlesbrough TS5 6SD Lead Inspector
Julia Connor Unannounced 19 July 2005 10:35 am 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 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. Loxley Chase B51-B01 S39334 Loxley Chase V238907 190705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service Loxley Chase Address 3a & 5 The Crescent Linthorpe Middlesbrough TS5 6SD 01642 818921 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr George Dixon Mrs Michelle Morrell Care home only 19 Category(ies) of OP - Old age registration, with number of places Loxley Chase B51-B01 S39334 Loxley Chase V238907 190705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 19th January 2005 Brief Description of the Service: Loxley Chase is a care home providing personal care for older people. It is a two storey building providing both single and shared accommodation for 19 Residents. There are 13 single bedrooms and 3 double bedrooms one of which is currently being used as a single bedroom. The single bedrooms are a minimum of 10 sq.m and the double bedrooms are a minimum of 16 sq.m. There is a stair lift giving access to the upper floor. There is a lounge and dining room on the ground floor and a lounge/dining room on the first floor. There is also a small sitting area, known as the Library, that over looks the front of the house and a small area for those Residents who smoke. Loxley Chase is situated close to local shops and amenities; a bus service provides access to Middlesbrough town centre. There is car parking at the rear of the home. Loxley Chase B51-B01 S39334 Loxley Chase V238907 190705 Stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection commenced at 10.35 a.m. and concluded at 2.30 p.m. Five Residents, one visitor and two members of staff were spoken to during the inspection. What the service does well:
Many of the staff have worked at the home for many years and have a good knowledge of the Residents they care for. One Resident informed the Inspector that she had just been taken to the local shops to do some shopping which she had enjoyed; and she was looking forward to going to the Little Theatre the next day to see Memory Lane. Another Resident who spoke to the Inspector stated that it had taken time for her to settle into the home but was now fine and found the staff pleasant and helpful. She stated that she preferred to stay in her room, which the staff respected, but they were always popping in to see her. She stated that she did join in some of the activities that were on offer such as the Craftwork, Bingo and scrabble. This Resident had a telephone in her room, which enabled her to keep in contact with her family and friends. She stated that she felt that she still had control over her life, she stated that she managed her own finances, and that the staff treated her as an individual not just another Resident. She stated that she had confidence in the Manager and that gave her peace of mind. The other Residents who spoke to the Inspector stated that the staff was polite and they were always treated as individuals. The daughter of one of the Residents stated that she had heard the staff speak to the Residents nicely even when they did not know that she was within hearing, which gave her peace of mind as she lived some distance form the home and did not visit her Mother as often as she would like. The Residents informed the Inspector that the activities within the home were improving and one Resident stated that the home had arranged for her to attend art classes. All of the Residents stated that the Motivation person who visited the home once a month was very good and they intended to speak to the Manager so that she could arrange for more frequent visits. Loxley Chase B51-B01 S39334 Loxley Chase V238907 190705 Stage 4.doc Version 1.40 Page 6 The Residents stated that they enjoyed the arts and crafts that the staff did and one Resident said that she liked the visiting library that called into the home every three weeks as they made sure that they brought her the special books she liked and gave an example of the Art books that were included in the books supplied to the home. The Residents thought that the Manager was very efficient and understanding. The daughter of the Resident who spoke to the Inspector stated that because she lived so far away the Manager would telephone her and let her know how her Mother was and she trusted the Manager to let her know what was happening in regards to her Mother. All of the Residents who spoke to the Inspector stated that they felt they still had control over and choice in, their day-to-day life. What has improved since the last inspection? 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. Loxley Chase B51-B01 S39334 Loxley Chase V238907 190705 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Loxley Chase B51-B01 S39334 Loxley Chase V238907 190705 Stage 4.doc Version 1.40 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 standard(s) 2 and 3 Each Resident has a contract with the providers of their care. No Resident is admitted to the home without having had their needs assessed prior to admission. EVIDENCE: Contracts were evidenced in both of the care files that were audited. There was evidence in the care files that the home received information from the Social Worker or discharging ward regarding the Resident prior to them being admitted to the home. A member of staff also visits the Resident prior to admission to ensure that the home can meet the prospective Residents needs. Loxley Chase B51-B01 S39334 Loxley Chase V238907 190705 Stage 4.doc Version 1.40 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 standard(s) 7, 8 and 10 The Residents health, personal and social needs are recorded in an individual plan of care. The Residents health care needs are met and Residents are treated with respect and dignity. EVIDENCE: Two sets of Residents care files were audited and all contained an adequate amount of information. There was evidence that Residents or their representative had had access to their files and agreed the plans of care. The Residents have access to out side health professionals e.g. Doctor, District Nurse, Dentist and Optician. The Residents who spoke to the Inspector stated that the staff always treated them with respect and dignity. The daughter of a Resident informed the Inspector that she had heard the staff speak respectfully to the Residents unaware that she was within hearing distance. Loxley Chase B51-B01 S39334 Loxley Chase V238907 190705 Stage 4.doc Version 1.40 Page 10 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 standard(s) 12, 14 and 15 Residents are satisfied that the home meets their social, religious and recreational needs. Residents are helped to exercise choice and control over their lives. Residents are not satisfied with the quality of the food that is served to them. EVIDENCE: The Residents who spoke to the Inspector felt that the activities had improved recently and they particularly enjoyed the person from Motivation who visited the home once a month. The Residents stated that they intended to speak to the Manager so that she could arrange a fortnightly visit from the Motivation person. The Residents stated that other activities are also on offer and gave the examples of bingo, scrabble and craftwork. One Resident also stated that she enjoyed the visiting library as they bring her Art books to choose from. The Inspector was informed that the Catholic Residents received Holy Communion every week and Residents of other denominations once a month. Loxley Chase B51-B01 S39334 Loxley Chase V238907 190705 Stage 4.doc Version 1.40 Page 11 Residents stated that they were encouraged to be as independent as possible but knew that the staff were there for help and assistance. The Residents stated that they felt they had choice in their every day lives. The Residents stated that the food was acceptable but could be improved, for example one Residents stated that there were occasions when the beef was not up to standard; another Resident stated that when she alone had chicken it tended to be cubed and often tasteless; however when all of the Residents had chicken it was nice. All of the Residents stated that the fish was nice but again would be better if it was fresh. All of the Residents stated that there was an alternative offered if they did not like what was on the menu. There was also discussion that the vegetable were often over cooked. The daughter who was visiting her Mother had eaten lunch at the home and had requested a vegetarian diet which she had been given and enjoyed. On the day of the inspection the kitchen was clean and there was a good stock of dried food. Loxley Chase B51-B01 S39334 Loxley Chase V238907 190705 Stage 4.doc Version 1.40 Page 12 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 standard(s) 16 Residents are confident that if they complained they would be listened too and action taken. EVIDENCE: There is a complaints policy and procedure in place, which outlines the stages the complainant should take to make a formal or informal complaint. The Residents who spoke to the Inspector stated that they would speak to the Manager if they had any complaints or concerns and were confident that she would take the appropriate action. The staff that spoke to the Inspector were aware of the action to take should they receive a complaint. There has been one complaint to the Commission for Social Care Inspection since the last inspection, which was not upheld. Loxley Chase B51-B01 S39334 Loxley Chase V238907 190705 Stage 4.doc Version 1.40 Page 13 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 standard(s) 19, 23, 24, 25 and 26 Residents live in a well-maintained environment, which on the day of the inspection was clean and odour free. Resident’s bedrooms are comfortable and meet their needs. EVIDENCE: On the day of the inspection the home was clean and odour free. However, the small area that is used by those Residents that smoke needs to have the ventilation improved and the area decorated. The Inspector was informed that the hall was next on the redecorating and refurbishment list. The Residents and staff who spoke to the Inspector stated that they were happy with the décor of the home.
Loxley Chase B51-B01 S39334 Loxley Chase V238907 190705 Stage 4.doc Version 1.40 Page 14 The Residents bedrooms had been personalised to their choice, one Resident had a telephone in her bedroom so she could keep in touch with family and friends. The home still does not have a sluice but the plans have been drawn up ready to implement. Loxley Chase B51-B01 S39334 Loxley Chase V238907 190705 Stage 4.doc Version 1.40 Page 15 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 29 and 30 The Residents are protected by the home’s recruitment practices and the staff have received training to do their jobs. EVIDENCE: Three personnel files were audited; all contained the required information as stipulated in Schedule 2 of the Care Homes Regulations 2001. The following is an example of the training that has taken place: Manual Handling. Health and Safety. Basic Life Support. Food Hygiene. Loxley Chase B51-B01 S39334 Loxley Chase V238907 190705 Stage 4.doc Version 1.40 Page 16 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 35 and 36. A person who is fit to be in charge manages the home. The Residents personal finances are safeguarded. Staff receive formal supervision EVIDENCE: The Manager has the experience to ensure that the needs of the Residents are met; she is currently studying for her NVQ Level 4 in management. The Residents, visitor and staff spoke well of the Manager. The Residents stated that they found the Manager very efficient and understanding. The visitor stated that she had every confidence in the Manager and that she always let her know how her Mother was which gave her peace of mind as she lived so far away. Loxley Chase B51-B01 S39334 Loxley Chase V238907 190705 Stage 4.doc Version 1.40 Page 17 Each Resident has their own money wallet. A record is kept of all money a Resident receives and spends and receipts are obtained and kept in the individual wallets. There are two signatures when money is deposited or withdrawn. The Manager carries out an audit of the Residents personal finances on a regular basis. There is a policy and procedure in place for Residents finances. Four personnel files were audited and all contained supervision documentation. The staff that spoke to the Inspector confirmed that they received regular supervision. Loxley Chase B51-B01 S39334 Loxley Chase V238907 190705 Stage 4.doc Version 1.40 Page 18 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x 3 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 3 15 2
COMPLAINTS AND PROTECTION 3 x x x 3 3 3 2 STAFFING Standard No Score 27 x 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x 3 3 x x 3 3 x x Loxley Chase B51-B01 S39334 Loxley Chase V238907 190705 Stage 4.doc Version 1.40 Page 19 YES Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP15 Regulation 16 Requirement The registered person must ensure that food is wholesome and nutritious and properly prepared. The registered person must install a sluice machine in the home. THIS REQUIREMENT IS OUTSTANDING FROM THE JANUARY 2005 INSPECTION. Timescale for action Immediate 2. OP26 23 31st January 2006 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 OP26 OP31 Good Practice Recommendations The registered person should improve the ventilation and decorate the area that is used by those Residents who smoke. The Manager should obtain her NVQ Level 4 in management. Loxley Chase B51-B01 S39334 Loxley Chase V238907 190705 Stage 4.doc Version 1.40 Page 20 Commission for Social Care Inspection Unit B, Advance St Marks Court Teesdale Stockton-on-Tees TS17 6QX 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 Loxley Chase B51-B01 S39334 Loxley Chase V238907 190705 Stage 4.doc Version 1.40 Page 21 - 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!
