Inspection on 11/03/09 for Luke Senior

This inspection was carried out on 11th March 2009.

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

Luke Senior 19/02/07

Luke Senior 22/09/05

Luke Senior 11/07/05

Luke Senior 16/11/04

Luke Senior 29/06/04

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Middlesbrough Intermediate Care Centre

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Luke Senior Park Lane Guisborough TS14 6ER     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Susan Lowther     Date: 1 1 0 3 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 25 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 25 Information about the care home Name of care home: Address: Luke Senior Park Lane Guisborough TS14 6ER 01287632378 F/P01287632378 geraldine-handley@redcar-cleveland.gov.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Redcar and Cleveland Borough Council care home 41 Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home Luke Senior is registered to provide care to thirty-one older people and ten older people with dementia. The home is owned by Redcar and Cleveland Borough Council. Luke Senior is situated in Park Lane, Guisborough and is close to local shops and amenities. It is a two storey, purpose built facility offering single room accommodation to residents. Bedrooms in the home environment contain a hand washbasin, however not all meet with space requirements of national minimum standards. The dementia unit is situated on the ground floor of the home; this unit has separate lounge, dining room toilet and bathing facilities. Facilities for the older persons unit are situated on the ground and first floor of the home. There are a number of lounge/dining areas and a large communal dining area situated on the ground floor of the home. There is a Care Homes for Older People Page 4 of 25 Over 65 10 31 0 0 Brief description of the care home passenger lift giving access to the upper floor. The home continues to provide day care for a small number of additional older people. Care Homes for Older People Page 5 of 25 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our 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 on 11th March 2009. Time was spent reviewing records, speaking to members of staff, the people who live in the home, visitors to the home and to the manager. The company supplied some information prior to the inspection on a form called an AQAA. This is an annual quality assurance assessment for the agency to provide information about their service. Information was also received from people who use the service and their relatives. The inspection focused on key standard outcomes for people using the service and to Care Homes for Older People Page 6 of 25 check whether the requirements and recommendations from the previous inspection had been met. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. The fees charged at the time of this inspection were 835 pounds per week. This does not include hairdressing, chiropody, newspapers and personal toiletries. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking Care Homes for Older People Page 8 of 25 following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 25 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 25 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Sufficient information is available for people to decide whether they would like to live in the home. Assessment procedures are in place to ensure that the home can meet all of the needs of the people who go to live there. Evidence: People are only admitted after a full assessment of need is carried out by an appropriately trained person. This is usually the manager. This is to make sure that the home can meet the care needs of the people who go to live there. The family of one person confirmed that they had looked around the home and had been supplied with all of the information they needed to make a decision about whether or not their relative would like to live there. One person said, I came to look around before my relative came in. Staff were very helpful and were lovely with the people who live in the home. Care Homes for Older People Page 11 of 25 Evidence: The contracts seen were up to date and contained the relevant information so that people are aware of the service that they can expect to receive. This was a requirement in the last inspection report. All of the people spoken with confirmed that they have a contract. The home does not admit people for intermediate care therefore assessment of standard 6 is not required. Care Homes for Older People Page 12 of 25 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Systems are in place to ensure that health care needs of the people who live in the home are met. Evidence: The manager said that all of the people who live in the home have care plans so that staff know how to look after people on an individual basis. Three were examined during the inspection. These were comprehensive and contained individual plans of care. However they would be further enhanced by the addition of formal nutritional and tissue viability assessments. This would alert staff at an early stage that people are at risk of malnutrition or developing a pressure sore. People spoken to during the inspection said that they are happy with the care received and the level of information given. One relative said, I cannot fault the care my relative gets at this home. I would recommend it to anyone. The carers are always there when needed. Records examined showed that people receive visits from other healthcare professionals. These include district nurses, doctors, and care managers. One person wrote on a survey, If my relative is ill they get the doctor out and let me know what Care Homes for Older People Page 13 of 25 Evidence: he has said. No problem that way. Medication is administered by people who have received the appropriate training. The home has a comprehensive medication policy. Accurate records of all medicines received, administered and those leaving the home are maintained. People spoken with said that staff always treat them with dignity and respect. Care Homes for Older People Page 14 of 25 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The activities are varied and provide recreation for some of the people living in the home. Family and friends can visit the home at any time and are made to feel welcome. The meals are of a good standard. Menus are varied and people are given a choice. Evidence: Most of the people said that activities are suitable. The activities organiser spends time with people on an individual basis to find out what activities they would like to do. Regular activities include card and board games, bingo and arts and crafts. Outside entertainers visit on a regular basis and a church service is held once per month. People are also taken out. One person said, If my relative is taken out I can go with her. They also take her into town if it is fine. They are very good. Relatives said that they could visit at any time and that they are always made welcome. People said that they have a choice about how they like to spend their day. They can also choose what time to get up and go to bed and when they would like to have a shower or bath. The lunch looked nice. Staff who were helping people were doing this in a discreet and Care Homes for Older People Page 15 of 25 Evidence: dignified manner. people confirmed that there is always a choice available and that the cook does her best to give people whatever they want. One person said, There is always a good menu. The food is always very nice and there is plenty to eat and it is always nicely presented. Care Homes for Older People Page 16 of 25 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can be confident that their concerns and complaints are dealt with appropriately and that safeguards are in place to protect them from abuse. Evidence: Information about complaints, how and who to make them to, is made available to the people who live in the home and their families through information displayed in the entrance to the home and in the Service Users Guide. There have been two complaints recorded since the last inspection. Both of these were investigated by the home. People confirmed that they would know how to make a complaint. One person said, I would know to speak to staff if I had a complaint. However I have never been unhappy about anything. The home had a comprehensive adult protection procedure. This gives staff the support they need to make a referral should this be required. The staff spoken to during the inspection were asked about abuse and what they would do if they saw or heard anything inappropriate. All said that they would tell someone, for example the manager, or make a referral themselves if this was more appropriate. Training is provided for all staff in adult protection. Care Homes for Older People Page 17 of 25 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is clean and in the main well maintained. It is decorated and furnished to an adequate standard and provides a homely environment for the people who live there. Evidence: During a tour of the building the inspector saw that many of the rooms are decorated to the persons own taste and there was evidence to confirm that people can take in some personal items when they go to live there. This includes pieces of furniture as well as photographs and ornaments. An adequate standard of decor and furniture is provided throughout the home. Some of the recommendations from the last report have been met. The carpet has been replaced and some of the corridors decorated. However if a decision is made to keep the home open after the consultation period, then a programme of refurbishment needs to be put in place. The inspector found the building to be clean, tidy and free from offensive odours. One person said, The lady is always going round with the hoover and mop. She is always dusting the rooms keeping the home very clean. Care Homes for Older People Page 18 of 25 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff are appropriately recruited, trained and in sufficient numbers to meet the needs of the people who live in the home. Evidence: From the rota supplied at the inspection there was sufficient care staff on duty to meet the assessed care needs of the people who were using the service. People said that staff were usually around and answered the call bells quickly. One person said, The staff come quickly when I need them. The home had evidence in place, to confirm that the appointment of a new staff member is in the main made through proper recruitment processes. This includes the vetting of staff through the use of references, POVA first checks and Criminal Record Bureau (CRB) checks. There is a commitment at the home to having a trained workforce with most of the staff having an NVQ at level 2 or above. Recent training has taken place in food hygiene, tissue viability, safeguarding adults, medication competancy, first aid, equality and diversity and fire safety. However it is was noted that moving and handling training takes place every two years. It is recommended that this takes place on an annual basis. Staff said that they are also supported with regard to personal training needs. Staff comments in this area were positive. Comments included There Care Homes for Older People Page 19 of 25 Evidence: is always plenty of training going on and you can ask for additional training if you want to. Another said, I have regular supervision with the manager where personal training needs are discussed. Care Homes for Older People Page 20 of 25 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can be assured that the home is well managed and they are given the opportunity to comment on how the home is run. Policies and procedures are in place to safeguard their health, safety and wellbeing. Evidence: The manager is qualified and competant to run the home. There was an open and friendly culture between the management team and staff working at the home. There was evidence in staff files to show that supervision was taking place and that the staff were being appraised. This was a recommendation in the last inspection report. Staff confirmed that supervision takes place on a regular basis and that they are well supported. People living at the home and visitors who were spoken to during the inspection confirmed that the manager is approachable and that they would go to her if they had any concerns. Staff also confirmed this to be the case. Care Homes for Older People Page 21 of 25 Evidence: Regular meetings are held and there are a number of systems in place to consult with people living at the home. Relatives and the people who live in the home can approach the staff at any time. Regulation 26 visit reports were available. This is an audit covering all environmental and care aspects which may result in improvements being made. A recent health and safety audit has been carried out. The manager said that all of the issues identified had been addressed. A recent fire audit has resulted in the replacement of one fire door. Personal finances are kept in the home for people who request this. Signatures are obtained and receipts are kept to ensure peoples financial interests are safeguarded. The manager confirmed that all equipment in the home is regularly checked. The maintenance certificates that were seen at this inspection were found to be in order. Care Homes for Older People Page 22 of 25 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 23 of 25 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 7 It is recommended that care plans include a formal tissue viability assessment tool. This would alert staff at an early stage as to whether people are at risk of developing a pressure sore. It is recommended that evaluations are expanded further to demonstrate that these are considered in a person centred way. It is recommended that care plans include a formal nutritional screening tool. This would alert staff at an early stage as to whether people are at risk of malnutrition. Following the consultation process and in the event that the home continues to operate the Registered Person should develop a programme of refurbishment. It is recommended that staff receive moving and handling training on an annual basis. 2 7 3 7 4 19 5 30 Care Homes for Older People Page 24 of 25 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 25 of 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!