Inspection on 16/05/07 for Neale Court

This inspection was carried out on 16th May 2007.

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

Neale Court 04/01/06

Neale Court 20/09/05

Neale Court 17/03/05

Neale Court 26/05/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Neale Court Neale Road North Hykeham Lincs LN6 9UA Lead Inspector Mr Ken Hague Key Unannounced Inspection 08:00 16th May 2007 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 Neale Court DS0000002390.V329474.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. Neale Court DS0000002390.V329474.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Neale Court Address Neale Road North Hykeham Lincs LN6 9UA 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) 01522 682201 enquiries@lacehousing.org LACE Housing Limited Mrs L M Smith Care Home 23 Category(ies) of Old age, not falling within any other category registration, with number (23) of places Neale Court DS0000002390.V329474.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 4th January 2006 Brief Description of the Service: Neale Court is a care home providing personal care and accommodation for up to twenty-three older people. The home is owned and operated by LACE Housing Ltd, which is a voluntary organisation. The home also has a day centre facility attached to it, which is operated by the North Hykeham Day Centre group. The dining area within the home is used and shared with the day centre for five days a week. Residents at the home are able to attend the day centre if they choose to. The home is located in a quiet cul-de-sac in a residential area of North Hykeham. There are local shops and community facilities close by. Neale Court was registered in nineteen ninety-three and is a purpose built two story building. The accommodation comprises of a communal lounge area, a sunroom, communal dining room and two assisted bathrooms. All of the private accommodation consists of self-contained bed-sits, which comprise of a kitchenette, en-suite bath or shower room with toilet. The home has a lift, which serves both floors of the home. The home is set in well-maintained secure gardens. There is open parking for fifteen cars at the front of the home. The registered manager makes available to all potential new residents a copy of the statement of purpose of the care home when they visit the home for the first time. A copy is displayed in the care home reception area. A copy of the last Commission for Social Care Inspection report is included in the statement The home charges £373 to £419 per week. Neale Court DS0000002390.V329474.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over 6.0 hours. A tour of the premises was undertaken. The deputy manager was provided with feedback at the end of the inspection. The main method of inspection used was called ‘case tracking’ which involved selecting three residents and tracking the care they receive through the checking of their records, discussion with them and the staff, and where more appropriate observation of interaction between staff and residents and related care practices. A sample of care records was inspected. Two members of staff were interviewed and the opinions of five residents were sought. A Pre-inspection questionnaire was supplied prior to the site visit being made. In addition 16 “have your say” documents completed by residents were sent to the Commission for Social Care Inspection. This document asks 12 questions and invited residents to make comments regarding the care they receive from the home. The home supplied a further 21 quality assurance questionnaires completed by residents in April 2007. The feedback and comments from the ”Have your say documents” and the quality assurance documents are included within this inspection report What the service does well: The home provides a comfortable, safe and homely environment for people to live in. It is very well managed and organised. Residents have detailed care plans, which enables staff to know how residents’ needs are to be met. Regular residents’ meetings and care reviews are held where residents comment on the services provided by the home. Staff are well trained and supported by the registered manager and have a sound knowledge of residents’ needs. The staff team work well together and have established a good working relationship with the community health care teams and local GPs. Neale Court DS0000002390.V329474.R01.S.doc Version 5.2 Page 6 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. The summary of this inspection report can be made available in other formats on request. Neale Court DS0000002390.V329474.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 Neale Court DS0000002390.V329474.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): Standard 3 Quality in this outcome area is Good This judgement has been made using available evidence including a visit to this service. People who use this service have good information about the home in order to make an informed decision about whether the service is right for them. The personalised needs assessment means that people’s diverse needs are identified and planned for before they move to the home. EVIDENCE: Three individual residents files were examined as part of the case tracking process. They all contained a full assessment including a risk assessment for each individual resident. The assessment set out care needs, social needs and health needs. Residents stated that they have been involved in the initial assessment with their families. The registered manager confirmed this statement to be correct. The registered manager stated that no one has been admitted to the home without an initial assessment being made. All assessments are normally carried out by the registered manager. In the event Neale Court DS0000002390.V329474.R01.S.doc Version 5.2 Page 9 of an emergency admission, she may have to delegate this task to a senior member of staff. The Deputy Manager stated that the home does not offer a dedicated intermediate care service. Neale Court DS0000002390.V329474.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): Standards 7,8,9,10 &11 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home identifies the health, personal and social care needs of each resident and records them on their care plan. This enables staff to meet their needs in a manner, which is described within the individual’s care plan. The medication policy of the home is being followed ensuring that residents receive their medication as prescribed. Staff respect the dignity and privacy of residents. EVIDENCE: Three individual residents’ care plans were inspected. They all contained the information obtained at the initial assessment. The care plans set out the methods of providing safe care to each resident. Care files contained the residents’ choices of activities, health care needs, personal care needs and dietary needs. Where a risk had been identified the management of the risk had been balanced against the choices and wishes of the individual resident. The management strategy had been agreed with the resident and recorded in their individual file. Medical history was recorded. The input from community Neale Court DS0000002390.V329474.R01.S.doc Version 5.2 Page 11 health care services, chiropodist, dental care and eye care were recorded on each care plan. Staff have been trained by outside agencies in the administration and storage of medication. Medication records had been completed in accordance with the national guidelines. Drugs are being stored correctly. Staff and the registered manager stated that residents can self medicate if they request to do so and a risk assessment confirmed that this would be safe practice. A pharmacy report dated the 28th of March 2007 confirmed no problem had been found in the administration and storage of medication. There was however, no clear audit trail to demonstrate that medication was recorded when it was received into the home on individual residents records. It was therefore impossible to match stock levels against medical admission records. The deputy manager agreed action would be taken to ensure records allowed stock checks to be made effectively. Information from the “have your say documents” completed by residents and discussion with residents and staff provided evidence that the rights of residents are respected and their privacy and dignity is upheld. Observations on the day of the site visit supported this judgement. Residents live in separate flats. They all have there own front door and letterbox. External doors are fitted with a push bell which staff use to gain access. Residents’ mail is delivered directly to individual flats. A resident stated “staff are very kind they provide my help in a very sensitive way”. Care records demonstrated that each resident has been asked how care should be provided. Many residents choose to carry out some personal care themselves with the support of a carer who helps them with any area. The action to be taken in the event of the death of the residents was found to be recorded on individual care plans. Neale Court DS0000002390.V329474.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): Standards 12,13,14 &15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are enough activities provided for residents that are in accordance with their needs and wishes. They receive a healthy and balanced diet that is based on their likes and dislikes. They are enabled to control their own lives as far as practicable taking into account their personal abilities and health. EVIDENCE: The registered manager listed, in the Pre inspection questionnaire, a number of activities offered to residents including opportunities to take part in events in the community. Staff and residents confirm these activities do take place during the site visit. The home provides religious services for residents who wish to take part and pursue their individual religious beliefs Staff stated that the care home has a visiting policy, which is flexible to meet the choices and wishes of the residents. Residents confirm that family and friends are made welcome when they visit. Relatives are encouraged to visit at any reasonable hour. The visiting policy was not displayed in the care home; the deputy manager agreed that this would now be placed in the reception area. Neale Court DS0000002390.V329474.R01.S.doc Version 5.2 Page 13 The choices and wishes of residents in respect of their social life and in the provision of personal care were found to be recorded on their individual files. Residents choose which chiropodist, hairdressers and optician they use. They stated in discussions that they felt able to decide what activity they took part in and if appropriate not to take part in activities. There was evidence of quality assurance questionnaires being completed in April 2007. The registered manager had recorded the comments passed by residents and acted on their requests for adjustments to the menu. A more sensitive request relating to the behaviour of an individual resident has been addressed. The registered manager sent a copy of the menu prior to the site visit; this demonstrated that choice was being offered. The inspector observed staff asking residents at lunchtime what choice of meal they required. The dietary needs of individual residents were found to be recorded on their care plan. Neale Court DS0000002390.V329474.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): Standards 16 &18 Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. The home listens to residents’ views and wishes, and acts on them. There are procedures in place to protect residents from any possible abuse. Staff have received appropriate training to protect residents from being harmed. EVIDENCE: Staff were aware of the home’s and Lincolnshire County Council’s Adult Protection procedures. They also demonstrated a clear understanding of what the key issues are. They confirmed that they would not hesitate to report any concerns. Residents said that they knew how to complain and would if they needed to. The complaints policy is on display in the entrance hall and residents have their own personal copy in the service user guide. No complaints have been received since the last key inspection. There has been no adult protection investigation carried out in the home since the last inspection. Neale Court DS0000002390.V329474.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a comfortable, homely, clean environment with a choice of communal areas and personalised bedrooms. The infection control policy of the home is being followed. EVIDENCE: The home is very well maintained, decorated to a high standard and clean throughout. The area outside the home is also well maintained and safe. Residents are encouraged to bring possessions into their rooms and to make them homely. Each room is individually furnished, and residents stated that they were fully supported to use their rooms safely and in the way they wished. There are enough bathrooms and toilets to meet the needs of the residents and appropriately serviced equipment is in place to support residents’ physical needs, as appropriate. Neale Court DS0000002390.V329474.R01.S.doc Version 5.2 Page 16 Staff confirmed they regard the needs and safety of residents as central to their role. The staff interviewed confirmed that fire alarms are tested weekly, and were able to describe the appropriate action they would take in order to maintain residents and staff safety in the event of a fire. All areas of the home were clean and smelt fresh. Discussions with staff members and the deputy manager identified no health, safety or infection control problems. Neale Court DS0000002390.V329474.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 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. Residents are supported by well-trained staff, who are recruited safely EVIDENCE: Staff stated there are always sufficient numbers on duty to answer the needs of all residents. The deputy manager stated that staffing levels are constantly reviewed to ensure residents’ needs can be met by the numbers of staff on duty. Additional staff will be provided if residents’ needs change or if there is a crisis. Residents confirmed that they were happy with the present staffing levels. They stated that requests for help using the call bell were always answered quickly. There have been very few notifications since the last inspection and none of which raise concern in relation to staffing levels. The Commission for Social Care Inspection and the home have received no complaints since the last key inspection. No investigations have been carried out under the Lincolnshire County Council abuse procedures. Three Residents stated that they feel safe living in the care home. Staff stated they felt residents are in safe hands at all times. Care records inform staff how to meet individual residents’ needs safely. Neale Court DS0000002390.V329474.R01.S.doc Version 5.2 Page 18 The Deputy manager stated that the recruitment policy of the home is being followed at all times. The inspection of the recruitment records for a new member of staff confirmed this to the case. All appropriate documentation was on the individual staff members’ files. This included POVA, CRB, references and proof of identity. A new member of staff’s recruitment records were not available at the time of the site visit. The head office of the company confirmed that all appropriate checks have been made and the documentation had been given to the registered manager three days ago. The registered manager was on leave on the day of the site visit. It was agreed that the registered manager would write on her return from holiday to confirm that the appropriate documentation had been added to this staff member’s file. There is an ongoing training programme in place and training continues to be used by the home to increase NVQ qualifications for staff. One team member is also an NVQ assessor, this role helps to further develop the good practice observed, 60 of staff hold an NVQ2 or equivalent. Introductions are being given to all new staff in order that they have the basic core skills to meet residents’ needs. Neale Court DS0000002390.V329474.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31.33.35 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is leadership and guidance for staff. The environment is safe. The home’s health and safety policy and infection control policy is being followed which ensure a safe environment is maintained. Residents feel that the home is well managed EVIDENCE: The care home has a registered manager in post supported by a deputy manager. The Pre- inspection information supplied by the registered manager was completed to a good standard. Staff stated that she is approachable; residents described her as a very caring professional person. Neale Court DS0000002390.V329474.R01.S.doc Version 5.2 Page 20 There are financial procedures in place to ensure that residents’ financial interests are safeguarded and protected. No health and safety issues were identified. The care home was found to be clean and tidy. Staff were seen to treat residents with courtesy and respect. No negative evidence was found for these standards in any discussions or documents. Neale Court DS0000002390.V329474.R01.S.doc Version 5.2 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 X X 3 X X N/a HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X x 3 Neale Court DS0000002390.V329474.R01.S.doc Version 5.2 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. Refer to Standard Good Practice Recommendations Neale Court DS0000002390.V329474.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN 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. Extracts may not be used or reproduced without the express permission of CSCI Neale Court DS0000002390.V329474.R01.S.doc Version 5.2 Page 24 - 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. 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