Inspection on 20/09/05 for Neale Court

This inspection was carried out on 20th September 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

Neale Court 16/05/07

Neale Court 04/01/06

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 Roger Harrison Unannounced Inspection 20th September 2005 09:00 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.V250417.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. Neale Court DS0000002390.V250417.R01.S.doc Version 5.0 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.V250417.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 17/03/05 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, ensuite 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. Neale Court DS0000002390.V250417.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was undertaken over a five-hour period, with the inspector using a method of inspection called “case tracking”. This involved selecting three residents who currently live at the home and tracking their experience of the care and support they have received during the time they have lived at the home. This was achieved by the inspector talking to the manager, touring the home, looking at information on care plans and files, talking to residents and care staff, and observing day-to-day care practice within the home. The aim of the inspection was to establish whether the care provided to a sample of residents is consistent with the care given to all residents who choose to live at Neale Court. What the service does well: What has improved since the last inspection? Since the last inspection the manager has taken action to increase consultaion and communication with residents, for example, through the use of questionnaires. Risk assessments have been carried out with current and new residents to protect individuals from hot radiator temperatures. The inspector was able to confirm that a planned decoration programme has commenced which will result in improvements to carpets on one of the main corridors, communal toilets and bathing facilities. Neale Court DS0000002390.V250417.R01.S.doc Version 5.0 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Neale Court DS0000002390.V250417.R01.S.doc Version 5.0 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.V250417.R01.S.doc Version 5.0 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 the following standard(s): 1,2 and 3 Residents are assessed prior to any admission taking place. Trial periods of care are used to confirm that all physical and social care needs can be met. Appropriate information is provided for all residents to ensure a full understanding of the responsibilities of the homes care team, the resident and of the way care will be provided. EVIDENCE: Residents confirmed that they were included in making an informed choice to move in to the home. Assessments take place prior to admission and service users have access to the service users guide and statement of purpose, which have recently been developed by the home. The manager confirmed that all service users were given a copy of the homes terms and conditions on admission to the home. Copies of documentation are retained on the residents care file. The home also provides an information pack about the organisation for anyone considering a placement at Neale Court. The home uses a trial/introductory period for all new residents which is used to carry out a further assessment of need within the home enviroment. This is used to Neale Court DS0000002390.V250417.R01.S.doc Version 5.0 Page 9 confirm whether the home is able to meet the overall physical and social needs of each resident. All new residents also sign a contract to confirm they are in agreement with terms and conditions at the home. Relatives or their representative signs this if they are unable to do this. The home does not provide an intermediate care service. Neale Court DS0000002390.V250417.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 and 10. Detailed care plans are in place for all residents. These are reviewed each month to ensure changes in need are responded to. Residents are protected by the homes policy and procedures for supporting them with medication. Residents are involved in care plan reviews and are supported to maintain their privacy and dignity. EVIDENCE: Care plans are developed by the care team and are reviewed regularly with residents to ensure action is taken to address any changes to need. Two residents told the inspector that they sign their care plans and had been involved in a monthly review of their care which was also signed. One resident told the inspector “ I understand the risk I take in staying as independent as I can, the staff are good and support me to do what I want” Residents care plans were seen to provide details regarding physical and social needs and how each need identified is met. Risk assessments have been used to ensure that individual risk is identified and where there are issues of concern they are acted upon. During the last inspection there was an issue regarding the protection of residents when near to, or in contact with hot radiators. Evidence Neale Court DS0000002390.V250417.R01.S.doc Version 5.0 Page 11 was provided which confirmed risks have been addressed using risk assessments with residents with the outcome being that a radiator shelf cover has been discussed with, and fitted to one resident’s room where the individual was seen to be at high risk. Residents told the inspector that they knew how to control radiator temperatures and that they were included in the assessment of risk undertaken. Health and safety training is undertaken with staff in order to help recognise where there are further risks and how to respond to risk with all new residents. All residents are encouraged to self medicate wherever possible, however there are very few residents currently able to take on this role. Medicines are kept in a locked, wall mounted cabinet in a locked room as required. The manager, deputy manager and three senior supervisors take responsibility for handling and administering medication. Senior carers are trained to undertake this task and staff activity observed during the inspection demonstrated consistency in practice. Residents told the inspector that medicines are kept and given on their behalf with one resident saying “They look after my medicine and make sure I get it as I should”. On the day of inspection medication record systems were up to date and signed appropriately, which confirmed that all residents are receiving medication as prescribed. Neale Court DS0000002390.V250417.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): 12,13,14,15 The manager and care team support the right for residents to maintain control over their lives through encouraging family and community contact. Food in the home is varied and of high quality offering a wholesome diet for residents. Further consultation is required regarding the sharing of dining facilities with Neale Court Day Centre. EVIDENCE: The home operates an open door policy. On the day of inspection the inspector observed family carers and residents coming into and leaving the building as they wished. There is a visitor’s book in reception, which is used to record activity along with other useful information about the organisation available if needed. Each resident has a single room, which has a small kitchen area. Most rooms have their own en suite bathroom or shower facilities. Locks have been fitted to all doors, which allow privacy for residents and access for staff in an emergency. There are call bells in all rooms, which the residents had good access to. Rooms were seen by the inspector to be personalised to a high standard. There is a telephone point in all rooms so that residents have a choice about using a phone of their own. Where this is not required there is a communal telephone in the reception area. One resident told the inspector “My family call every day, I see them wherever I want but mostly in my own room”. One resident told me that the home had arranged for him to have his Neale Court DS0000002390.V250417.R01.S.doc Version 5.0 Page 13 own befriender who visits to take him out to places he wants to go to, for example, football matches. The whole staff team take responsibility for day-today activities, which are organised around resident’s individual needs. On the day of inspection a group of residents were seen to be talking together in the lounge area, reading, watching television and talking with staff generally. Staff were seen to be providing sensitive support and care in a way which residents responded to positively. Trips are organised through discussions between staff and residents with residents telling the inspector that they had been to local parks and garden centres and that some were “going to Skegness to see the lights”. Residents told the inspector they were happy with arrangements for activities and that their own personal and religious needs are supported. The manager and senior supervisor showed the inspector evidence of the development of a detailed social history on the care plan file of one resident, and that this system was to be used and included on all residents file in order to understand history, culture and social needs more clearly. Meals within the home are planned on a five-week rotating basis. The kitchen area is clean and hygiene standards followed appropriately. The menus were seen to be varied, offering alternatives, including a vegetarian option. Menu plans are set over five week periods and are put together using feedback from residents. Meals are usually taken in the communal dining area but residents told the inspector they could have meals in the room of their choice. The dining area is shared with the adjoining day centre at lunchtime only. This involves providing meals from the homes kitchen using two sittings. During the inspection a discussion was held with residents, the manager and the inspector about this arrangement. Residents confirmed they had been fully consulted about the issue and that most continued to be happy to share facilities. However, residents felt they would like to further explore alternatives. The manager agreed to arrange a full meeting to ensure further discussion takes place so that residents are able to make a group decision regarding the matter. Neale Court DS0000002390.V250417.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): Outcomes not looked at on this occasion. EVIDENCE: Neale Court DS0000002390.V250417.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): 19,20,23, and 26 Residents live in a safe, clean enviroment, which suits each individual need and is regarded by individuals as “Their home”. Rooms are personalised in the way residents choose them to be. An annual maintenance programme is in place and required work is being undertaken by the organisation appropriately. EVIDENCE: The building is clean and well maintained. The gardens at the rear of the building are well maintained and provide safe access for residents. One resident told the inspector “I usually try to help water the garden as I enjoy gardening, the staff help me to do this so I am safe”. Indoor communal areas were open and free from clutter. A high standard of hygiene practice was seen to be operating within the home and residents told the inspector that they felt this is “Their home”. The home operates an open door policy. On the day of inspection the inspector observed family carers and residents coming into and leaving the building as they wished. There is a visitor’s book in reception, which is used to record activity along with other useful information about the organisation available if needed. Each resident has a single room, which has a Neale Court DS0000002390.V250417.R01.S.doc Version 5.0 Page 16 small kitchen area. Most rooms have their own en suite bathroom or shower facilities. There are communal bathing areas, which are used regularly when specialist-hoisting equipment is required. This equipment has been serviced appropriately and is kept in the bathing areas for staff use. The bathrooms are in need of decorative update, which was discussed with the manager, confirmed that this work will be commencing within the next three weeks. Communal toilet facilities have recently been redecorated. All rooms are numbered and include resident’s names on the doors. Dorr locks have been fitted which allow privacy for residents and access for staff in an emergency. There are call bells in all rooms, which the residents had good access to. Rooms were seen by the inspector to be personalised to a high standard. There is a telephone point in all rooms so that residents have a choice about using a phone of their own. Where this is not required there is a communal telephone in the reception area. One resident told the inspector “My family call every day, I see them wherever I want but mostly in my own room”. There is a small tear on two areas of carpet within the hallway of the ground floor. Action has been taken by the manager to repair this area with hazard strips to ensure the safety of residents. The manager informed the inspector that there is an ongoing programme of maintenance for the year, which is to be used to undertake some further room decoration. This work is currently being planned. Neale Court DS0000002390.V250417.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 There is a well-established care team at the home who know resident’s needs and how to meet them in a safe and professional way. The home retains good staff numbers through robust recruitment practice; positive training opportunities and a range of policies and procedures that care staff have access to. EVIDENCE: The manager confirmed that no new staff member commences work until all checks and references have been received. Induction is undertaken by new staff and a checklist is used by the manager to ensure that each individual understands their role within the care team. Informal day-to-day supervision is undertaken by a team of three senior supervisors and the deputy manager. The manager has a formal supervision system in place, which ensures regular supervision occurs and is recorded and signed by staff. All staff have a comprehensive training folder in place and training records looked at provided details about each staff members achievements and future need. A senior staff member told the inspector about training received and how this related to policy and procedures that the home uses. This training was seen to be used by staff in undertaking the care role, for example, appropriate moving and handling, hygiene practice and fire awareness. Training is being used by the home to increase NVQ qualifications for staff and there is an NVQ assessor working closely with staff in order to further develop the good practice observed. The manager uses a rota system to ensure appropriate cover is maintained throughout each twenty-four hour shift period. The home has Neale Court DS0000002390.V250417.R01.S.doc Version 5.0 Page 18 retained good staffing levels and on the day of inspection there were only two vacant positions at the home. Whenever a team member is absent the manager ensures agency cover is used to provide cover. Residents told the inspector that the staff are always available when needed. Neale Court DS0000002390.V250417.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): 31,33, and 38 The manager ensures each residents social and health care needs are safeguarded and seen as central to service provision. Consultation and communication is undertaken with residents to ensure that the home is run in the resident’s best interests. EVIDENCE: There is a well-established registered manager in post. The inspector spoke to three residents who said that they trusted the manager and senior care team and that they were consulted regularly regarding the service and any developments. The manager Lorna Smith demonstrated a very good working knowledge of each resident and confirmed that consultation with residents takes place using residents meetings, reviews and written consultation questionnaires. One resident told the inspector “The manager listens to us and is always there, she gives so much time to the home” The health and safety of residents has been considered by the home manager and action has been Neale Court DS0000002390.V250417.R01.S.doc Version 5.0 Page 20 taken to undertake risk assessments with residents to ensure that all residents are aware of their right to take risks with support when required. For example, Risk assessments have been used, recorded and signed to ensure that individual risk is identified and where there are issues of concern are acted upon. The manager regards the staff team as important and recognises the need to create a strong culture within the team. External courses have been accessed by the manager to ensure wider opportunities are offered for staff to develop their skills and there is one member of staff who has achieved NVQ assessor status. All staff are currently in the process of either applying for, or commencing NVQ qualifications. The managers are open to discuss issues with staff and team meetings are used to talk about ideas for development or concerns. Neale Court DS0000002390.V250417.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 3 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 4 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X 3 3 X X 4 X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X X X X 3 Neale Court DS0000002390.V250417.R01.S.doc Version 5.0 Page 22 No. 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 12(2)(4)( a). Requirement The current lunchtime arrangements must be reviewed to enable residents to be further consulted regarding the sharing of facilities, and on the impact this continues to have on their privacy and dignity. Timescale for action 30/11/05 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.V250417.R01.S.doc Version 5.0 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: 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 Neale Court DS0000002390.V250417.R01.S.doc Version 5.0 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. 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. 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