Inspection on 19/06/06 for Netherlands

This inspection was carried out on 19th June 2006.

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

Netherlands 18/06/07

Netherlands 03/10/05

Netherlands 25/04/05

Netherlands 17/01/05

Netherlands 16/08/04

Netherlands 22/03/04

Netherlands 05/12/03

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

CARE HOMES FOR OLDER PEOPLE Netherlands Spilsby Road Horncastle Lincs LN9 6AL Lead Inspector Dawn Podmore Key Unannounced Inspection 19th June 2006 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 Netherlands DS0000002392.V300390.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. Netherlands DS0000002392.V300390.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Netherlands Address Spilsby Road Horncastle Lincs LN9 6AL 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) 01507 522009 Prime Life Limited Miss Valerie Evans Care Home 11 Category(ies) of Learning disability (1), Learning disability over registration, with number 65 years of age (10) of places Netherlands DS0000002392.V300390.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 3rd October 2005 Brief Description of the Service: Netherlands cares for up to ten older persons and one under 65 years of age who have learning disabilities. It is a detached, two storey house situated on a main road in Horncastle. Horncastle is a small town, which has a variety of facilities and services. A stair lift is available for residents who are unable to manage stairs. With the exception of one room, all bedrooms are for single occupancy and the one double room is currently being used as a single. Bedrooms are located both on the ground and first floors. Outside there is a large garden to the back and side of the property; there is also a decked area. There is car parking available to one side of the property. The home is part of Prime Life Limited. At the time of the inspection the home confirmed that the weekly fees ranged from £392 - £730 depending on the residents assessed needs. Additional charges are made for services such as chiropody, hairdressing and toiletries. Information about these costs as well as the day-to-day operation of the home, including a copy of the last inspection report can be found in the reception area. Netherlands DS0000002392.V300390.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection was unannounced and took any previous information held by CSCI, about the home into account. The site visit took place over 4 hours. The main method of inspection used was called case tracking. This involves selecting a proportion of residents and tracking the care they receive through the checking of records, discussion with them, the care staff, and observation of care practices. A partial tour of the premises was conducted, documentation sampled and the care records of three residents were examined. Interviews with residents and staff took place; this included the Registered Manager. Preinspection information requested by the Commission had not been returned prior to the visit, the manager confirmed that this had been received and forwarded to head office. On the day of the initial visit 11 people were living at the home. What the service does well: What has improved since the last inspection? There were no requirements made at the last inspection and the home continues to operate at a good level. Netherlands DS0000002392.V300390.R01.S.doc Version 5.2 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. Netherlands DS0000002392.V300390.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 Netherlands DS0000002392.V300390.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3&6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has an assessment process in place that ensures that it can meet the needs of the people admitted to the home. EVIDENCE: The home has an admission policy, which includes assessing residents prior to admission. Records and staff comments confirmed that people had received an assessment before they came to live at the home. Other information, such as hospital needs assessments, had also been collated to help the manager decide if the home could meet their needs. The manager confirmed that the home is not providing intermediate care. Netherlands DS0000002392.V300390.R01.S.doc Version 5.2 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 the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Shortfalls in care planning and risk assessments puts residents and staff at risk and could lead to residents needs not being met. Residents’ health needs are being met. Medications are stored, administrated and disposed of safely. Staff respect the wishes and preferences of people living at the home while maintaining their privacy and dignity. EVIDENCE: Each resident had an individual plan, which contained information relating to his or her care needs. However the plan for a recently admitted resident did not contain information about all their care needs. One area omitted was regarding the resident’s unpredictable behaviour. There was no risk assessment or guidance in place, which would instruct staff on how to manage any incidents, this could lead to the resident’s needs not being met and people being put at risk. Two other plans contained detailed information regarding residents care needs and risk management strategies, which addressed any potential risks. Netherlands DS0000002392.V300390.R01.S.doc Version 5.2 Page 10 Plans had been reviewed regularly but would benefit from the archiving of old information so that staff have easy access to up to date information. Records and staff comments showed that people such as district nurses, doctors and chiropodists visited the home to meet people’s health care needs. The home has satisfactory policies and procedures concerning the receipt, storage, administration and disposal of medications. Computer generated medication sheets are provided by the pharmacist. Senior care staff are responsible for administering medications. Records regarding the receipt, administration and disposal of medications had been completed satisfactorily. Resident’s comments indicated that they were satisfied with the care and accommodation provided. Observation and discussions with staff demonstrated that they respected people’s privacy and dignity; they were seen knocking on resident’s bedroom doors, consulting them about their preferences and closing doors when providing personal care. Residents were smartly dressed and some ladies said that they liked wearing their jewellery. Netherlands DS0000002392.V300390.R01.S.doc Version 5.2 Page 11 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides an activities programme to meet the needs of the residents living at the home. Residents are encouraged to maintain contact with their relatives and the local community. Staff encourage people to make choices about their day-to-day lives. Meals provided offer variety and choice. EVIDENCE: The monthly events programme was displayed on the notice board. It identified events of interest, such as the World Cup and the Queens’s birthday, as well as in house events, such as a resident’s birthday party, bingo and outings. Participation in activities was recorded in resident’s daily notes. The home shares the use of a minibus with another home and outings are arranged on a monthly basis. Resident and staff comments confirmed that outings to visit former residents and to have a fish and chip supper had recently taken place. One resident said that she was having a birthday party soon and another said that he enjoyed going out into the town and playing dominos. Netherlands DS0000002392.V300390.R01.S.doc Version 5.2 Page 12 The home encourages visitors and entries in the visitors’ book showed that people have visited regularly. . A local minister visits monthly to provide a Church service for those residents who wish to attend. The home is aware of advocacy services and how to contact them should residents need such a service. Residents and staff comments demonstrated that people are given choices at the home. Bedrooms had been personalised and residents confirmed that they had been encouraged to bring small items of furniture, photographs and mementoes into the home. The meal on the day of the visit was nutritionally balanced and well presented. It consisted of pork chops and vegetables, followed by fruit and yogurt. One resident had chosen to have sandwiches as an alternative. The meal was served in a very relaxed manner in the dining room; staff ate with the residents, offering help as needed. Residents said that they enjoyed the food provided, comments included: ‘the food is good, well I like it’ and ‘we get a choice if we don’t like the food on offer’. One resident seen setting the tables prior to the meal said that she also helped to wash the dishes, as she liked to keep busy. Netherlands DS0000002392.V300390.R01.S.doc Version 5.2 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has satisfactory procedures for handling complaints. Residents are protected by the home’s procedures for handling allegations of adult abuse. EVIDENCE: Prime Life Limited has a complaints procedure, which tells residents and relatives how to make a complaint and how it will be handled. This was on display on the notice board. It is also included in the information pack that is given to prospective residents. There is a system for recording any complaints that are raised and a comments book is available in the reception hall for people to record any concerns or compliments. The Commission has received no complaints about the service provided by the home since the last inspection. The manager said that the home had received one complaint since the last inspection; this had been appropriately addressed. Meetings are held and provide another means where residents can air their views and raise concerns if they wish. There are satisfactory procedures in place relating to adult protection and the home has a copy of Lincolnshire County Council’s adult protection procedure. Staff members spoken to were aware of their role in reporting any matters of concern to the manager and records showed that staff had received adult protection training. Netherlands DS0000002392.V300390.R01.S.doc Version 5.2 Page 14 Netherlands DS0000002392.V300390.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at the home live in a clean, comfortable and homely environment. EVIDENCE: A partial tour of the home was undertaken which included viewing the three bedrooms of the residents being case tracked. The general environment was clean, tidy and homely, with no unpleasant odours. Bedrooms had been personalised by the residents and/or their relatives. Residents spoken with said that they were very happy with the home’s facilities and their own accommodation. The TV stand, identified as needing replacing in the last inspection report, had been purchased. The risk assessment regarding the river area had been reviewed but access for residents to the area had not been improved. Netherlands DS0000002392.V300390.R01.S.doc Version 5.2 Page 16 Seating and tables are available in the courtyard area so that residents can sit out in fine weather. Residents are supported by staff to be involved in some domestic duties around the home such as the cleaning of their rooms and helping in the kitchen. Netherlands DS0000002392.V300390.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 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. Staff are on duty in sufficient numbers and skill mix to ensure that the residents are cared for in a safe, caring and competent manner. Procedures for the recruitment of staff are robust and therefore offer protection for people living at the home. Staff receive training to meet the needs of people living at the home. EVIDENCE: Records and discussions with staff demonstrated that there are three staff on duty in the mornings and two in the afternoons. At night there is one wakeful staff member and one on “sleep-in” duty who is on-call. Staff and residents confirmed that these numbers were sufficient to meet the needs of people living at the home at this time. The home currently has some staff vacancies due to long-term sickness. The manager said that either she or existing staff had covered these shortfalls to ensure that staffing levels were met, but this had led to some management jobs having to wait. Some staff have now been appointed and will commence their induction as soon as all recruitment checks have been completed. The home has a satisfactory recruitment procedure but the manager needs to ensure that essential information is contained in each file. For example one Netherlands DS0000002392.V300390.R01.S.doc Version 5.2 Page 18 file for a recently recruited member of staff contained only one reference. The second reference was faxed to the Commission the day after but should have been available on the day of the site visit. Other files contained an application form, 2 satisfactory written references and a C.R.B. (Criminal Records Bureau) check. Staff spoken to confirmed that a robust recruitment process was in place. The manager said that staff receive an induction to the home, which includes an initial introduction to the home and how it operates. This is then followed by a more in depth induction and essential training. On the day of the visit there was no evidence on file that two recently employed staff had received this training however one of them confirmed that she had. Signed and dated induction records were faxed to the Commission the following day, which evidenced that they had received appropriate training. The manager confirmed that one carer has attained an N.V.Q. (National Vocational Qualification) and another one is currently undertaking the course. The manager said that although this meant that the home was not meeting the 50 target it was due to staff leaving for various reasons. The Company offers a variety of training to staff including: manual handling, fire awareness, basic food hygiene and first aid. Staff also undertake the L.D.A.F. (Learning Disability Award Framework) course, which includes an awareness of leaning disabilities and adult protection. Netherlands DS0000002392.V300390.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Sufficient leadership, guidance and direction are provided to staff to ensure residents receive consistent quality care. Residents’ finances are handled appropriately. The home has health and safety policies and procedures, which help to safeguard staff and residents. EVIDENCE: The Registered Manager Mrs Val Evans has managed the home for over 3 years and has many years of experience working in the care sector. Staff said that she was supportive and approachable and felt confident to take any concerns to her. Netherlands DS0000002392.V300390.R01.S.doc Version 5.2 Page 20 There are systems in place where residents and staff can air their views such as staff and residents meetings. Residents know who is in charge of the home and they said that they would discuss any concerns with the manager, or any of the staff, should any arise. Questionnaires have been used in the past to gain peoples views; the possibility of these being reintroduced was discussed with the manager. All residents spoken with said that they were happy living at the home and felt that the staff cared for them well. Comments included: ‘they are lovely’ and ‘I like them all’. There is a comments book in the entrance hall that anyone can use to make suggestions about the home. It was noted that this contained three comments, one from the bus driver who takes residents out regularly and 2 from students, who made very positive comments about their experience at the home. A representative of the company had visited the home at least monthly and prepared a report of their visit. Reports seen also included information about the various audits that have taken place such as financial checks. The personal allowance records of 3 residents were examined and found to be accurate, with receipts and 2 signatures for each transaction. Regular company audit are also undertaken to ensure that records are being maintained satisfactorily. At the time of the last two inspections it was recommended that the arrangements concerning residents monies held by the company be reviewed in order that residents’ accounts can accrue interest. The manager confirmed that there has been no change to these arrangements as yet. Some staff files contained evidence that appraisal and supervision sessions had taken place, but others did not. Staff comments confirmed that this was the case. It was recommended the system be improved to ensure that all staff received regular support sessions. There are a range of policies and procedures regarding health and safety available to guide and instruct staff. There is also a programme in place to service and maintain the equipment in the home on a regular basis. A sample of records were checked in relation to the environment of the home such as service certificates for the stair lift, bath hoists, electrical installation and portable electrical appliances. The latter was not available on the day of the visit but was faxed to the Commission the following day. These demonstrated that checks were being regularly made. Netherlands DS0000002392.V300390.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 2 8 3 9 3 10 3 11 X 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 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 2 2 X 3 Netherlands DS0000002392.V300390.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? N/A 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 OP7 Regulation 15 (1) & (2) 13 (4) Requirement Care plans must be in sufficient detail to enable care staff to provide comprehensive care; this must include risk assessments and management strategies. Timescale for action 14/08/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP35 Good Practice Recommendations It is recommended that the arrangements for the safe guarding of residents monies be reviewed in order that they can accrue interest. (CSCI policy & guidance on Monies held on Service Users’ behalf by Corporate Appointees - Issued 28/04/05). All staff should receive regular formal supervision. 2 OP36 Netherlands DS0000002392.V300390.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: 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 Netherlands DS0000002392.V300390.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. 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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