Inspection on 03/10/05 for Netherlands

This inspection was carried out on 3rd October 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

Netherlands 18/06/07

Netherlands 19/06/06

Netherlands 25/04/05

Netherlands 17/01/05

Netherlands 16/08/04

Netherlands 22/03/04

Netherlands 05/12/03

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Beech Lodge

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Hunter`s Lodge

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 Sue Hayward Unannounced Inspection 3rd October 2005 09:15 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.V258442.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. Netherlands DS0000002392.V258442.R01.S.doc Version 5.0 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.V258442.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 25th April 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. Netherlands DS0000002392.V258442.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the second of two inspections, which are required by law each year. It was unannounced and took place from 09:15 to 14:45. The main method of inspection used was “case tracking”. This involved selecting a resident and tracking the care they receive through the checking of their records discussion with care staff and observation of care practices. One other residents record was also checked. It also included discussion with three residents individually and joining all residents at their morning coffee time. Three resident’s bedrooms, the lounge, dining room and an upstairs bathroom were seen on this occasion. Since the last inspection the CSCI have received feedback cards from two visitors and a resident. What the service does well: What has improved since the last inspection? The requirements of the last inspection have been addressed. Information about the home is on display in the entrance hall for anyone to see. Arrangements have been reviewed to ensure records needed for inspection are available at all times and a specific risk assessment relating to a bedroom radiator has been reviewed. Radiator covers have been provided to some radiators since the last inspection to reduce the risk of burns. The manager has been in touch with the local minister who is arranging for services to be held in the home on a monthly basis for those residents who wish to attend. She is also in the process of trying to arrange for some specific craft sessions to be held in the home. In addition the garden areas to the front of the home are in the process of being changed so that they can be more easily maintained and new garden furniture has been provided. Netherlands DS0000002392.V258442.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. Netherlands DS0000002392.V258442.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 Netherlands DS0000002392.V258442.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 and 3 The systems in place for the admission of residents to the home, ensure that residents needs are identified, assessed and can be met at the home. Information about the home is made available to residents and their representatives to ensure that they are fully aware of the facilities and services the home provides. EVIDENCE: The records of a resident who had been admitted to the home demonstrated that the home operates a thorough assessment procedure. This had included a visit to the residents previous home and discussion with other people involved in providing care to the resident. The homes statement of purpose, service users guide and copies of inspection reports, all which give information about the home are on display in the entrance hall. The service user guide is available in symbol form. Netherlands DS0000002392.V258442.R01.S.doc Version 5.0 Page 9 Most residents have been at the home for many years. The inspector was not able to discuss with the resident who had been recently admitted their experience in view of communication difficulties. The manager said that an advocate had visited to make sure that the resident was settled at the home. The manager had also been in contact with the resident’s relatives who had visited. Records showed that other professionals such as social workers are involved and had provided assessment information. Both resident’s records checked contained care plans. Comments from both relatives/visitors who had returned feedback cards to the CSCI indicated that they were satisfied with the overall care that the home provides and felt they were kept informed about important matters. Netherlands DS0000002392.V258442.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 and 8 The care planning system in operation provides detailed information and contributes to making sure that the health and care needs of residents and their preferred lifestyles are met. This is supported by good liaison with healthcare services. EVIDENCE: Both records seen on this occasion contained detailed information about residents and included care plans and risk assessments. They included a health action plan and details of other medical professionals involvement such as doctors, district nurses, dentists and opticians. Records confirmed that resident’s health is checked on a regular basis and appointments made to see other medical professionals as necessary. There is a key worker system in place. This gives staff specific responsibilities for specific residents, for example taking residents shopping or shopping for them. Records also demonstrated that a nutritional assessment is carried out and that weight is monitored. Netherlands DS0000002392.V258442.R01.S.doc Version 5.0 Page 11 Care plans included evidence that these had been discussed and agreed with residents. They are well-organised, available for staff to refer to and are reviewed on a monthly basis. Residents spoken to on an individual basis made comments, which indicated that they were satisfied with the care and accommodation provided. Netherlands DS0000002392.V258442.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): 13 and 14 Visitors are welcomed at the home and the home promotes and assists residents to have contact with friends, family and the local community. EVIDENCE: Residents made comments that indicated that they are able to have visitors when they wish. A staff member spoken to gave a good description of the homes visiting policy. Discussion with the manager indicated that visitors are welcomed at the home and an example was given of the way in which the home had promoted contact with a resident’s relative. Both feedback cards received from relatives/visitors indicated that they were made welcome at the home. The manager said that since the last inspection she had been able to arrange with a local minister for Church services to be held in the home on a monthly basis. She was also in the process of arranging for a local person to visit the home to hold a craft session. Information also confirmed that residents have visits from neighbours. Netherlands DS0000002392.V258442.R01.S.doc Version 5.0 Page 13 Residents participate in a range of community events such as visits to places of interest. They had for example, been to a parrot centre. Staff were heard to discuss with residents their preferences for future trips out. The home also hosts events that the local community are invited to attend such as a recent coffee morning that was held in aid of the Macmillan Trust. The home shares the use of a minibus with another home and outings are arranged on a monthly basis. The home is aware of advocacy services and how to contact them should residents need such a service. During the inspection it was noticed that residents had choices as to what they did. For example whether they spent time in their rooms or with others. One resident also said that she was due to have her room repainted and that she had chosen the colour she wanted. Netherlands DS0000002392.V258442.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): 16 and 18 Residents are protected by procedures in place for handling complaints and allegations of abuse. EVIDENCE: Prime Life Limited has a complaints procedure. This was on display on the notice board. The complaints procedure is included in the information pack that is given to prospective residents. There is also a system for recording any complaints that are raised, however neither the home nor the commission have received any complaints within the last twelve months. Residents made comments, which indicated that they felt safe at the home and would know who to tell if they had a problem or were unhappy. Meetings are held and provide another means where residents can air their views and raise concerns if they wish. A staff member spoken to was aware of her role to report any matters of concern and who to report to. There are satisfactory procedures in place relating to adult protection and since the last inspection the home has obtained an updated copy of Lincolnshire County Council’s adult protection procedure. Netherlands DS0000002392.V258442.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, 25 and 26 There is an on-going programme of maintenance and redecoration to ensure the home provides comfortable, clean and safe accommodation for residents who are involved in the choice of décor and furnishings of the home. EVIDENCE: The home is generally well maintained. Since the last inspection some radiators have had covers provided. Water temperatures are also regulated to reduce the risks of scalds to residents. Three bedrooms were seen on this occasion and residents made comments, which indicated that they found their rooms to be comfortable and they had choices as to how they were furnished and decorated. Residents are also supported by staff to be involved in some domestic duties about the home such as the cleaning of their rooms. Netherlands DS0000002392.V258442.R01.S.doc Version 5.0 Page 16 It was noticed that a T.V stand is needed for the television in the lounge. The manager confirmed that this has been reported to the organisation as needing replacement. The immediate garden area is in the process of being improved and new garden furniture has been provided. The garden area leading down to the river needs attention to ensure that it is more easily accessible to residents as paths are uneven. A risk assessment was in place in relation to this however it is recommended that it be reviewed. The fire brigade and environmental health departments inspect the home however there have been no visits since the last inspection. The last visit by the environmental health officer was on 29/04/04 and recommendations were made in relation to food hygiene training for staff. Records checked and discussions with staff indicated that this matter had been addressed. The home does not currently have a sluicing facility however discussion with the manager confirmed that this matter had been referred to the organisation’s estates department and was to be addressed however there has been no further progress since the last inspection. Netherlands DS0000002392.V258442.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 and 29 There is a satisfactory recruitment process in operation and staffing arrangements ensure the needs of residents are met. EVIDENCE: Discussion with residents at the time of the inspection and from the feedback card completed by a resident indicated residents felt well cared for and could talk to staff if they had problems. Comments from relatives/visitors were varied as to whether staffing levels were sufficient, one stated there was always sufficient staff on duty another that on occasions more staff were needed. Discussions and records checked demonstrated that there are three staff 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. Comments from staff and the manager indicated that there is some flexibility with staffing arrangements for example should residents have a medical appointment in the afternoon an additional staff member would be on duty to accompany the resident. Comments also confirmed that in the case of staff absence, members of the staff teamwork additional hours to cover shifts and generally staffing levels are maintained. At the time of the inspection staff were attentive to residents needs. All staff joined residents in the lounge at coffee time and it was said that this was the usual practice. Netherlands DS0000002392.V258442.R01.S.doc Version 5.0 Page 18 A new staff member was spoken to who had just commenced her employment and was going through her induction. She was additional to the usual staffing arrangements. She confirmed the recruitment procedure, which included the taking up of references and satisfactory checks in relation to criminal records and protection of vulnerable adults register prior to commencing her employment at the home. Netherlands DS0000002392.V258442.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): 33 and 35 The home is being well managed. The record keeping systems in place and policies and procedures help to ensure the health and welfare of residents. There are arrangements in place to obtain the views of residents and staff to ensure a quality service. EVIDENCE: 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 and comments indicated that they would feel able to talk over any problems with staff and the manager should they have any. There is a quality assurance book in the entrance hall that anyone can complete to make suggestions about the home. It was noted that this Netherlands DS0000002392.V258442.R01.S.doc Version 5.0 Page 20 contained two comments from students who made very positive comments about their experience at the home. Also included is information about the various audits that have taken place such as training, financial and refurbishment. The information details the outcome of the audits and when they are next due. A representative of the organisation also visits the home on a regular basis. There are a range of policies and procedures in place. Records were overall being well maintained. At the time of the last inspection a recommendation was made in relation to residents’ money, which is held in safekeeping and regularly audited by the organisation. It was recommended that the arrangements be reviewed in order that residents’ accounts can accrue. It was understood that there has been no change to these arrangements as yet. A sample of records were checked in relation to health and safety matters concerning the environment of the home such as service certificates of the bath hoist, checks of the fire alarm system and emergency lighting system of the home, gas safety and portable electrical items. They demonstrated that checks were being regularly made. Netherlands DS0000002392.V258442.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 X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 X 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 3 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X 3 3 STAFFING Standard No Score 27 3 28 X 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X 3 X X X Netherlands DS0000002392.V258442.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. 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. 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). Netherlands DS0000002392.V258442.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 Netherlands DS0000002392.V258442.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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