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Inspection on 05/09/05 for Ruckland Court Care Home

Also see our care home review for Ruckland Court Care Home for more information

This inspection was carried out on 5th 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Residents are cared for in a safe, well-maintained, homely environment by staff who are aware of their needs. Care plans identify residents` needs in detail and this helps staff to provide consistent care. People who use the service are happy with the care they receive and find the staff pleasant and helpful. The home offers intermediate care and a planned return to their own home in the community. In order to achieve this the manager and staff work closely with community services.

What has improved since the last inspection?

The home has improved its records in relation to the supervision of staff. Staff supervision is now planned over a 12 month period with appropriate time periods between each supervision. Individual staff members are advised in advance of their supervision programme. The records of supervision are very detailed and identify personal development, in addition to looking at the care practice carried out by individual members of staff.

What the care home could do better:

The home would benefit from a rolling maintenance program ensuring that the environment of home is decorated in a planned manner ensuring that the standard of decor is maintained.

CARE HOMES FOR OLDER PEOPLE Ruckland Court Nursing Home Ruckland Avenue Lincoln LN1 3TP Lead Inspector Ken Hague Unannounced 5 September 2005 @ 9am 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 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. Ruckland Court Nursing Home C53 C04 S2550 Ruckland Court V248136 5-9-05 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Ruckland Court Nursing Home Address Ruckland Avenue Lincoln LN1 3TP Telephone number Fax number Email 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 530217 01522 513371 Lace Housing Limited Care Home with Nursing 50 Category(ies) of PD - Physical Disability - 1 registration, with number OP - Old Age - 49 of places Ruckland Court Nursing Home C53 C04 S2550 Ruckland Court V248136 5-9-05 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: A condition of registration is that the maxium number of service users in the home with Nursing needs does not exceed 14, and the maximum number of service users with Personal Care needs only, does not exceed 36. Any service user admitted within the category PD shall be between the ages of 50 and 64 years inclusive. Date of last inspection 23 February 2005 Brief Description of the Service: Ruckland Court is a purpose-built establishment. It provides both personal and nursing care for older people over the age of 65 years. It is owned by a voluntary organisation; LACE Housing and the day-to-day running of the home is organised by a Registered Manager, Pat Schuck.The home is located in a residential area to the north of the City of Lincoln. The city’s amenities can be reached by car or bus. Accommodation for service users comprises mainly of single occupancy flats. Single flats usually contain a bed, sitting room, kitchenette, shower and toilet, although there are 8 single occupancy flats with a separate bedroom. There are 6 double flats; these are usually allocated to married couples or relatives who may choose to share.The double flats have similar accommodation and a separate lounge. Each flat has a lockable front door with a letterbox. Newspapers, mail and groceries are delivered directly to each flat. The home has communal dining areas and lounges for service users to use if they wish to. The dining room is a shared facility with day centre attendees. Service users from the home can also choose to attend the day centre if they wish. There is a small shop and hairdressing salon on-site. The home is surrounded by gardens and there is a central courtyard area with raised flowerbeds and seating for service users to use and enjoy, weather permitting. There are designated car parking spaces available at the front of the property. Ruckland Court Nursing Home C53 C04 S2550 Ruckland Court V248136 5-9-05 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place between 8am and 12.30pm. The main method of inspection used is called case tracking which involved selecting three residents and tracking the care they receive through the checking of their records, discussion with them, the care staff and observation of care practices. A tour of the premises was conducted and care records were inspected. One member of staff and six service users were interviewed. What the service does well: 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. Ruckland Court Nursing Home C53 C04 S2550 Ruckland Court V248136 5-9-05 Stage 4.doc Version 1.40 Page 6 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 Standards Statutory Requirements Identified During the Inspection Ruckland Court Nursing Home C53 C04 S2550 Ruckland Court V248136 5-9-05 Stage 4.doc Version 1.40 Page 7 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 standard(s) 1,2,3&6 There are satisfactory procedures for the introduction and assessment of people to the service, ensuring that care needs are met. Residents and relatives are on the whole happy with the care provided and feel that their needs are being met. The home admits residents for intermediate care and successfully enables them to return to the community in a planned manner. EVIDENCE: The homes service user guide and statement of purpose is displayed in the reception area of the care home. These documents set out the resources of the care home and the facilities offered to all new residents. A resident returning to the community after a short period of intermediate care confirmed that staff had helped her to maximise and retain her independence in preparation for her return home. The intermediate care co-ordinator stated that this lady had improved her independence and increased her mobility whilst staying in the care home. All files sampled during this inspection contained a full initial assessment, which included a copy of the terms and conditions for residents stay at the care home. Ruckland Court Nursing Home C53 C04 S2550 Ruckland Court V248136 5-9-05 Stage 4.doc Version 1.40 Page 8 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 standard(s) 7,8, & 10 All service users have a detailed care plan which is written immediately after the initial assessment. This includes a full risk assessment and the management strategy for any identified risk. Service users are involved in a drawing up of their own individual care plan. EVIDENCE: Each resident has an individual plan, which contains information relating to his or her care and social needs. All care plans seen during this inspection had been reviewed in the last four months, demonstrating that the care needs of the residents had been reassessed. The care plans included the goals and aims of individual residents, which included how these aims were to be achieved. The files viewed in this inspection contained details of dental and eye appointments. District nurse visits and chiropody appointments were also recorded. A resident stated “I must say that the staff are very kind here, they check me at night time to make sure Im safe”. A second resident stated staff are very careful in the way they help you with personal care. I need them to help me get into the bath and they do this very carefully. They stay with me to keep me safe but allow me to stay in the bath as long as I choose. A third file was found to contain the following statement “the goal for this resident is Ruckland Court Nursing Home C53 C04 S2550 Ruckland Court V248136 5-9-05 Stage 4.doc Version 1.40 Page 9 to maintain the level of personal care which is acceptable to her, allows choice and promotes independence”. Ruckland Court Nursing Home C53 C04 S2550 Ruckland Court V248136 5-9-05 Stage 4.doc Version 1.40 Page 10 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 standard(s) 12,13,14 & 15 A wide range of activities are available for residents to take part in ensuring that they have an enjoyable and stimulating day. Catering arrangements reflect service users preferences and choices. Residents are encouraged to maintain links with family and friends. Visitors to the home are made welcome. EVIDENCE: Residents seen during this inspection stated there were activities planned each day which were displayed on the notice board. There is a day centre attached to the care home which provides facilities for people living in the community. Residents of the care home can attend this centre as an alternative to other organised events within the care home. A local minister visits the home on a three weekly basis to take a religious service and provide communion. The home has a visiting policy displayed in the foyer of the home. All residents spoken to during this inspection said their families were encouraged to visit and are made very welcome. Residents choose to see the families in their own personal flats which are part of the care home. Residents stated that they had been asked at teatime their choice of menu for the following day. One residents stated “ the food varies but generally its very good”. A second resident stated my only complaint about food is that they do give you quite a large meal. I now ask for a smaller portion.” All residents confirmed that in their opinion their personal choice and diet were being met by the home. Ruckland Court Nursing Home C53 C04 S2550 Ruckland Court V248136 5-9-05 Stage 4.doc Version 1.40 Page 11 Ruckland Court Nursing Home C53 C04 S2550 Ruckland Court V248136 5-9-05 Stage 4.doc Version 1.40 Page 12 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 standard(s) 16,17 &18 There are robust procedures for handling complaints and allegations of adult abuse, and staff were clear on the action to take in the event of this occurring, ensuring that service users are safe. Residents do feel safe living at the care home. EVIDENCE: There is information for residents and their relatives about how to make a complaint which is displayed in the entrance hallway. Residents said they felt confident that they could raise any concerns with the management of the home. One of the files sampled contained details of a complaint made by a resident. The records demonstrated that this was investigated appropriately. Consultation had taken place with a consultant psychiatrist who was working with the residents. The resident stated that they were satisfied with the outcome of their complaint. A copy of the Lincolnshire Adult Protection Committee procedures was in place, enabling staff to follow the correct local procedures. These are crossreferenced with the home’s policy. Staff were able to describe how they would respond to allegations made by residents, in order to keep them safe. Residents said that they felt safe when staying in the home. Ruckland Court Nursing Home C53 C04 S2550 Ruckland Court V248136 5-9-05 Stage 4.doc Version 1.40 Page 13 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 standard(s) 19&26 Residents live in a safe and clean environment. EVIDENCE: A tour was made of the care home. All areas of the home were found to be clean and smelt fresh. There was evidence of ongoing maintenance being carried out. All of the rooms were seen to be decorated to a good standard. A sample number of bedrooms were viewed and they all met the National Minimum Standards in relation to the provision of facilities and equipment. The rooms viewed had been personalised by the individual service users. The service users confirmed their satisfaction with the environment of the care home and their own individual bedroom. A resident stated “I am very happy with my room, I have my own TV and my personal possessions around me.” A second resident stated I remain in my room for most of the day, I am a very private person and I am allowed to choose how frequently I wish to be involved in activities in the home.” Ruckland Court Nursing Home C53 C04 S2550 Ruckland Court V248136 5-9-05 Stage 4.doc Version 1.40 Page 14 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,29 & 30 The home ensures that appropriate staff are recruited and employed by the home. There are always sufficient numbers and skill mix of staff on duty. Staff are trained to ensure they are competent to carry out their employment tasks. EVIDENCE: The inspection of the homes recruitment policy confirmed that it does meet the National Minimum Standards. The inspection of the records for two new members of staff confirmed that the company’s recruitment policy was being followed. A new member of staff was interviewed and they confirmed that the interview process and induction process set out in the homes procedure manual had been followed. The three residents involved in detailed discussions stated that there are always enough staff on duty to answer their care needs. One resident stated, “staff are very gentle with me I feel very safe living here.” The inspection of induction records confirmed that an initial appraisal is given to new members of staff followed by a formal induction process. Records for the induction of a new member of staff were seen. They were signed by the staff member being trained and the trainer. All records were dated. Ruckland Court Nursing Home C53 C04 S2550 Ruckland Court V248136 5-9-05 Stage 4.doc Version 1.40 Page 15 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33,35, 36 &38 The home has an experienced and supportive registered manager who has worked in the provision of residential care for many years. Staff are being provided with training, supervision and appraisals as required by the Care Home Regulations. EVIDENCE: The register manager has been in post at the home for 14 years. Staff stated that she is very supportive and approachable. In formal interviews staff stated that appraisals and supervision are being provided in accordance with the National Minimum Standards. The inspection of supervision records and appraisals confirmed this statement to be correct. The supervision records have been improved since the last inspection and set out the personal development of individual members of staff, in addition to the monitoring of care practice. Individual members of staff have set dates for supervision over the next 12 months. The staff member and the supervisor both sign the records. The registered manager stated that staff development needs are Ruckland Court Nursing Home C53 C04 S2550 Ruckland Court V248136 5-9-05 Stage 4.doc Version 1.40 Page 16 identified during supervision and appraisals. The identified needs are then matched to the home’s training programme to ensure goals and aims set out in the appraisals are met. A Resident stated “the home holds resident meetings where we invited to express our views and opinion regarding the help provided to us by the home.” A second resident stated “staff sit down with us regularly and ask us if we are happy with the service. They do listen to our comments and will help us with any difficulties or problems.” The registered manger stated the financial policies of the home are being followed by staff. A sample of financial records seen supported this statement. The Residents interviewed stated that they felt safe living in the care home. A resident stated “I can close my door lock it and feel secure”. Ruckland Court Nursing Home C53 C04 S2550 Ruckland Court V248136 5-9-05 Stage 4.doc Version 1.40 Page 17 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 x x 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 x x 3 x 3 x x 3 Ruckland Court Nursing Home C53 C04 S2550 Ruckland Court V248136 5-9-05 Stage 4.doc Version 1.40 Page 18 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 Regulation none 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 none Good Practice Recommendations Ruckland Court Nursing Home C53 C04 S2550 Ruckland Court V248136 5-9-05 Stage 4.doc Version 1.40 Page 19 Commission for Social Care Inspection 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. 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