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Inspection on 14/06/05 for Saxilby House Residential Care Home

Also see our care home review for Saxilby House Residential Care Home for more information

This inspection was carried out on 14th June 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

This home provides a comfortable, clean and homely environment for residents living here. The staff group know the residents well and residents said they liked the staff and could talk to them if they had a problem. Staff were seen to be kind and polite when speaking to residents. Care records are detailed and give a clear picture of the needs of residents. Meals are varied, well balanced and nicely presented offering choice and variety.

What has improved since the last inspection?

The registered manager has completed a National Vocational Qualification (NVQ) level 4 in management. Both the Statement of Purpose and Service User Guide have been revised and updated. All windows have been replaced and the ground floor hallways have been re-decorated and the outside of the building has been painted and decorated. No requirements were made during the last inspection. Ten staff have received training regarding safe handling of medicines and training has commenced covering health and safety and moving and handling.

What the care home could do better:

Staff must be recruited correctly to ensure people living in the home are protected. Although the environment was generally safe, risk assessments should be written regarding the use of communal soap and towels. Risk assessments should also be developed about the locks fitted to bedroom doors as residents risk locking themselves in should they leave their key in the lock. They should also be written regarding falls and for one resident who uses an electric mobility scooter.

CARE HOMES FOR OLDER PEOPLE Saxilby House Residential Home Highfield Road Saxilby Lincoln LN1 2QP Lead Inspector Elisabeth Pinder Unannounced 14 June 2005 @ 09:00 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. Saxilby House Residential Home C53 C04 S59111 Saxilby House V233178 140605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Saxilby House Residential Home Address Highfield Road Saxilby Lincoln LN1 2QP 01522 704025 01522 704025 TRISKELION @ BTINTERNET.COM Mr C R Hayes 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) Mr C R Hayes Care Home Only (PC) 10 Category(ies) of Physical Disability (PD) - 1 registration, with number Old Age, Not falling within any other category of places (OP) - 9 Saxilby House Residential Home C53 C04 S59111 Saxilby House V233178 140605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 01.03.05 Brief Description of the Service: Saxilby House cares for older people in a family environment in a detached property situated in the village of Saxilby. The home is approximately six miles from the historic city of Lincoln. The home is a converted farmhouse standing in its own grounds and gardens with car parking facilities to the rear. The home has two floors and there is a stair lift to the bedrooms on the first floor. There is a variety of aids and adaptations around the building to allow residents to move around the home more independently. All of the bedrooms are single. There are five communal toilets and two communal bathrooms. Saxilby House Residential Home C53 C04 S59111 Saxilby House V233178 140605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over 4 hours and was carried out by two inspectors as the first of two statutory inspections for 2005/6. The main method of inspection used was “case tracking”. This 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. It also included discussion with three other residents in a group. A tour of the premises took place and a selection of care records were inspected. The registered manager is only in the home two days a week and a lot of management responsibilities are carried out by the former owner/manager who has stayed on and now works as deputy manager. What the service does well: What has improved since the last inspection? The registered manager has completed a National Vocational Qualification (NVQ) level 4 in management. Both the Statement of Purpose and Service User Guide have been revised and updated. All windows have been replaced and the ground floor hallways have been re-decorated and the outside of the building has been painted and decorated. No requirements were made during the last inspection. Ten staff have received training regarding safe handling of medicines and training has commenced covering health and safety and moving and handling. Saxilby House Residential Home C53 C04 S59111 Saxilby House V233178 140605 Stage 4.doc Version 1.30 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. Saxilby House Residential Home C53 C04 S59111 Saxilby House V233178 140605 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Saxilby House Residential Home C53 C04 S59111 Saxilby House V233178 140605 Stage 4.doc Version 1.30 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 standard(s) 1, 2, 3 & 4 Information about this home is available and residents are admitted only after a full care needs assessment has been carried out and written confirmation has been sent assuring them that their needs will be met. EVIDENCE: The Service User Guide and Statement of Purpose contains information about the home and its terms and conditions. These documents have recently been updated and were available in the hallway of the home. Care records of one resident recently admitted showed that a pre-admission assessment had been carried out forming the basis of their care plan. Two residents said that they chose the home with the help of their family. Both staff spoken to knew about the care needs of residents and were aware of the homes pre-admission assessment procedure. They also confirmed that the management always discuss the needs of new residents before their admission. One relative spoken to said she had not seen the Statement of Purpose or Service User Guide and did not think her relative had a copy. This was discussed with the deputy manager who said that copies had been given to all residents and their relatives/representatives but she would re-issue the updated copy. Saxilby House Residential Home C53 C04 S59111 Saxilby House V233178 140605 Stage 4.doc Version 1.30 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 standard(s) 7, 8, 9 & 10 There is good care planning in this home. This ensures that the health and social care needs of the people living in his home are identified and met. EVIDENCE: Individual care plans contain sufficient information to ensure that all aspects of health, personal and social care needs are identified and planned for. Those examined were up to date and showed that residents and/or their representatives have been involved. One relative spoken to, said that she was happy with the care provided and feels the home accommodates personal preferences and although she had not seen a copy of the care plan she was aware that her relative was capable of signing their own plan. Records showed appointments made to visit the dentist, optician and chiropodists. Daily entries are written by care staff identifying the care given. Some risk assessments have been drawn up, however, these need to be developed to include falls and a risk assessment should also be written for one resident who uses an electric mobility scooter. Two residents spoken to were aware of their care plans and were very happy with the care given. One resident said “it’s brilliant here, everything is done for you and the boss is especially good” Both staff spoken to were aware of residents needs and said that they are kept informed of all changes by the management. Saxilby House Residential Home C53 C04 S59111 Saxilby House V233178 140605 Stage 4.doc Version 1.30 Page 10 Staff responsible for the administration of medication have recently received relevant training. Medication given to residents at lunch-time was given safely and recorded correctly. Saxilby House Residential Home C53 C04 S59111 Saxilby House V233178 140605 Stage 4.doc Version 1.30 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 standard(s) 12, 13 & 15 Relatives and friends of residents are made welcome in this home. Meals are well managed and reflect resident’s likes and dislikes. Social activities are arranged after discussions with residents. EVIDENCE: Residents spoken to said that they were happy with the food provided, commenting that the food “is very good” “brilliant, plenty of choice”, although one resident said she would like to have more choice of puddings. Menus were inspected and found to be balanced with flexible mealtime arrangements. Care plans evidence residents likes and dislikes and dietary requirements. Tables were laid with clean tablecloths and the lunchtime meal was gammon, mashed potatoes and vegetables, this was nicely presented, and there was a choice of baked egg custard or treacle sponge and custard for desert. One relative was spoken to and confirmed that she can visit at anytime. Residents also said that they are able to see their visitors when they want and in privacy and can choose not to see a visitor. The home provides a small range of activities which are carried out by care staff in the afternoons. These include dominoes, bingo and jigsaws. Staff said that some residents like to have their nails manicured and one resident has a massage. Discussions are held with residents where social events and outings Saxilby House Residential Home C53 C04 S59111 Saxilby House V233178 140605 Stage 4.doc Version 1.30 Page 12 are discussed. Representatives from the Methodist chapel visit monthly and an organist comes in to have a sing-a-long with residents once a month. Saxilby House Residential Home C53 C04 S59111 Saxilby House V233178 140605 Stage 4.doc Version 1.30 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 standard(s) 16 & 18 The home takes the issue of addressing complaints very seriously and residents are confident that their concerns will be listened to and acted upon. There is a complaints procedure for residents and/or their relatives to follow. EVIDENCE: The home has a detailed complaints procedure within it’s Statement of Purpose and Service User Guide. No complaints have been received by the CSCI or the home since the last inspection. The home uses the Lincolnshire County Council Adult Abuse procedure and the revised version was available. Both residents spoken to said that they “feel safe living here” and said that the “manager is very helpful”. Care staff spoken to knew what to do should a complaint be reported to them or if they needed to report an allegation of abuse. Saxilby House Residential Home C53 C04 S59111 Saxilby House V233178 140605 Stage 4.doc Version 1.30 Page 14 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, 21, 22, 23, 24, 25 & 26 Residents living in this home live in a clean and comfortable environment. The standard of the environment is good with the home continuously improving the decor on a planned basis. Although the environment is generally safe risk assessments should be written regarding the use of communal soap and towels. Risk assessments should also be developed about the locks fitted to bedroom doors as residents risk locking themselves in should they leave their key in the lock. They should also be written regarding falls and for one resident who uses an electric mobility scooter. EVIDENCE: The home is clean and well decorated. All furnishings are of a domestic nature and residents said they like the home, and are happy with their bedrooms and felt that they were kept clean. One resident said that she would feel safer if she had a different emergency call system, preferring to wear a pendant and this was discussed with the deputy manager. Staff said they felt they worked in a safe environment and said that they are both currently undertaking a health and safety course. Saxilby House Residential Home C53 C04 S59111 Saxilby House V233178 140605 Stage 4.doc Version 1.30 Page 15 Bathrooms and toilets were clean and are lockable. There are hoists available and handrails to assist residents. Plans to change the ground floor bathroom into a walk in shower room are currently being discussed. Saxilby House Residential Home C53 C04 S59111 Saxilby House V233178 140605 Stage 4.doc Version 1.30 Page 16 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, 28, 29 & 30 The staff group are an established team and staffing levels are sufficient to meet the current needs of residents. Staff are provided with training to ensure they have the skills needed to carry out their roles and are committed to the work they do. However, staff must be recruited correctly to ensure people living in the home are protected. EVIDENCE: There is a low staff turnover in this home. The file of one new member of staff showed that Criminal Records Bureau (CRB/POVA) checks had not been obtained before she started working in the home, however, when the owner arrived he said that this had now been obtained. Records showed that there are always three care staff on duty in the mornings and two in the afternoons. There is one wakeful and one staff member “sleeping-in” and on-call at night. A training programme is in place which includes all statutory training as well as more specific training to meet individual residents needs. Residents spoken to said that staff in the home are kind and approachable and one resident said “all staff are good and they always listen to me”. Staff also said they felt there is sufficient staff on duty to care for residents. Saxilby House Residential Home C53 C04 S59111 Saxilby House V233178 140605 Stage 4.doc Version 1.30 Page 17 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) 31, 32, 33, 35 & 36 There is clear leadership in this home. Management offer guidance and direction to staff to ensure residents receive consistent quality care. EVIDENCE: The registered manager has completed a National Vocational Qualification (NVQ) level 4 in management. The deputy manager has extensive experience in caring for elderly people. Residents, staff and relatives made positive comments about the management and said that they feel they can approach them at anytime if they have any concerns. Records were available to show that staff receive regular one to one time with the deputy manager. Residents families are involved in managing and supporting their finances and both residents spoken to were happy with this arrangement. Saxilby House Residential Home C53 C04 S59111 Saxilby House V233178 140605 Stage 4.doc Version 1.30 Page 18 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 3 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 x 15 3 COMPLAINTS AND PROTECTION 3 x 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 3 3 x 3 3 x x Saxilby House Residential Home C53 C04 S59111 Saxilby House V233178 140605 Stage 4.doc Version 1.30 Page 19 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 29 Regulation 19(1)(b) Requirement The registered person must not employ a person to work at the care home unless an enhanced CRB disclosure or at least a POVA first check has been received. Timescale for action 31st July 2005 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. 2. 3. Refer to Standard 1 7 9 Good Practice Recommendations An admission checklist should be drawn up to evidence when relevant documents are given to residents and their representatives Risk assessments should be developed to include falls, a risk assessment should also be written for one resident using an electric mobility scooter. Although the home does not currently hold any controlled drugs it was strongly recommended that the home purchase an appropriate cabinet for their safe keeping in case the need arises. This has been identied during the last two inspections. Risk assessments should be written regarding the use of communal soap and towels in toilets and bathrooms. Action should then be taken to minimise any risk identified. C53 C04 S59111 Saxilby House V233178 140605 Stage 4.doc Version 1.30 Page 20 4. 19 Saxilby House Residential Home 5. 23 Risk assessments should be developed about the locks fitted to bedroom doors as residents risk locking themselves in should they leave their key in the lock. Saxilby House Residential Home C53 C04 S59111 Saxilby House V233178 140605 Stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection Unity House 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 Saxilby House Residential Home C53 C04 S59111 Saxilby House V233178 140605 Stage 4.doc Version 1.30 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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