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Inspection on 21/11/05 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 21st November 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 safe, comfortable, clean and homely environment for residents living here. The staff group know the residents well and residents said they liked the staff. Specific comments were "The staff are very kind" and "Staff listen to my views, they`re always good"

What has improved since the last inspection?

The home has addressed the requirements made in the last unannounced inspection report. The acting manager has re-commenced NVQ level 4 and most staff have undertaken training relating to dementia care, dealing with challenging behaviour and oral hygiene. Quotes are being obtained to refurbish the kitchen and plans to undertake this work will commence shortly.

What the care home could do better:

Quality assurance monitoring should be further developed and views should be sought from all people using the service. Views should also be sought from residents and/or their representatives in relation to an application to vary registration to provide care for residents with dementia care needs.

CARE HOMES FOR OLDER PEOPLE Saxilby House Residential Care Home Highfield Road Saxilby Lincoln Lincolnshire LN1 2QP Lead Inspector Elisabeth Pinder Unannounced Inspection 10:00 21 November 2005 st 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 Saxilby House Residential Care Home DS0000059111.V265107.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. Saxilby House Residential Care Home DS0000059111.V265107.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Saxilby House Residential Care Home Address Highfield Road Saxilby Lincoln Lincolnshire LN1 2QP 01522 704025 01522 704025 triskelion@btinternet.com 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) Mr Colin Roy Hayes Mr Colin Roy Hayes Care Home 10 Category(ies) of Old age, not falling within any other category registration, with number (9), Physical disability (1) of places Saxilby House Residential Care Home DS0000059111.V265107.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 14th June 2005 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 Care Home DS0000059111.V265107.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over 5 hours and was carried out by one inspector as the 2nd 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. Two bedrooms were viewed and a selection of care records inspected. 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. Saxilby House Residential Care Home DS0000059111.V265107.R01.S.doc Version 5.0 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 Outcomes Statutory Requirements Identified During the Inspection Saxilby House Residential Care Home DS0000059111.V265107.R01.S.doc Version 5.0 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 the following standard(s): Standard 3 was assessed at the last inspection, standard 6 is not applicable. EVIDENCE: Saxilby House Residential Care Home DS0000059111.V265107.R01.S.doc Version 5.0 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 the following standard(s): 7 Care planning in this home is good, providing detailed information on how the health and social care needs of the people are met. However, these could be improved by evidencing that residents are involved in this process. EVIDENCE: Individual care plans contain sufficient information to ensure that all aspects of health, personal and social care needs are identified and planned for. However, care plans examined did not all show that residents and/or their representatives are involved in this process or are involved in reviews and agree to any changes being made. Residents spoken to said that they are aware information is written about them but did not know what was written in their individual care plan. Although bedroom doors are lockable, locks fitted are not suitable as residents with a key could leave the key in their door locking themselves in. Since the last inspection individual risk assessments have been written but this information has not been included in the home’s fire risk assessment. The acting manager agreed to liaise with the fire officer on this matter. Saxilby House Residential Care Home DS0000059111.V265107.R01.S.doc Version 5.0 Page 9 Two members of staff spoken to had a good knowledge of the needs of residents currently living in the home and were aware of individual preferences, likes and dislikes. Staff were seen to be polite and treated residents with respect during the visit. Saxilby House Residential Care Home DS0000059111.V265107.R01.S.doc Version 5.0 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 the following standard(s): 14 Residents living in this home are helped to make choices and live their preferred lifestyle. EVIDENCE: Observations indicated that residents have a choice as to what they do at the home. For example, on the day some residents were reading, some were watching television and one was in her bedroom listening to music. Another resident had gone out to the local pub and another was chatting to visitors. One resident who uses an electric scooter said that he was free to choose what he did and was given privacy if he wanted it. Saxilby House Residential Care Home DS0000059111.V265107.R01.S.doc Version 5.0 Page 11 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): Standards 16 and 18 were assessed during the last inspection EVIDENCE: Saxilby House Residential Care Home DS0000059111.V265107.R01.S.doc Version 5.0 Page 12 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): Standards 19 and 26 were assessed during the last inspection EVIDENCE: Although the above standards were not assessed, the home was inspected by the Environmental Health Officer on 19.09.05. The report was available and stated “kitchen well organised, records kept and seen”. Reference was made to this area needing an upgrade in the future and quotes to refurbish the kitchen are now being obtained. Saxilby House Residential Care Home DS0000059111.V265107.R01.S.doc Version 5.0 Page 13 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, 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. EVIDENCE: All residents spoken to were complimentary about the care staff provide and said that they all felt able to raise any problems with them should they arise. Records showed that there are normally 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. Domestic duties are undertaken by care staff. One member of staff spoken to felt that an additional staff member in the mornings would enable more flexibility and one to one time for residents, however, residents comments did not identify this as an issue. Statutory training is on-going and certificates were seen to support this. Most staff have undertaken a basic dementia training course and the acting manager is looking into other relevant courses as the home has an application with the Commission to register two beds specifically for residents with dementia. Three staff are currently trained to National Vocational Qualification (NVQ) level II and two are currently undertaking this. Once completed the home will have achieved the minimum ratio of 50 trained members of staff at NVQ level II as laid down in the National Minimum Standards. Saxilby House Residential Care Home DS0000059111.V265107.R01.S.doc Version 5.0 Page 14 The file of one member of staff recently recruited was examined and this showed that a satisfactory procedure to protect residents had been followed. Saxilby House Residential Care Home DS0000059111.V265107.R01.S.doc Version 5.0 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 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): 38 Quality assurance monitoring should be further developed to enable people using this service to make their views known. The health, safety and welfare of residents are promoted in this home. EVIDENCE: Quality assurance monitoring should be further developed and views should be sought from all people using the service. Views should also be sought from residents and/or their representatives in relation to an application to vary registration to provide accommodation for residents with dementia care needs. Risk assessments are documented in relation to health and safety issues that may arise from the environment of the home. Maintenance records are kept and there are a range of policies and procedures available relating to fire safety and fire risk assessments. There was evidence that regular fire alarm, fire drills and emergency lighting checks are carried out. Saxilby House Residential Care Home DS0000059111.V265107.R01.S.doc Version 5.0 Page 16 Certificates were available showing that the stair lift, hoist and wheelchairs had been serviced. The emergency call system had been checked and the Gas safety certificate obtained. However, it was noted that the plumbing and heating service is now due. Windows on the first floor open wide and must be fitted with restrictors to ensure the safety of residents and the acting manager agreed to consult with the home’s health and safety officer on this matter. A discussion was held in relation to the homes current application to vary their registration and management are asked to liaise with their fire officer regarding fitting an appropriate gate or door to the fire escape. Saxilby House Residential Care Home DS0000059111.V265107.R01.S.doc Version 5.0 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x X X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 X 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 x X X X X X X X X 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 X X X X X X X 3 Saxilby House Residential Care Home DS0000059111.V265107.R01.S.doc Version 5.0 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. 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. 2. Refer to Standard OP7 OP23 Good Practice Recommendations There should be evidence that residents and/or their representatives are involved in the care planning process and agree with any changes made It is acknowledged that risk assessments have been written regarding the locks fitted to bedroom doors, however, management should seek guidance from their fire officer as residents are at risk locking themselves in their rooms should they leave their key in the lock. Quality assurance monitoring should be further developed and views should be sought from all people using the service. Views should also be sought from residents and/or their representatives in relation to an application to vary registration to provide accommodation for residents with dementia care needs. Windows on the first floor should be secured to ensure the DS0000059111.V265107.R01.S.doc Version 5.0 Page 19 3 OP33 4 OP38 Saxilby House Residential Care Home safety of residents. Management should seek guidance from their health and safety officer regarding this matter. Saxilby House Residential Care Home DS0000059111.V265107.R01.S.doc Version 5.0 Page 20 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. 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