CARE HOMES FOR OLDER PEOPLE
Scalford Court Care Home Melton Road Scalford Melton Mowbray Leicestershire LE14 4UB Lead Inspector
Keith Williamson Unannounced Inspection 20th April 2006 09:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Scalford Court Care Home DS0000054020.V289726.R02.S.doc Version 5.1 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. Scalford Court Care Home DS0000054020.V289726.R02.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Scalford Court Care Home Address Melton Road Scalford Melton Mowbray Leicestershire LE14 4UB 01664 444696 01664 444499 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) V & L Corporation Limited Care Home 40 Category(ies) of Dementia - over 65 years of age (10), Old age, registration, with number not falling within any other category (40), of places Physical disability over 65 years of age (40) Scalford Court Care Home DS0000054020.V289726.R02.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. 3. To be able to admit the named person in category PD as identified in correspondence with the previous registration authority dated 12th April 2000 No-one under the age of 55 years maybe admitted into the Home. To be able to admit the named person in the category PD under 55 years as identified in correspondence dated 20th October 2003. 08/12/05 Date of last inspection Brief Description of the Service: Scalford Court is registered for 40 older people. It is registered to provide a service for older people with physical disabilities and for up to ten older people with dementia. The home is situated in its own grounds between the market town of Melton Mowbray and the village of Scalford and is mostly surrounded by farmland although there is a Conference Centre nearby. Public transport is limited but the home has its own minibus for the use of residents. The home is a converted and extended stable block with all rooms used by the residents being on the ground floor. Staff facilities and the Proprietors accommodation is located on the first floor. The main lounge/dining area has views of an internal courtyard that is well maintained with plenty of flowers and shrubs. This courtyard has seating and is used by the residents during the warmer months. There is a further lounge and a conservatory that overlooks another attractive internal courtyard. The home currently has 24 single and 8 double rooms although many of the double rooms are occupied by one person. Eleven of the single rooms and six of the double rooms have en-suite facilities. The current fees charged weekly fall between £319 and £450 per week, there are additional charges for hairdressing. The previous report is available in the foyer for prospective residents information. Scalford Court Care Home DS0000054020.V289726.R02.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The focus of the inspections undertaken by the Commission for Social Care Inspection is upon outcomes for service users and their views of the service provided. The primary method of Inspection used was ‘case tracking’ which involves selecting clients and tracking the care they received through looking at their records, talking with them where possible, and looking at their accommodation. The inspection took place over one and one half days, commenced at 9.30 am and was completed in ten and one half hours by one Inspector. An opportunity was taken to view the care plans and other records in detail. Two residents, two relatives and three staff were spoken with on this visit. The acting manager, principal and a senior carer assisted with the Inspection, spending time with the Inspector discussing the management of the home. What the service does well: What has improved since the last inspection?
The staff training records are more comprehensive, and are easy to follow. The proofs of identification required by law prior to staff commencing employment are now in place on staff files, thus affording protection for residents in the home. The availability of “core” training has been expanded and this has afforded better protection for residents in the home. Scalford Court Care Home DS0000054020.V289726.R02.S.doc Version 5.1 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. Scalford Court Care Home DS0000054020.V289726.R02.S.doc Version 5.1 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 Scalford Court Care Home DS0000054020.V289726.R02.S.doc Version 5.1 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): 2, 3 & 6. Quality in this outcome area is adequate. This judgement has been made using the available evidence including a visit to the service. The assessment process is detailed and effective resulting in accurate and detailed information for staff. EVIDENCE: Resident assessments are initially completed prior to admission, care plans and risk assessments are then compiled from the information supplied. The inspector viewed the assessments of two recently admitted residents these were detailed and comprehensive. The process was extended to look at the contracts issued to these residents, though these were not comprehensive and did not include all the appropriate information. The home does not provide services for residents with Intermediate Care needs.
Scalford Court Care Home DS0000054020.V289726.R02.S.doc Version 5.1 Page 9 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 & 11. Quality in this outcome area is poor. This judgement has been made using the available evidence including a visit to the service. Residents are not looked after well in respect of their health, medication and personal care needs, areas of risk are not assessed appropriately, resulting in residents being placed at risk in the home. EVIDENCE: The care plans of the case tracked residents were viewed, these have improved from the last inspection with an increased amount of detailed personal information, but gave no detail on personal social care or diversity. There is a weight of evidence to suggest care staff do not follow care plans or risk assessments in line with the homes’ written guidance. A key worker system is operated within the home, whereby staff are allocated to oversee the ongoing care needs of residents. One senior member of staff spoken with at inspection stated, “We do not have a lot of time to read care plans”. This was confirmed by other staff in the home, this is inappropriate and staff must be given time to read, digest and offer input to the care planning process, this
Scalford Court Care Home DS0000054020.V289726.R02.S.doc Version 5.1 Page 10 would ensure residents would receive a more detailed service from the staff group in general. The recording of health care information is not accurately reflected in the homes’ records, there are also a number of omissions from the content of specific forms; this resulted in staffs’ perception of the care given being misinformed. Medication is still not well managed with staff not following the recognised homes’ procedures, information on medication amendments are still unclear and in some cases missing; these issues place residents at a substantial risk. Residents’ privacy and dignity is in question with health care information being inappropriately placed in view of the public. The care offered to a resident who was in the final stages of their life was not considered in line with the homes policies and procedures. Scalford Court Care Home DS0000054020.V289726.R02.S.doc Version 5.1 Page 11 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15. Quality in this outcome area is adequate. This judgement has been made using the available evidence including a visit to the service. Residents are offered a limited lifestyle resulting in restricted choice being made available by staff. EVIDENCE: Residents are offered a limited range of social and recreational activities these are currently not planned in advance and relies on staffs’ availability and personal knowledge of residents’ current abilities. There is a lack of detailed social care information in the care plan, to enable care staff to provide a suitable and varied social care programme, this does not provide a stimulating environment for residents in which to grow and develop. Staff assist residents to maintain links with relatives and the local community, visiting times to the home are open and a visiting relative described access to the home as “having their doors open to me all the time”. The relative went on to indicate that residents are offered a good choice of food and meals, and indicated he visited regularly.
Scalford Court Care Home DS0000054020.V289726.R02.S.doc Version 5.1 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 the following standard(s): Quality in this outcome area is good. This judgement has been made using the available evidence including a visit to the service. Residents are protected from abuse by robust adult protection procedures. EVIDENCE: Staff demonstrated an awareness of the complaints procedure, though the current policy and procedure have yet to be amended and updated, were this done residents and their relatives would have accurate information to hand, to ensure complaints or concerns are recorded and dealt with appropriately. Since the last inspection there has been one complaint investigated by the Responsible Person, the allegations were found to be unfounded, the final recording of the complaint within the homes own complaints information has yet to be completed. Staff are now aware of the protection of vulnerable adults issues in the home, with staff training provided on these issues. Scalford Court Care Home DS0000054020.V289726.R02.S.doc Version 5.1 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 the following standard(s): 19 & 26. Quality in this outcome area is good. This judgement has been made using the available evidence including a visit to the service. Residents live in a homely, comfortable and clean environment. EVIDENCE: Residents’ personal bedroom space, and public areas of the home were viewed within the inspection process. The areas seen were pleasantly decorated; with an ongoing plan of decoration being executed by a professional decorator. One resident remarked, “they are always dusting”, and also indicated she was satisfied with the cleanliness of the home. Control of infection is well recognised in the home, staff showing a good awareness of the issues of cross infection and cross contamination, this offering residents a good degree of personal protection. Scalford Court Care Home DS0000054020.V289726.R02.S.doc Version 5.1 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 consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30. Quality in this outcome area is adequate. This judgement has been made using the available evidence including a visit to the service. Residents are not supported or protected by the homes recruitment policies. EVIDENCE: The staff rota was viewed; this accurately recorded the numbers of staff in the home Of the staff files viewed the home continues to use staff performing personal care tasks without the appropriate Criminal Records Bureaux check or appropriate induction in place. Staff have undertaken a number of the statutory training courses required by law. Scalford Court Care Home DS0000054020.V289726.R02.S.doc Version 5.1 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): 31, 33, 35 & 38. Quality in this outcome area is poor. This judgement has been made using the available evidence including a visit to the service. The management approach does not promote effective care practice in the home for residents’ care and protection. EVIDENCE: The current acting manager has recently completed her National Vocational Qualification level four award. There have been some questionnaires sent out for quality assurance purposes, though the findings off these were not available for the Inspector to view. Scalford Court Care Home DS0000054020.V289726.R02.S.doc Version 5.1 Page 16 Resident finances are kept appropriately; of those seen all records were up to date and accurate, this providing an appropriate level of security for the residents in the home. Staff supervision is currently not undertaken in the home, the registered provider must maintain appropriate levels of supervision. Staff were observed, and showed a good understanding of moving and handling residents, however a number staff did indicate they had difficulties with the battery operated hoist, this requires some attention to ensure residents’ safety is promoted. Other records were viewed, and accident reports are completed appropriately, though there is little correlation between these and the residents’ individual daily records, again this places residents at some degree of risk within the home. Currently the management structures within the home do not fully support effective and safe care practices in the areas of medication, Criminal Records Bureaux checks, staff supervision and areas of death and dying. Scalford Court Care Home DS0000054020.V289726.R02.S.doc Version 5.1 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 3 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 2 9 1 10 1 11 1 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 X 2 Scalford Court Care Home DS0000054020.V289726.R02.S.doc Version 5.1 Page 18 Are there any outstanding requirements from the last inspection? Yes. STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation 15 Requirement The registered person must ensure all residents care plans and risk assessments are kept under review. The original dates of the 12th April 2005 and the 16th January 2006 were not met. The registered person must ensure that suitable arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines received into the care home. The original date of the 19th December 2005 was not met. Timescale for action 01/06/06 2. OP9 13 20/04/06 Scalford Court Care Home DS0000054020.V289726.R02.S.doc Version 5.1 Page 19 3. OP10 12 4. OP11 12 5. OP29 18 The registered person must 01/06/06 ensure residents are afforded the appropriate levels of privacy whilst resident in the home. The registered person must 01/06/06 ensure that the appropriate care is provided at all times for residents who are in the final stages of their lives. 01/06/06 The registered person must not employ staff without an Enhanced CRB and POVA check. The original dates of the 12th April 2005 and the 19th December 2005 were not met. Scalford Court Care Home DS0000054020.V289726.R02.S.doc Version 5.1 Page 20 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 OP7 OP8 OP12 Good Practice Recommendations The registered provider should ensure that a written plan (care plan) is completed in respect of all residents needs including those of social care and diversity. The registered provider should ensure that residents’ safety is maintained by the proper assessment of cot sides prior to use. The registered provider must ensure proper correlation between daily records and the accident records take place in the home. Scalford Court Care Home DS0000054020.V289726.R02.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Leicester Office The Pavilions, 5 Smith Way Grove Park Enderby Leicester LE19 1SX 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 Scalford Court Care Home DS0000054020.V289726.R02.S.doc Version 5.1 Page 22 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
