Inspection on 02/10/08 for Skelton Court

This inspection was carried out on 2nd October 2008.

CSCI found this care home to be providing an Good service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Skelton Court 26/10/09

Skelton Court 09/10/07

Skelton Court 26/07/06

Skelton Court 01/11/05

Skelton Court 14/06/05

Skelton Court 08/03/05

Skelton Court 25/10/04

Skelton Court 09/12/02

Similar services:

St Marys Nursing Home

Thornham Grove

Chater Lodge

Conifer Lodge

Tixover Care Home

Toynton College (Cluster Five)

Egerton Lodge Care Home

Cedar Court Nursing and Residential Home

Extracts from inspection reports are licensed from CQC, this page was updated on 27/11/2008.

CARE HOME ADULTS 18-65 Skelton Court 41 Ryder Road Kirby Frith Leicester LE3 6UJ Lead Inspector Linda Clarke Unannounced Inspection 2nd October 2008 10:00 Skelton Court DS0000006312.V372652.R01.S.doc Version 5.2 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 Skelton Court DS0000006312.V372652.R01.S.doc Version 5.2 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 Adults 18-65. 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. Skelton Court DS0000006312.V372652.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Skelton Court Address 41 Ryder Road Kirby Frith Leicester LE3 6UJ 0116 2321834 0116 2321835 lynn.dickinson@lha-asra.org.uk www.lha.org.uk Leicester Housing Association 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) Manager post vacant Care Home 20 Category(ies) of Dementia (10), Dementia - over 65 years of age registration, with number (10), Mental disorder, excluding learning of places disability or dementia (20), Mental Disorder, excluding learning disability or dementia - over 65 years of age (20), Physical disability (10), Physical disability over 65 years of age (10) Skelton Court DS0000006312.V372652.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service User Numbers in `Yellow Acre`. No person falling within categories MD, DE, MD(E) or DE(E) may be admitted in ``Yellow Acre`` when 10 persons in total of these categories/combined categories are already accommodated within `` Yellow Acre``. Service User Categories accommodated in `` Yellow Acre ``. No person of category MD or DE who is under the age of 50 may be admitted to `Yellow Acre`. Service User Categories accommodated in `Redwood` No person falling within categories MD/PD or MD/E, PD/E, ie dual disability may be accommodated in `Red Wood` when 10 persons in total of these categories/combined categories are already accommodated in `Red Wood`. Categories admitted to `Redwood` No person falling within the categories PD or PD/E may be admitted to `Red Wood` unless that person also falls within category MD or MD/E I.e. dual disability 9th October 2007 2. 3. 4. Date of last inspection Brief Description of the Service: Skelton Court is a care home providing personal care and accommodation for people aged 50 and over with Dementia and Mental Health problems, including people who have Huntingdon’s Disease or an Acquired Brain Injury and associated Physical Disabilities. Skelton Court is situated on a modern housing estate within reach of a range of facilities, with a minibus providing additional transport. Skelton Court is single storey and horseshoe in shape; communal facilities consist of a smoking lounge, separate lounge, separate dining room and lounge/diner. All bedrooms are single and have an en-suite consisting of a toilet and wash hand basin. There is a central courtyard, which is partially paved with seating, a gazebo and mature plants and shrubs. Information is located on site detailing the range of services offered, which includes the Statement of Purpose and Service User Guide. Copies of the Commission for Social Care Inspections, Inspection Reports, are available by request at Skelton Court. Fees currently charged, as supplied by the Manager on the day of the visit range between £282.60 and £650.00. Additional information about fees is available by contacting the home. Skelton Court DS0000006312.V372652.R01.S.doc Version 5.2 Page 5 Inspection reports regarding the Home are available and can be accessed via the CSCI website: www.csci.org.uk. Further information about the home is available from the Registered Manager. Skelton Court DS0000006312.V372652.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. ‘We’ as it appears throughout the Inspection Report refers to ‘The Commission for Social Care Inspection.’ We did this Key Inspection with an expert by experience who spoke to ... people who are using this service. An expert by experience is a person who either has a shared experience of using services or understands how people in this service communicate. They visited the service with us to help us get a picture of what it is like to live in or use the service. This is important because the views and experiences of people who use services are central to helping us make a judgement about the quality of care. The ‘expert by experience’ consulted with nine people who live at they home to establish whether they would be willing to take part in a group activity, all agreed to this, and three requested one to one interviews afterwards. The inspection process consisted of pre-planning the inspection, which included reviewing the Annual Quality Assurance Assessment (AQAA), which is selfassessment tool completed by a representative of the service, reviewing previous Inspection Reports, and any information we have received. We sent surveys to ten people who use the service of which nine were completed and returned, ten surveys were sent to relatives of people who use the service of which one was returned, five staff surveys were sent out of which four were returned, four surveys were sent to Care Managers of which one was returned and two health professional surveys were sent of which none were returned. The unannounced site visit commenced on the 2nd October 2008, and took place between 10:00 and 17:15 The focus of the inspection is based upon the outcomes for people who use the service. The method of inspection was ‘case tracking’. This involved identifying people with varying levels of care needs and looking at how these are being met by the staff at Skelton Court. Four people accessing services were selected. Discussions were held with the two people chosen, along with three other people living at the Home, and a visiting relative. Three members of care staff were spoken with along with the Manager. In addition the ‘expert by experience’ spoke with several people in a group activity. Skelton Court DS0000006312.V372652.R01.S.doc Version 5.2 Page 7 What the service does well: The ‘expert by experience’ spoke with nine people in a group, and had individual discussions with three people, and asked them what they liked about the home, they said: • • • • • • • • • • • • • • • • • The garden Good food Able to choose their food from the menu as well as suggesting foods they should include on the menu in the future Staff are very good and helpful Can complain without fear Bedrooms are made nice Staff are lovely Hairdresser who visits us Knitting group Making cards Dancing Activities such as sing-a-longs, playing bingo, arts and crafts. Smoking room Able to say their opinions – one to one and in meetings. Given privacy Smoking room Able to say their opinions – one to one and in meetings. A survey received from a relative, to the question what does the service do well wrote, ‘the care home does well in creating a homely environment in making residents feel secure, also arranging days/evenings out is another feather in their cap. I feel welcome when I visit my relative, due to the friendliness of the staff who constant up date me on their progress.’ What has improved since the last inspection? In recent months the home has reviewed the way in which it operates, and has developed an action plan for improvements over the next twelve months, in the initial three months changes have already been implemented. Day to day management and communication have been improved between people who live at the home, and the staff team, by reviewing policies and procedures, some as a result of recommendations made on previous inspections, increasing the frequency of meetings within the home, the use of notice boards and the use of a monthly newsletter. Support and links with health care professionals has been improved to support people living at the home with specific health care needs, and the range and extent of training has improved to enable staff to provide a better level of care. Skelton Court DS0000006312.V372652.R01.S.doc Version 5.2 Page 8 The number of agency staff has reduced, and staff within the home are working to cover staff shortfalls, staff have been involved in fund raising activities to raise money to enable people living at the home to be more involved in social events within the community. Environmental improvements have also take place, which include the installation of a new call system for people to alert staff that they require assistance, new dining tables and easy chairs, and new a carpet in the central living/dining room. 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. The summary of this inspection report can be made available in other formats on request. Skelton Court DS0000006312.V372652.R01.S.doc Version 5.2 Page 9 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Skelton Court DS0000006312.V372652.R01.S.doc Version 5.2 Page 10 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 and 5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Skelton Court enables people who require residential care to make an informed decision as to whether the home is appropriate to their needs by providing comprehensive information about the service the home and through its comprehensive assessment process. EVIDENCE: We spoke with someone who had recently moved into Skelton Court, they told us that they had been given information about the home, but that they had not visited before moving in, as personal circumstances did not enable them to do so. They told us that moving into residential care had been difficult, but that the staff and a relative had helped them to adjust. The surveys we received from people who reside at Skelton Court informed us that a majority of people had received enough information about the home, to enable them to make the decision that the home was the right place for them to move into. One person wrote in their survey ‘very helpful, I was given time to decide.’ Skelton Court DS0000006312.V372652.R01.S.doc Version 5.2 Page 11 We looked at the information available to people moving into Skelton Court, the information provided is comprehensive and gives a good and detailed account of the service the home provides, photographs and symbols are included to support the written information. We looked at the records of four people who lived at the home; all had had an assessment of their needs carried out by a health and or social care professional. The assessments were comprehensive and gave a good account of the person’s needs, which enables the Manager of the home to make an initial decision as to whether the service can meet the needs of that person. The records we looked at showed us that when people move into the home they are provided with a contract which details their terms and conditions of occupancy and information about the fee payable. The person receiving care or their representative had signed the contracts we looked at. Skelton Court DS0000006312.V372652.R01.S.doc Version 5.2 Page 12 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People’s experience and ability to receive the care and support they need, and their right to make decisions about their lives is affected by the inconsistent approach and lack of understanding and awareness shown by some members of the staff team. EVIDENCE: People living at Skelton Court have a care plan, which details the care and support they need, and the role of staff in its implementation. The four care plans that we viewed were regularly reviewed, and were signed by the person living at the home or their representative. Care plans reflect all aspects of a person’s daily life, including the personal care and support they need with reference to their mental health, health and physical conditions. Skelton Court DS0000006312.V372652.R01.S.doc Version 5.2 Page 13 Information gathered from speaking to people living at Skelton Court provided us with information about their experience of the care and support they receive, and how they are involved in decision making. Views were mixed; highlighting that for some people their experience was good, whilst for others it was mixed. Experiences of people differ as a result of an inconsistent approach by some care staff, and a lack of understanding by some as to the needs and support people who live at the home require. The ‘expert by experience’ concluding after their discussion with people who live at the home that: - people are consulted in their care plan and say how they would like to receive services. Only issue of concern in the home is it being short staffed. We spoke with one person living at the home, who said that their ‘keyworker’ had discussed with them a specific aspect of their care, which would enable them to be happier and more relaxed about something which is important to them, it is unclear as to whether the agreement reached between the ‘keyworker’ and the service user has been communicated to other staff, as the person we spoke with said other staff did not support them in the same way, and that this caused them to be anxious and stressed. One person told us “the staff here have helped me to turn my life around, I think of some of them as friends, I can speak with most of them when I get upset, and this helps me to stay well.” Whilst someone else told us “the staff are helpful and friendly, and look after me well.” Risk assessments are undertaken on a range of activities which individuals living at the home participate in, in order that the risks to a person can be minimised, whilst this works well in some instances, in ensuring peoples health, safety and welfare are maintained, their remains an institutional approach to people who smoke, resulting in people having to surrender their cigarette lighters in the late evening to a member of staff. We looked at the daily records of four people, which recorded staffs’ account as to an individual’s daily life. The daily records of one person recorded that they had woken up in the early hours of the morning, and requested to have a cigarette, but were advised by night staff that this was not possible as smoking isn’t permitted ‘out of hours’. This shows an institutional approach by some staff, and does not support the rights and individuality and decision making of people living in the home. One person told us that the Manager has asked them about their views about how smoking was managed in the home, and that they hoped rules about smoking would change. Surveys received from people who use the service, a relative and a care manager provide us with information that the people living at the home are cared for and are supported, and that they are generally satisfied. Skelton Court DS0000006312.V372652.R01.S.doc Version 5.2 Page 14 We looked at the information provided in the AQAA prior to our visiting the home, which sets out planned improvements for the next twelve months, and discussions with the Manager during the site visit show a commitment to make changes that will benefit the care and support people living at Skelton Court experience and receive. Skelton Court DS0000006312.V372652.R01.S.doc Version 5.2 Page 15 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Opportunities for service users to engage in activities and recreational pursuits are provided; access to activities outside of the home is hindered by a shortage of staff. Service users benefit from a wholesome and varied diet, and have their specialist dietary needs met. EVIDENCE: The ‘expert by experience’ concluded that people said that they are consulted on the range of activities they would like to see happen. They are consulted individually and one to one. They also contribute in the regular meetings they have. The only complaint they have is the lack of care staff to take them out. One person said that had enjoyed their holiday to Skegness this year. One person would like to learn to read and write and would like a Polish evening Skelton Court DS0000006312.V372652.R01.S.doc Version 5.2 Page 16 with Pargoi to eat, someone else that they would like to go to Church, whilst another person said they would like to go Christmas shopping. The ‘expert by experience’ views are that - there seems to be a need for reminiscence groups, particularly for people with dementia, as this is one of the ways for them to feel alive and useful. Unlocking memories to stimulate them could reduce unhappiness, they need to be given opportunities to visit places where they grew up and try to recognise familiar places. It appears that the home is not fully capitalising on services that are on offer in the community e.g. social groups, visits to the library, befriending service etc. It would also be worth contacting the Library Housebound services to bring reading resources to the home. Skelton Court supported by other professionals works with some of the people living at the home to gain independent livings skills to enable them to move out and live in a more independent setting, for a majority of people this is not possible due to their deteriorating health. A significant number of people are reliant on the activities and recreational pursuits provided and organised by the staff of Skelton Court, several people attend a range of day care facilities, one person told us that they particularly enjoyed gardening, whilst two people said that they enjoyed doing pottery, one person saying that they had taken the pots they had made home with them, when they visited they family. We asked a number of people about their social and recreational pursuits, all said that a shortage of staff sometimes stopped them from being able to attend day centres or go out. One person said, “today is the first time we’ve gone to the day centre this week, as there wasn’t enough staff on duty on Monday, I don’t know about tomorrow we’ll have to wait and see.” Someone else told us “I like to go out, but there’s only so much the staff can do, as they’re very busy, I go out with my brother though.” One person said that they enjoyed knitting, whilst someone else said that prefer to sit in their bedroom in the evening and watch television. We looked at the information provided in the AQAA prior to our visiting the home, which sets out planned improvements for the next twelve months, and discussions with the Manager identified that care staff vacancies have been advertised, and some positions filled, but staff have not commenced work as yet, as they’re waiting for pre-employment checks to take place. One member of staff we spoke with said that they had recently been asked to oversee the organisation and provision of activities, and that staff were involved in fund raising events so as to raise money, some people have recently been on holiday for a short break. A weekly timetable of activities is displayed in the home, and includes, karaoke sessions, quizzes, sing a longs and visits to public houses, cafes and restaurants and visits to the cinema. Skelton Court DS0000006312.V372652.R01.S.doc Version 5.2 Page 17 Relatives and friends are encouraged to visit, one person said “I go and see my husband and family regularly for the weekend.” Whilst someone else told us that their relatives visit them regularly. We spoke with a relative who was visiting, and they told us that staff were always very welcoming, and that they could visit whenever they wanted to. Care plans provide information about a persons social live including information about family and friends, and records the need for staff to ensure privacy to enable individuals to continue and develop relationships. The ‘expert by experience’ following discussions with people who live at the home concluded that with regards to meals and mealtimes – people said they are consulted in what meals they would like to see on future menus. They are very happy with the quality of meals given which are cooked from scratch. They also choose the meals they would like to eat. They can also request supper and snacks in between. At the moment there are limited opportunities to be able to prepare their own meals/snacks and drinks. We sat and ate with people at lunchtime in one of the two dining areas; the atmosphere was calm and quiet. Staff supported and served people with their choice of meals, everyone we spoke with was very complimentary about the meals and the food, with a majority of dishes being prepared and made within the homes kitchen by the catering staff. There was a wide selection of desserts, which supported a wide range of tastes and dietary needs. One person said “I have high cholesterol levels, so I’ve been on a special diet for several months, and my cholesterol level has reduced, I’ve also lost weight, it’s hard at times, but I’ve stuck with it, I feel a lot healthier now and I don’t get out of breath so easily, the staff have helped me.” People who require specialist methods of feeding for example those that are Peg fed, have a clear regime detailed within their care plan, which is decided by a health care professional, and overseen by care staff on a day to day basis, aids are provided for some to enable them to maintain their independence. The Manager said that one of the changes they wanted to introduce was to encourage people living at the home to accompany staff to the local supermarket to purchase products, so that they could build on independent livings skills and be more proactive and involved in the decisions about what they eat. We observed staff supporting people throughout the day, the atmosphere was friendly, and people living at the home and staff shared jokes, experiences, views and general conversations throughout our visit. The atmosphere was inclusive, and staff sat with people throughout the day, one person living at Skelton Court contributed to the day to day running by setting and clearing tables for the lunchtime meal, and by sweeping up afterwards. Skelton Court DS0000006312.V372652.R01.S.doc Version 5.2 Page 18 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health and personal care that people receive is based on their individual needs, and the principles of respect, dignity and privacy are put into practice. EVIDENCE: Skelton Court as a home has good links with specialist health care professionals who provide care and support to people with Huntingdon’s Disease, which includes training specific to the needs of individuals, an example of this is instruction provided to staff on how staff are to ‘Peg’ feed someone in their care. Records we looked at showed that people living at the home have good access to a range of health care professionals, and are supported by staff to attend appointments, at present the care staff at Skelton Court are all female, which prevents people living at the home from requesting care and support from someone of a specific gender. Skelton Court DS0000006312.V372652.R01.S.doc Version 5.2 Page 19 We spoke with a relative who was visiting, they told us that they were very satisfied with the care their relative receives, and that they are kept up to date and are involved in the care of their relative, they also said that they were confident in the abilities and knowledge demonstrated by staff, and told us that they regularly attend meetings with staff at the home along with specialist health care professionals to review the package of care. Specialist equipment is provided for people who require assistance when moving from one place to another, this includes hoists, there are a number of assisted baths and shower facilities at Skelton Court, enabling people with a range of needs to be supported. We looked at the medication of four people living at the home and found the medication and medication records to be in good order; staff responsible for the administration of medication have received the appropriate training. A survey received from a care manager, to the question what does the service do well, wrote – ‘carers have a good understanding as well as experience of people with Huntingdon’s Disease.’ The ‘expert by experience’ following discussions with people that live at the home about accessing equipment and technical aids concluded: - People have said they are able to access equipment and aids. They receive assistance is using the equipment/aids. The Manager in their AQAA detailed planned improvements for the next twelve months, which include developing health action plans for people, and the development of health life style groups within the home. In addition the Manager wishes to implement policies and procedures relating to ‘end of life stages’, people will need to be consulted as to their wishes should they become ill and their health deteriorates whilst considering the mental capacity of individuals to make decisions. Skelton Court DS0000006312.V372652.R01.S.doc Version 5.2 Page 20 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at Skelton Court are able to express their concerns, and have access to a robust complaints procedure, and are protected from abuse by a supportive and knowledgeable staff team. EVIDENCE: Skelton Court has a complaints procedure; we along with Skelton Court have not received any complaints or concerns in the last twelve months. The ‘expert by experience’ following discussions with people that live at the home concluded: - people do feel safe to complain and feel that complaints are acted upon. They know who to complain to. They are given an allowance each week. This is given to the individual or it is looked after in the home’s safe. We observed that the atmosphere at the home is very positive, with a good rapport existing between people who live at the home and the staff that provide support. Throughout the day people spoke with staff, and staff took an active interest in what people were saying, and provided reassurance and assistance where necessary. In addition regularly meetings take place in the home, providing an additional opportunity for people to discuss any concerns or worries they may have. Skelton Court DS0000006312.V372652.R01.S.doc Version 5.2 Page 21 There are clear policies and procedures in place, which provide information to staff about their role and responsibility in supporting people living at the home, to lead a life free from abuse, neglect and harm. Staff in addition receive training specific to safeguarding adults from abuse. Risk assessments are in place, where people access the community, where people have been identified at risk of exploitation, and financial abuse. Skelton Court DS0000006312.V372652.R01.S.doc Version 5.2 Page 22 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Skelton Court enables people to live in a safe, well-maintained and comfortable environment. EVIDENCE: The ‘expert by experience’ wrote an account as to their first impressions when arriving at Skelton Court – ‘I arrived at the care home after 10am, I was taken round to view a couple of bedrooms, laundry room, smoke-room, lounge, garden and kitchen. I was impressed by the facilities they have on offer for example they have: • • A beauty room for hairdressers to use, Mini greenhouse for those who are green fingered, container plants – they promote container gardening including growing produce for the home. DS0000006312.V372652.R01.S.doc Version 5.2 Page 23 Skelton Court • • • • • A portable loop system A payphone and chair Music room Computer and printer Designated smoke room First impression is that the home is accessible, warm, clean and friendly. The staff are friendly and helpful. The home is planning, subject to health and safety regulations, to: • • Raise garden beds so that people with mobility problems can tend the gardens more easily. Install a working kitchen to give residents some independence in making snacks and drinks for themselves.’ The Expert by Experience noted:• • • There is a fire alarm, however some deaf/hard of hearing people may have difficulty in hearing the alarm, and consideration is needed to install red flashing light fire alarms. More loop systems may need to be installed in main areas. Subtitles are not always on TV programmes. Some digital programmes provide audio description for those having a visual impairment. The ‘expert by experience’ after speaking with people who live at the home about smoking legislation concluded that: - people are happy with the process and outcome in having a smoking room. Only complaint is they sometimes have to wait up to half an hour before they are given a cigarette. This is due to being short staffed. Skelton Court has a small car parking facility to the front of the property, and access to the front door is via an access level ramp. Mechanisms on the front door prevent individuals entering or leaving the building who do not have the access code. Individuals sitting in the home near main entrance can hear the lengthy and loud chime of the doorbell, when visitors arrive, people who live at the home do not answer the doorbell, but the noise may disrupt individuals in whatever they are doing. Skelton Court has an on-going programme of refurbishment and maintenance. All accommodation and facilities are provided on one level. People living at the home have access to a central courtyard, with matures trees, shrubs and plants, which has seating, throughout the day several people chose to walk in the courtyard, some to smoke a cigarette. Skelton Court DS0000006312.V372652.R01.S.doc Version 5.2 Page 24 All bedrooms have an en-suite facilities consisting of a wash hand basin and toilet, communal bathing and showering facilities are adapted to meet the needs of individuals with a physical disability, there is a central laundry for the laundering of clothing, and a hair dressing salon for the visiting hairdresser. The layout of Skelton Court has a ‘horseshoe’ shape, with the front doors and offices being in the centre, which then lead into an open plan dining and living space. Each side of the ‘horseshoe’ is referred to as Redwood and Yellow Acre, both providing lounge and bedroom facilities along with bathing and shower facilities. The two areas provide support for people specific needs, but are not exclusive, in that people are encouraged to utilise all areas of the home. The lounge located in Yellow Acre is designated as the lounge for people who live at the home who wish to smoke. Skelton Court DS0000006312.V372652.R01.S.doc Version 5.2 Page 25 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35 and 36. Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People who live at Skelton Court are supported by staff who have undergone a robust recruitment process and are supervised, and are experienced and trained, and who are employed in sufficient numbers to meet their personal care needs. EVIDENCE: There are a number of vacant care staff positions in the home, positions have been advertised, and some appointments made but individuals have not started work yet as the home is waiting for their pre-employment checks such as Criminal Record Bureau disclosures (CRB’s) to be obtained. We looked at the records of three members of staff employed by the home, the records we viewed showed that pre-employment checks are obtained before people commence work, to ensure that the people who live at the home are supported by people of good character and experience. Skelton Court DS0000006312.V372652.R01.S.doc Version 5.2 Page 26 We observed during our site visit, that their were sufficient staff to meet the day to day needs of people living within the home, but that in the evening their were not enough staff on duty to support people to go out should they so wish to. The ‘expert by experience’ following discussions with people that live at the home concluded – generally staff are praised highly. No complaints of rudeness or disrespect. Staff are courteous, polite, professional and friendly. People who live at Skelton Court have their care and support provided by staff who have good access to a range of training, of which 87 of staff have attained a qualification in care (NVQ) with others working towards the award. Staff told us that they receive regular supervisions from their line manager, and attend regular staff meetings. One member of staff said that they were given additional responsibilities as part of their professional development, which had a direct benefit on the care people who live at the home receive. Skelton Court DS0000006312.V372652.R01.S.doc Version 5.2 Page 27 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The management of Skelton Court encourages and includes people who live at the home to share their views to ensure that the home is well run and whilst safeguarding their rights and interests. EVIDENCE: The Assistant Manager has overseen the day-to-day management of the home since July 2008, supported by their line manager, who has worked closely with them. The Assistant Manager has a National Vocation Qualification at level 2 and 3, and has worked at the home in the capacity of Assistant Manager for three years. In recent months the Management Team have revised all policies and procedures and have worked with the staff team to improve the service Skelton Court DS0000006312.V372652.R01.S.doc Version 5.2 Page 28 they provide, this has meant that staff meetings have been held frequently, and that individual members of staff have been given specific responsibilities. One member of staff in their survey wrote, ‘the home has ran smoothly and teamwork is evident with the care team, the home has been a lovely place to work over the last few months and the support from the management teams has been effective. Staff morale is better that it has been for a while and this helps a lot to move forward and improve.’ The ‘expert by experience’ after discussions with people who use the service concluded: - in general people are consulted on the way the home is run. They feel they are being listened to and their opinions/suggestions are valued and acted upon. They have regular meetings and are able to contribute their views on matters. The Manager in their AQAA detailed planned improvements for the next twelve months, which includes a Quality Assurance process, which will include sending out surveys to people who live at the home, their relatives and health and social care professionals who advise and support people living at the home, the information will be used to improve and develop the service. People who live at the home, and their relatives receive a monthly newsletter which provides useful information about the home, including items written by people who live at the home, information about staffing and organised events and outings. Information submitted prior to the site visit detailed the regular maintenance of health and safety systems within the home, including fire systems and equipment, environmental health visits, central heating systems and emergency call systems. Skelton Court DS0000006312.V372652.R01.S.doc Version 5.2 Page 29 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 3 2 3 3 X 4 X 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 X 27 X 28 X 29 3 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 2 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 2 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Skelton Court DS0000006312.V372652.R01.S.doc Version 5.2 Page 30 N/A 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. Refer to Standard Good Practice Recommendations Skelton Court DS0000006312.V372652.R01.S.doc Version 5.2 Page 31 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Skelton Court DS0000006312.V372652.R01.S.doc Version 5.2 Page 32 - 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. 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