Inspection on 26/07/06 for Skelton Court

This inspection was carried out on 26th July 2006.

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.

Other inspections for this house

Skelton Court 26/10/09

Skelton Court 02/10/08

Skelton Court 09/10/07

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 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Skelton Court 41 Ryder Road Kirby Frith Leicester Leicestershire LE3 6UJ Lead Inspector Keith Charlton Unannounced Inspection 26th July 2006 09:30 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 Skelton Court DS0000006312.V304348.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 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. Skelton Court DS0000006312.V304348.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Skelton Court Address 41 Ryder Road Kirby Frith Leicester Leicestershire LE3 6UJ 0116 2321834 0116 2321835 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) Leicester Housing Association Lynn Dickinson 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.V304348.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, i.e. 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 1/11/2005 2. 3. 4. Date of last inspection Brief Description of the Service: Skelton Court provides care for younger adults with Huntingdons Disease and older people with mental health problems. The large purpose built building is organised in a horseshoe shape with separate accommodation for each set of residents. The home is situated on a modern housing estate, within reach of local facilities. The home has a mini-bus, which is used for visits to the surgery, shops and for outings. Residents are taken out during the day and in the evening. Activities are also provided in the home. The home provides a specialist service and staff are trained to meet the residents needs. The weekly fee is from £270 - £370, which was provided on the day of the Inspection. There are additional costs for hairdressing, toiletries, outings, insurance, chiropody and dry cleaning. Skelton Court DS0000006312.V304348.R01.S.doc Version 5.2 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 user and their views of the service provided. The primary method of inspection used was ‘case tracking’ which involved selecting three service users and tracking the care they received through looking at their records, discussion, where possible, with them and care staff and observation of care practices. This was an unannounced Inspection. The Registered Manager was present and helped in carrying out the inspection. Planning for the Inspection included looking at notifications of significant events sent to the Commission for Social Care Inspection and the issues contained in the last Inspection Report. There have been no complaints made about the service since the last inspection. The Inspection took place between 9.30 and 15.30 and completed the following day and included a selected tour of the building, inspection of records and indirect observation of care practices. The Inspector spoke with eight service users, three members of staff and the Registered Manager. What the service does well: The services that are provided generally meet the needs of the people who live there. Care plans are clear and comprehensive, providing staff with the information they need to meet residents’ needs. Residents on the day said that staff were friendly towards them, that they are treated with respect and that their right to privacy is in place, there are activities in the morning and afternoon seven days a week and arrangements for going out to the local community are in place. There is a keyworker system in place so that every resident has a staff member to relate to and once a month time has been allocated so that the resident can go out for the day with the keyworker and carry out activities of their choosing. All residents spoken to said the food was very good and choice was always available. A total of forteen Comment Cards were received from residents and two from relatives – generally there were very positive comments regarding the service: ‘Staff are wonderful. Food is great’. ‘I am well cared for’. ‘It’s a nice clean place to live in’. Skelton Court DS0000006312.V304348.R01.S.doc Version 5.2 Page 6 ‘This place is a very nice residential Home. The staff employed are all very caring and look after our needs well’. ‘The cooks are good here’. A relative spoken with said staff always meet the needs of his wife at all times and that he is always welcomed when he visits. Facilities are kept clean and tidy and residents choose how they wish to have their bedrooms decorated and how to personalise them. What has improved since the last inspection? What they could do better: Residents needs could be further enhanced by ensuring that any behavioural programme is agreed in writing with relevant professionals. The annual audit could include the views of other stakeholders for example, relatives and GPs, and the outcome of the review could be published to provide information for prospective residents to deceide whether they want to live in the home. Six Comment Cards received from residents had a number of issues that the Registered Manager is to look into regarding issues of staff relations, privacy, safety, being more involved in decision making in the home, and arranging more suitable activities. Skelton Court DS0000006312.V304348.R01.S.doc Version 5.2 Page 7 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. Skelton Court DS0000006312.V304348.R01.S.doc Version 5.2 Page 8 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 Skelton Court DS0000006312.V304348.R01.S.doc Version 5.2 Page 9 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): 3,6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ needs are well assessed before admission so that staff are able to meet their needs. EVIDENCE: Some residents said that management from the home came to see them before their admission. The policy of the service, seen in the Policies and Procedures file, is to visit the prospective service user prior to admission to the home. The Inspector looked at three service users files. There was a good deal of relevant information in terms of medical, physical and social needs of service users, which helps staff to deal with the individual needs of service users. The Registered Provider does not provide intermediate care. Skelton Court DS0000006312.V304348.R01.S.doc Version 5.2 Page 10 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The individual needs and choices of residents living in the home are generally well met. EVIDENCE: Some residents said that they knew they had Care Plans. The Care Plans inspected set out residents’ needs in respect of their health and social care. Records indicate that the plans have been kept under review. The plans that were inspected had been signed by the resident to indicate that they were in agreement with the care to be provided. There is a format for recording the outcome of risk assessment reviews. Individual plans detailed the personal support residents require. They also set out details of any healthcare needs that have been identified and of any action that is felt to be necessary as a result. Skelton Court DS0000006312.V304348.R01.S.doc Version 5.2 Page 11 One record showed no recorded dental check for three years. The Registered Manager said this would be followed up. Residents stated that staff would take action to ensure that the doctor was called if they were feeling unwell. Residents stated that they were treated with respect and said staff knew they had a right to privacy, for example when receiving visitors. They stated that staff members knock and wait for a response before entering their rooms. Residents stated that they could decide when to undertake the various activities of daily living and how to spend their day. Individual plans emphasise the need to respect residents’ preferences with regard to these issues. One of the residents who was chosen for the purposes of case tracking appeared to have a behavioural programme in place in that if she had challenging behaviour then her drawing activity was withdrawn from her as a punishment. The Registered Manager agreed this appeared to treat her as a child but said she was following the treatment set out by the Social Worker. However there was nothing recorded to support this. The Registered Manager said she would contact the Social Worker to have this programme properly set out and in writing. Medication was issued to service users. This is carried out in residents bedrooms if possible as medication is kept in a secure cabinet in the bedroom toilet en suite. None of the service users who were asked wanted to self medicate and all those asked appreciated the staff holding their tablets and giving them at prescribed times. There was evidence of training in staff training records and a staff member said she had received medication training by an outside training organisation.The medication administration records were generally well kept, with few gaps. The Registered Manager is to ensure that when creams, inhalers and food supplements are issued then this is recorded to provide evidence that the medication has been administered to residents. Skelton Court DS0000006312.V304348.R01.S.doc Version 5.2 Page 12 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 good. This judgement has been made using available evidence including a visit to this service. Residents living at the home have a generally good lifestyle, and meals continue to be seen as good. EVIDENCE: The Residents spoken with said they were satisfied with the organised daily activities. One resident said he attended a day centre three days a week and he liked going out. It was his day in the month to be going out with his keyworker to go clothes shopping. Staff at the home organised daytime activities for others. Another resident said she often caught a bus to go to the shops. Residents also said they had day trips out and that they had been to Skegness the day before, which they had enjoyed. A resident said staff had advised her to have sunscreen applied to protect her skin. Residents also said they had holidays which they enjoyed. The Registered Manager said the Registered Provider funds one holiday a year for residents – this situation is commended. Residents stated that they are able to maintain contact with their families & friends and to see visitors in private if they wish. A relative spoken with said Skelton Court DS0000006312.V304348.R01.S.doc Version 5.2 Page 13 staff always welcomed him and he thought that the home was well run and the care provided was very good. The Registered Manager was interested in looking at how to incease residents’ involvement in the running of the home by, e.g., representatives from residents attending staff meetings and interviewing prospective staff. Staff said that it was important that service users were able to keep their independence so they could still do things for themselves. This was confirmed by service users. Residents said they enjoyed the food and there was always choices for meals every day. Food records showed there were a variety of vegetables offered. Staff were aware of service users food preferences and this information was in Care Plans. The food tasted was found to be of a good standard. Evidence in Care Plans showed nutritional needs are assessed. Skelton Court DS0000006312.V304348.R01.S.doc Version 5.2 Page 14 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): 16,18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users views are listened to and acted upon and they and their representatives can be confident their concerns will be properly attended to. EVIDENCE: Service users said that they would go to management or staff if they had a problem and were confident it would be properly sorted out. The Complaints book was viewed - the service has had no complaints since the last inspection. Previous complaints were well dealt with by the Registered Manager and contained outcomes reported to the complainant. The Commission for Social Care Inspection has not received any complaints about the service since the last inspection. There is a Complaints Procedure, which nearly complied with the National Minimum Standard – the Registered Manager said this would be altered to fully comply with the National Minimum Standard. Staff members were asked about their understanding of the adult protection procedures, and demonstrated a generally good understanding. Leicester Housing Association has produced policies & procedures on the protection of vulnerable adults and whistle blowing. Staff members stated that these issues had been covered as part of their induction. Skelton Court DS0000006312.V304348.R01.S.doc Version 5.2 Page 15 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 available evidence including a visit to this service. Residents live in a homely and comfortable environment, and standards of hygiene are very good. EVIDENCE: Residents all said that they liked their bedrooms and they could bring in their own things including furniture. These were observed to be personalised and homely by the inspector. Lounges were comfortable and furnished in a homely fashion. Service users in one lounge said that the new carpet was a big improvement on the old one. The Registered Manager said that there will be new furniture provided in lounge areas in the near future and residents had chosen this. Service users also appreciated the well maintained garden patio area. Skelton Court DS0000006312.V304348.R01.S.doc Version 5.2 Page 16 The facilities were found to be clean and completely odour free. The hot water temperature was measured at 42.5c degrees centigrade, within the National Minimum Standard of 43c, to protect residents from scalding, and all radiators are guarded throughout the property to offer protection from burning. A number of doors were squeaky which could be a noise nuisance – the Registered Manager said that would be dealt with. Skelton Court DS0000006312.V304348.R01.S.doc Version 5.2 Page 17 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): 27,28,29,39 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The current staffing levels and recruitment practice lead to service users welfare needs being generally met. Staff training is largely comprehensive which is important to understand and meet residents needs. EVIDENCE: There were a number of comments from residents saying that they thought there was time for them to spend with them and they didn’t have to wait long when they needed help. The staff rota indicated that there are four carers on duty in the morning with one cook and one cleaner. There are three carers on duty in the afternoon/evening shift. Staffing levels are two awake staff with one sleeping in at night. Staff records were inspected. There was only one reference for one staff member and identification - copies of passport or birth certificates – were not available. The Registered Manager said that these were at head office but agreed to obtain copies so that they could be checked upon inspection. Staff said that training is emphasised by the Registered Manager and that there is encouragement to complete National Vocational Qualification training in essential care issues to the extent that all staff will have National Vocational Skelton Court DS0000006312.V304348.R01.S.doc Version 5.2 Page 18 Qualification level 2 training when the current number of staff complete this. This situation is commended. There is also an extensive induction programme that covers important care topics. The training records were viewed for the staff team and a range of training has been undertaken. The inspector recommended that the training programme cover all service user medical conditions – mental disorders etc, and that a training matrix is set up to show at a glance who needs training in specific issues so that action can quickly be planned to provide such training. Skelton Court DS0000006312.V304348.R01.S.doc Version 5.2 Page 19 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 good. This judgement has been made using available evidence including a visit to this service. Management systems protect the health and safety of residents. EVIDENCE: Service users and staff spoken to said that the home was run very well and they could not think of any improvements that were needed. This situation is commended. There is a Quality Assurance system in place. This is to be carried out on a yearly basis to ensure that the service is effective in meeting service users needs and wishes. Some questionaires were seen. The Registered Manager said that they will be analysed and this information published in the Statement of Purpose, to be made available to all stakeholders. Skelton Court DS0000006312.V304348.R01.S.doc Version 5.2 Page 20 There are service user and staff meetings to ensure that there is a forum to air views and preferences, put forward suggestions etc, and these were well minuted with good detail showing what was discussed and agreed. Staff said there is a regular staff supervision system in place and this was recorded in records. Records indicated the frequency of fire drills meets the requirement and there is regular emergency lighting and fire bell testing. The staff members spoken with had a good awareness of the fire drill procedure. A fire risk assessment was seen which covered relevant issues. The Registered Manager said that fire strips to doors, identified in the Registered Provider monthly report were on order to ensure fire protection to these areas. Service users monies accounts were checked and found to be largely in order with proper balances, receipts and two signatures recorded – one being a resident’s if they are able to sign. One record was behind schedule, which the Registered Manager agreed needed to be kept up to date. Regarding Health and Safety training, all staff are expected to complete fire training, infection control training, moving and handling training and food hygiene training. The Registered Manager said that there was always a trained first aider on duty in the home. There were written Risk Assessments for safe working practices and these were evidenced in the Health and Safety records. Skelton Court DS0000006312.V304348.R01.S.doc Version 5.2 Page 21 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 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 4 15 4 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 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 3 Skelton Court DS0000006312.V304348.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No 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 OP10 OP33 Good Practice Recommendations The Registered Manager needs to ensure that any behavioural programme for any resident is agreed in writing with relevant professionals It is recommended that the Registered Manager publish the findings of the annual audit, based on the views of residents and of other stakeholders. Skelton Court DS0000006312.V304348.R01.S.doc Version 5.2 Page 23 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 Skelton Court DS0000006312.V304348.R01.S.doc Version 5.2 Page 24 - 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. 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