Inspection on 13/04/05 for Skirbeck Court

This inspection was carried out on 13th April 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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

Other inspections for this house

Skirbeck Court 08/08/06

Skirbeck Court 05/10/05

Skirbeck Court 14/10/04

Skirbeck Court 06/04/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Skirbeck Court 55a Spilsby Road Boston Lincolnshire PE21 9NU Lead Inspector Julie Western Unannounced 13 April 2005 09:30 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Skirbeck Court Version 1.10 Page 3 SERVICE INFORMATION Name of service Skirbeck Court Address 55a Spilsby Road Boston Lincolnshire PE21 9NU 01205 361444 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) The Order of St John Care Trust Mrs Patricia Porter Care Home - PC Care 41 Category(ies) of Older Person, 41 registration, with number of places Skirbeck Court Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 14/10/05 Brief Description of the Service: Skirbeck Court is a purpose-built home, owned and formerly managed by Lincolnshire County Council and now managed by the Orders of St. John Care Trust. It is registered to give care and accommodation for up to 41 residents over 65 years of age, in 31 single and 5 double rooms, all at ground level. On the day of the inspection 36 residents were being accommodated. The home is set in its own spacious grounds in a quiet residential area of Boston and is adjacent to local schools, overlooking the school grounds. Shops and local facilities are a short walk away and transport can be arranged for those unable to walk into the town centre. The home’s stated aims are to provide the highest quality of residential care on a 24-hour basis. Skirbeck Court Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place over 4 hours. A partial tour of the premises took place and care records were inspected. Three residents were selected and their care plans were used for case tracking. Some policies and procedures were examined and records concerning the safety of the home were also seen. Nine of the thirty-six residents, eight of the twelve staff and two visitors were spoken with. The Manager of the home was present throughout the inspection. What the service does well: What has improved since the last inspection? What they could do better: The owners must beware of having created such large and complex manuals for policies and procedures that staff cease using them for daily reference. Staffing remains an issue and, while on paper there are adequate staffing levels, the owners are reminded that issues such as accompanying service users to hospital etc. will deplete staff levels drastically. While residents now have a full activities programme in the home, some expressed a wish to be taken out from time to time; this was not thought to be possible with current Skirbeck Court Version 1.10 Page 6 staffing levels. One room smelled strongly of urine – the Manager was aware of this and discussions were held as to how different flooring could be used while still maintaining the dignity of the resident. The paving slabs in the inner courtyard identified in the previous report still need pointing from the previous inspection. Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Skirbeck Court Version 1.10 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Skirbeck Court Version 1.10 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,2,3,4,5 The home clearly sets out what it intends to provide for its residents and prospective residents are encouraged to take time before making the decision to move into the home on a permanent basis. EVIDENCE: The statement of purpose was comprehensive and was available at the front entrance, along with the residents’ handbook. Residents said they received copies of the handbook. Copies of the home’s ‘in—house’ magazine were also available in the entrance hall. The admissions policy, which included a policy on emergency admission, was up to date and comprehensive and the Manager said that she or a Care Leader carried out pre-assessments, either in the prospective resident’s home or in a care setting. Two residents said that before admission to the home they had visited for the day and were able to eat the meals and to join in with the activities. This had allowed them to make a decision about moving into the home in their own time. Skirbeck Court Version 1.10 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,9,10 The home’s records give a full picture of the needs of each resident to ensure that health and personal needs are met. EVIDENCE: The home used a card system for recording care plans; these were clear as to the needs of residents and contained full assessments including risk assessments. There was a fully developed procedure for medication and a pharmacist met with the Manager on a quarterly basis to check the medication and to discuss any issues arising from this. A number of residents were spoken with and all said they could get up and go to bed when they chose. They said they were approached daily by catering staff to discuss their choice of food for the day. Staff members were observed to knock on doors before entering and to give time and consideration to residents, particularly with regard to assistance with toileting and assisting with moving around the home. Skirbeck Court Version 1.10 Page 10 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,14,15 Social activities are extensive and are well managed, creating daily variation and interest for people living in the home. The residents can exercise choice regarding daily activities and meals. EVIDENCE: A number of people were spoken with and all residents said they enjoyed the food. They said they could have whatever they like for breakfast and tea and there was always a choice for the main meal of the day. The kitchen staff demonstrated a knowledge and awareness of special diets Menus showed that there was a balanced and varied diet and mealtimes were flexible. Residents commented that the food was ‘excellent’ and one said that she recently had stuffed chine, which she called ‘a good old-fashioned Lincolnshire meal’. The home has an activities co-ordinator who works 16 hours weekly; she was developing a newsletter to be sent to all residents and relatives. The weekly programme of activities was displayed in various places around the home. Other residents said they would like to be taken out individually but that there were not always enough staff to do this. Skirbeck Court Version 1.10 Page 11 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16,18 Complaints are handled objectively and residents are confident that their concerns will be listened t and acted upon. There is a robust vulnerable adults procedure. EVIDENCE: The home had received 3 complaints in the past twelve months – all were unsubstantiated, but one also had a suggestion about displaying forthcoming events on a notice board in the entrance hall; this had been acted upon. The home had the Local Authority’s Adult Protection procedures and a ‘whistle blowing’ policy. One resident said ‘I’d go to the boss – she always listens to what I have to say’ and others said the Manager came round regularly to ask their opinions on issues concerning the running of the home. Skirbeck Court Version 1.10 Page 12 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 22, 26 The home is maintained to a high standard internally, with well-furnished rooms which residents are able to personalise. Work is continually in progress to ensure that the environment is kept up to standard. EVIDENCE: The home has a rolling maintenance programme and the handyman has a book where identified items needing repair or renovation were logged; the corridors are currently undergoing redecoration. One room smelled strongly of urine and it was advised that alternative flooring for this resident was provided. Externally, the paving slabs identified in the previous report as being in need of re-pointing had still not been repaired; the handyman said he was waiting for good weather to complete this task. The Manager and administrator’s two dogs were in the central courtyard and resident said they enjoyed watching them playing. However, one of the dogs had been digging and had left muddy footprints on the windows and scattered some soil around. It was suggested to the handyman that if the dogs were to stay in the courtyard, any open soil should be covered with pebbles. Skirbeck Court Version 1.10 Page 13 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 30 Sound procedures for the recruitment of staff are in place and the residents are cared for by a staff group who are knowledgeable and well trained. Some issues remain as to whether staffing numbers are adequate to meet all of the residents’ needs. EVIDENCE: Since the last inspection an activities co-ordinator has been appointed. Staff files showed that the home had undertaken all necessary recruitment checks and training records showed that the home had completed all statutory training with each staff member having a skill matrix. All new staff had a ‘probationary period record’. Future training planned included Moving and Handling, Fire training and specialist courses included a course on Alzheimer’s disease and a distance learning course on dementia. Although there were sufficient staff on duty to meet the staffing matrix, residents and staff members said they still thought there were not always enough staff available, particularly in the mornings. Residents said they would like to go out with a staff member but this was not always possible due to staff numbers. A member of staff who had been a carer but was now part of the housekeeping team said she had more time to talk to residents in her new post. Staff members said that they still took residents shopping in their own time. Skirbeck Court Version 1.10 Page 14 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33, 35, 38 The considerable experience and knowledge of the Manager and her open management style enable the home to run smoothly and regular monitoring by the home and by the head office ensures that residents are protected and included in decisions affecting them. EVIDENCE: The Manager, who has had many years’ experience in the management of care homes, operated an open-door policy, which allowed residents and staff to talk to her throughout the day. She is currently working toward the Registered Manager ‘s Award. Visitors and staff were very positive in their comments about the staff and said they were very hard-working. The home has a large and extensive set of policies and procedures manuals; their size could deter staff from using them . The quality assurance manual demonstrated that the home had a positive approach towards seeking the views of residents, with results being taken from service user questionnaires, which were analysed and Skirbeck Court Version 1.10 Page 15 acted upon. The home has the ISO/200 award and the Investors in People award and received regular audits from headquarters. Skirbeck Court Version 1.10 Page 16 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. Where there is no score against a standard it has not been looked at during this inspection. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION 3 x x 3 x x x 2 STAFFING Standard No Score 27 3 28 x 29 x 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 3 4 x 3 x x 3 Skirbeck Court Version 1.10 Page 17 0 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 26 Regulation 13[3] 16[2][j] Timescale for action The registered person must 8th June make arrangements for replacing 2005 the carpet in Room 1 with a more hygienic alternative Requirement 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 19 27 Good Practice Recommendations It is a recommendation that all soil in the inner courtyard is covered with pebbles to avoid digging by the visiting dogs. It is a recommendation that staff deployment is constantly reviewed in order to enable staff to have quality time with service users and to allow them to accompany service users on individual outings from time to time. Skirbeck Court Version 1.10 Page 18 Commission for Social Care Inspection Unity House, The Point Weaver Road, off Whisby Road Lincoln LN6 3QN National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Skirbeck Court Version 1.10 Page 19 - 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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