CARE HOMES FOR OLDER PEOPLE
Skirbeck Court 55a Spilsby Road Boston Lincs PE21 9NU Lead Inspector
Julie Western Unannounced Inspection 4th October 2005 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 Skirbeck Court DS0000002417.V255880.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Skirbeck Court DS0000002417.V255880.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Skirbeck Court Address 55a Spilsby Road Boston Lincs PE21 9NU 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) 01205 361444 The Orders Of St John Care Trust Mrs Patricia Porter Care Home 41 Category(ies) of Learning disability (1), Old age, not falling registration, with number within any other category (41) of places Skirbeck Court DS0000002417.V255880.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. The home is registered to provide personal care to service users whose primary needs fall within the following categories: Old age, not falling within any other category (OP) 41 Learning disability (LD) 1 The category of Learning Disability applies to the service user named within the notice of proposal dated 12 July 2005. Date of last inspection 13th April 2005 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 34 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 DS0000002417.V255880.R01.S.doc Version 5.0 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-four residents, seven of the staff and three 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? The Standex card system used for recording care plans has been reviewed and is now more concise. Recent redecoration has included the total refurbishment of all corridors, with pictures on the walls chosen by the residents; these include pictures of film stars, World War II planes, trains and scenic views. The inner courtyard now has raised flower-beds, which are in the process of being planted up. One bedroom has been laid with laminate flooring. The home currently is currently working with a volunteer who is a nurseryman and the grounds have been planted with flowerbeds, tubs and hanging baskets to give an attractive and peaceful setting for residents to sit out in good weather, or to look out on. Skirbeck Court DS0000002417.V255880.R01.S.doc Version 5.0 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Skirbeck Court DS0000002417.V255880.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Skirbeck Court DS0000002417.V255880.R01.S.doc Version 5.0 Page 8 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 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 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. One resident said ‘I was recommended this home so I did not need to visit it beforehand’. Skirbeck Court DS0000002417.V255880.R01.S.doc Version 5.0 Page 9 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 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. One visitor said ‘I’m impressed with the care of my mother’. A number of residents were spoken with and all said they could get up and go to bed when they chose. 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. the Manager said that there was always staff representation at the funerals of residents and on the day of the inspection two residents were accompanied by staff to the funeral of a resident. Skirbeck Court DS0000002417.V255880.R01.S.doc Version 5.0 Page 10 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 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. One resident said ‘the food’s excellent – there’s a lot of choice and we’re asked at breakfast what we’d like for lunch’. 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. 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 and included flower arranging and making Christmas cards. Residents described a baking session they had taken part in last week and also a trip to a local airfield which had a war museum. One resident said she did not wish to take part in the trips but really enjoyed the in-house entertainment. Skirbeck Court DS0000002417.V255880.R01.S.doc Version 5.0 Page 11 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 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 one complaint since the last inspection – this had been addressed within the given time. The home had the Local Authority’s Adult Protection procedures and a ‘whistle blowing’ policy. One resident said ‘I’d go to the Manager – she would listen to me’ and others said the Manager came round regularly to ask their opinions on issues concerning the running of the home. Skirbeck Court DS0000002417.V255880.R01.S.doc Version 5.0 Page 12 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 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. Recent redecoration has included the total refurbishment of all corridors, with pictures on the walls chosen by the residents; these include pictures of film stars, World War II planes, trains and scenic views. The carpet in the entrance hall and top corridors now looks faded and plans should be made to replace it. The inner courtyard now has raised flower-beds installed and there are plans to plant them with flowers and shrubs to develop a sensory garden. One bedroom has been laid with laminate flooring. The home currently is currently working with a volunteer who is a nurseryman and the grounds have been planted with flowerbeds, tubs and hanging baskets to give an attractive and peaceful setting for residents to sit out in good weather, or to look out on.
Skirbeck Court DS0000002417.V255880.R01.S.doc Version 5.0 Page 13 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Sound procedures for the recruitment of staff are in place and the residents are cared for by a knowledgeable and well trained group of staff. EVIDENCE: 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 planned training included Health and Safety, Death and Dying and Dementia. The Orders of St. John Care Trust have their own training manager at headquarters and there is a full training programme. Residents and staff said that there were enough staff available to complete their tasks in the given time. There were currently two vacancies and staff were currently covering shifts. Skirbeck Court DS0000002417.V255880.R01.S.doc Version 5.0 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 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): 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. Visitors and staff were very positive in their comments about the staff and said they were very hard-working. A resident said ‘they’re very patient and kind’. 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 acted upon. The home has the ISO/200 award and the Investors in People award and received regular audits from headquarters.
Skirbeck Court DS0000002417.V255880.R01.S.doc Version 5.0 Page 15 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X 3 3 3 3 3 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 Standard No Score 16 3 17 X 18 3 4 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 4 X 3 3 3 3 Skirbeck Court DS0000002417.V255880.R01.S.doc Version 5.0 Page 16 Are there any outstanding requirements from the last inspection? none 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 Refer to Standard OP19 Good Practice Recommendations It is a recommendation that a plan is made for the renewal of the carpet to the entrance hall and top corridors. Skirbeck Court DS0000002417.V255880.R01.S.doc Version 5.0 Page 17 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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