Inspection on 05/10/05 for Sovereign Court

This inspection was carried out on 5th October 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 found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Sovereign Court 01/10/09

Sovereign Court 27/11/08

Sovereign Court 07/12/06

Sovereign Court 31/01/06

Sovereign Court 02/02/05

Sovereign Court 18/08/04

Sovereign Court 15/03/04

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

CARE HOME ADULTS 18-65 Sovereign Court Newbiggin Lane Westerhope Newcastle Upon Tyne Tyne & Wear NE5 1NA Lead Inspector Alan Baxter Announced Inspection 5th October 2005 09:30 Sovereign Court DS0000000495.V259258.R01.S.doc Version 5.0 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 Sovereign Court DS0000000495.V259258.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 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. Sovereign Court DS0000000495.V259258.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Sovereign Court Address Newbiggin Lane Westerhope Newcastle Upon Tyne Tyne & Wear NE5 1NA 0191 271 6151 0191 271 6151 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) Mrs Jennifer Houghton Ms Susan Gray Care Home 12 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (12) of places Sovereign Court DS0000000495.V259258.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The home may not admit any person under the age of 40, or over the age of 65, without the prior agreement of the CSCI. The home may not take any emergency admissions without the agreement of the CSCI. 2nd February 2005 Date of last inspection Brief Description of the Service: This is a relatively new, purpose-built care home that opened for its current client group (persons with acquired brain injury and Huntington’s syndrome, aged between 40 and 65 years) in May 2005. It is a single storey building, with twelve single bedrooms, all en-suite, lounge, smoking lounge and dining room. It is situated on the outskirts of Newcastle upon Tyne, on a bus route, and fairly close to local shops. Sovereign Court DS0000000495.V259258.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place in September 2005. It was the first inspection of the home with the current client group. It took approximately six hours. Time was spent with the manager examining care records and other relevant documentation. Residents and staff were engaged in conversation, as were visiting relatives, who said that they are very pleased with the service being provided. Questionnaires were sent out to staff, relatives and professionals before this inspection. The building was toured. What the service does well: The home makes sure that there is a very thorough assessment of each resident’s needs before they are admitted to the home. Residents are given proper contracts. There is an individual plan of care for each resident, reflecting their differing needs. The home conducts detailed risk assessments, and aims to keep residents safe, without unnecessarily restricting their choice and rights. Many residents have noticeably improved since recently being admitted to the home. Residents are actively encouraged and supported to use all the usual social and leisure facilities available in the local community. Residents are encouraged to express themselves and enjoy a good quality of life. Residents are encouraged to make and keep personal relationships with family and friends. Residents receive a healthy diet, and have some degree of choice. Sovereign Court DS0000000495.V259258.R01.S.doc Version 5.0 Page 6 The health needs, including specialist needs, of residents are fully assessed and met. Residents and their families feel listened to, and their wishes are respected. The home has demonstrated a very good commitment to providing appropriate training for staff, including training in the protection of vulnerable adults. The home provides a pleasantly furnished and decorated environment, that is safe, warm and clean. There are sufficient staff to meet the needs of its residents. The home is well managed. Quality assurance systems are being developed. The health and safety of residents and staff are protected. What has improved since the last inspection? 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. Sovereign Court DS0000000495.V259258.R01.S.doc Version 5.0 Page 7 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 Sovereign Court DS0000000495.V259258.R01.S.doc Version 5.0 Page 8 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3,4,5. Residents receive a range of detailed assessments of need before they are admitted to the home, to make sure the home can meet those needs. Before being admitted to the home, there are opportunities for prospective residents to visit and spend time in the home where this has been assessed as appropriate. Each resident has an individual written contract with the home. EVIDENCE: The care records of three residents were examined. All had very detailed, comprehensive and holistic assessments, drawn up by involved professionals prior to admission. These included assessments undertaken by specialist multi-disciplinary teams, Occupational Therapists and social workers. The home’s manager conducts her own assessment before a new resident is admitted, to confirm that the home can meet the person’s needs. She uses a variation of the Activities of Daily Living format, extended to assess client group-specific areas such as affect, perception, insight and orientation. There was evidence that, where it has been deemed appropriate, a potential new resident would be able to visit the home and meet staff and other residents, before being admitted to the home (this is individually assessed, as some would be distressed by this process). Sovereign Court DS0000000495.V259258.R01.S.doc Version 5.0 Page 9 Written contracts were on each resident’s file. These were signed (by a relative or representative, where appropriate), dated, and fully completed. It was noted that the Primary Care Trust do not issue contracts. Sovereign Court DS0000000495.V259258.R01.S.doc Version 5.0 Page 10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9. Residents’ assessed needs are reflected in their care plans. Residents are given as much choice as possible, within the constraints of their condition. Residents are able to take reasonable risks, following careful assessment of those risks. EVIDENCE: The care records of three residents were examined. These showed that the care plans were generally in line with the assessed needs of those residents. Care plans are reasonably detailed and are holistic, including separate social care plans. Care plans are drawn up on the day of admission to the home: this is good practice. Care plans are evaluated monthly, and it was agreed that the care plans will be updated in the light of these evaluations. Due the nature of their conditions, residents lack insight and are not able to take full responsibility for their actions or choices. However, residents are given as much choice as possible, in areas such as appearance, dress, what to do and where to go during the day. Examples were given of how certain Sovereign Court DS0000000495.V259258.R01.S.doc Version 5.0 Page 11 residents now have more age-appropriate activities than when they had been in hospital. Care plans and assessments showed that risks are properly assessed. The home does not aim to be totally risk-free, but to carefully manage those risks identified. Each resident is individually assessed; one is able to go out unsupervised, and two others have been given the number for the key pad on the external door. Sovereign Court DS0000000495.V259258.R01.S.doc Version 5.0 Page 12 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11,12,13,14,15,17. Residents have opportunities for personal development. Residents are encouraged to take part in age, peer and culturally appropriate activities. Residents are part of the local community, and engage in appropriate leisure activities. Residents all have support from their families, and some have friends who visit. Residents have a healthy diet, and enjoy their meals. EVIDENCE: Care plans showed that residents are encouraged to do as much as possible for themselves, and showed that significant progress has been made by some, in the short time since the home opened. One resident now dresses herself; others now dress more age-appropriately than before. The care plans also Sovereign Court DS0000000495.V259258.R01.S.doc Version 5.0 Page 13 showed that some needs assessed before admission, such as mobility and diet, are no longer a problem to the resident. Residents and their relatives can access the kitchen, with supervision, and some help with washing up and other normal domestic chores. Residents are sometimes encouraged to bake. Good use is made of local amenities and leisure opportunities. Residents go out for meals, local shops, library, museums, swimming baths, gym, trips to the countryside and pubs, with supervision. Several attend the Disability Centre at Newburn, and enjoy sports and activities such as archery. All have cards to access a wide range of leisure facilities, free of charge. One has a Motability car, and goes out frequently with family members. There are activities such as scrabble, games, books, dominos and draughts in the home, and staff lead other activities, such as quizzes, which are popular. Much of these activities are spontaneous rather than planned, given the limited attention span of some residents. All residents get visits from their families at least weekly; some more frequently. Friends also visit and sometimes take a resident out. Residents may develop personal relationships, and, where informed consent can be demonstrated, more intimate relationships. Main meals are provided by the company’s other, larger, care home a short distance away, and are delivered in hot trolleys. Food temperatures are checked and recorded on arrival. The home follows specialist advice in providing a high-calory diet and all the residents have gained weight since admission. Speech and language therapists do nutritional assessments where required. Gluten-free, soft and diabetic diets are currently provided. Choice of main meals is restricted, again on specialists’ advice, to avoid to avoid conflict over meals. However, individual food likes and dislikes are recorded, and choice is given for other meals, with a good range of snacks, tinned and frozen foods, fruit drinks and chocolate available to residents at all times. Where necessary, a separate meal will be cooked for an individual resident, and one resident enjoys his breakfast in bed every morning. Residents spoken with all said that they enjoy the food provided. Sovereign Court DS0000000495.V259258.R01.S.doc Version 5.0 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20. Residents’ personal care is individually tailored to reflect their needs and wishes. All the residents’ physical, mental and emotional health care needs are fully assessed and met. Due to their condition, no resident currently takes responsibility for their own medication, but the home’s policies and procedures keep residents safe and make sure that the residents take all prescribed medicines. EVIDENCE: As described in standards 2 and 6, above, each resident has had a full assessment of their needs, and has had an individual plan of care drawn up, reflecting those needs and also the resident’s (and family’s, where appropriate) wishes. Examples seen included residents’ choice of clothing, preferred gender of carer, and preferred foods. All residents can let staff know if they are not happy with their care. Staff carry out requested tasks, such as dying hair and doing manicures. Some residents bathe themselves. Sovereign Court DS0000000495.V259258.R01.S.doc Version 5.0 Page 15 Physical, emotional, psychological and other health needs are also fully assessed, and met using detailed care plans. The home plans to have annual checks by dentists and opticians. There are regular visits by Community Psychiatric Nurses, and the home’s attached District Nurse attends the home every day. All residents have been registered with a local General Practitioner who has a particular interest and expertise in the client groups served by the home. Residents or their families may, however, ask for a different G.P. to attend them, if they wish. There is a ‘ward round’ conducted every few weeks (and more frequently, on request) Dr. Barber, the Consultant at the Hartside Unit, who refers the majority of the residents. Excellent relationships are reported with all the health and social care professionals involved in the care of the residents. This was confirmed by the responses of these professionals in questionnaires sent out by the C.S.C.I. before this inspection. These responses showed that the home communicates clearly with other professionals; always has a senior member of staff available to discuss concerns with; meets the residents’ requirements; shows a clear understanding of residents’ needs; and provides continuity of care. No involved professional had had cause to make a complaint about the service being provided; and all said that they are happy with the overall service being provided. Due to the condition of the residents, none have been assessed as being able to self-medicate. Therefore, the home takes responsibility for the safe recording, storage and administration of all medicines on behalf of its residents. The home uses the ‘Nomad’ system of medications. The home is in the process of drawing up a clear cross-reference of staff names against the staff initials used in the ‘Medication Administration Record’ (MAR). The home will also ensure that there is a photograph of each resident in the relevant section of the MAR; and that all hand written entries are signed and dated. Only one resident currently receives a ’Controlled Drug ‘. Clear records were seen regarding the administration of this drug, which was securely stored. Sovereign Court DS0000000495.V259258.R01.S.doc Version 5.0 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23. Residents feel listened to. Residents are protected from abuse, neglect and self-harm. EVIDENCE: No complaints have been received, either by the home or by the C.S.C.I. Those residents able to express an opinion said that they feel that the staff listen to them and take their views seriously. This was confirmed by visiting relatives, who seemed aware of the home’s complaints procedure. Care records showed that the home involves residents and their families in the assessment and care planning process, and that the care plans are sensitive to the needs and wishes of those parties. The home has acceptable policies and procedures for the protection of residents from all aspects of abuse. All staff have read and signed these policies. The manager has given in-house staff training in the Protection of Vulnerable Adults (POVA). POVA training is also covered in the National Vocational Qualification course in care that all staff are due to start shortly, and in the ‘Future Strategies’ specialist training course, also due to start shortly. All staff have been checked against Police and POVA list records. Sovereign Court DS0000000495.V259258.R01.S.doc Version 5.0 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,30. The home provides residents with a homely, safe and comfortable living environment. The home is clean and hygienic. EVIDENCE: The building was toured. It is pleasantly furnished and decorated, warm and comfortable. Appropriate risk assessments have been carried out on the building and working practices. All areas of the home were clean and hygienic. Sovereign Court DS0000000495.V259258.R01.S.doc Version 5.0 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,33,34,35. The new staff group is being well-trained, but has yet to achieve the required levels of competence, demonstrated by at least half the staff holding NVQ level two in care. Residents are supported by an effective staff team, the size of which reflects the assessed needs of the residents. Residents are protected by most of the home’s recruitment policies and procedures, but must keep Criminal Record Bureau checks for inspection. Residents’ needs are being met by the home’s current and planned staff training programme. EVIDENCE: As the home has only been open a number of months, there has not been time to train all staff to National Vocational Qualification (NVQ) level two in care. It currently has 30 of care staff with NVQ level two, as against the 50 minimum required. However, all unqualified care staff are due to start the training for NVQs very shortly. The staffing levels in the home reflect the assessed needs of each resident. The necessary staff funding is negotiated with each individual resident’s Sovereign Court DS0000000495.V259258.R01.S.doc Version 5.0 Page 19 specialist social worker, and costs are shared between Social Services and the Primary are Trust. Currently, staffing levels are four carers (including senior carers) between 8am and 9pm. The home was able to demonstrate that it’s staff recruitment and selection processes are thorough and appropriate in all areas, other than with regard to the company’s policies on Criminal Record Bureau (CRB) checks and proof of identity of staff. These records are held at the company’s head office, rather than in the home, and therefore are not available for inspection, as is required. There has been a good start to the staff training programme. Staff have had induction training (to TOPSS standards); specific training in the needs of the client group (acquired brain injury and Huntington’s syndrome; LDAF training; Protection of Vulnerable Adults training; all the required statutory/mandatory courses; and health issues training. In addition, all care staff are due to start working towards achieving NVQ level two in care, and also an accredited City & Guilds course, specifically tailored to the client group. This is good practice. Sovereign Court DS0000000495.V259258.R01.S.doc Version 5.0 Page 20 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42. Residents are benefiting from a well-run home. Although some residents are limited in their ability to express themselves, it is clear that this is a very resident-centred home. The health, safety and welfare of residents are respected and protected. EVIDENCE: The overall conclusion reached, having studied care records, spoken with residents, relatives and staff, and considered the responses to various questionnaires sent out, is that this is a well-managed home, which has the welfare of its residents as the main focus of the service. Comments from relatives include: “My daughter has improved in every way since coming to the home five weeks ago…the carers are wonderful”. “I find the staff pleasant, well turned out and polite at all times.” Sovereign Court DS0000000495.V259258.R01.S.doc Version 5.0 Page 21 “This home provides a high level of individual care.” One professional commented: “I am very pleased with their person-centred care.” Formal risk assessments of individual and general risks have been carried out, and are regularly reviewed. There was evidence of remedial actions being taken where risk has been identified, such as key pads on external doors, padding to hard surfaces, aides and adaptations fitted, a secure enclosed garden provided, adaptations to the shower room, bedding cocoons provided and wardrobes fixed to walls. Servicing of equipment is regular, and records are kept. The fire logbook is kept up to date, with all the required checks and tests of equipment carried, and staff training given. The accident showed that only three accidents are recorded as having occurred since the home opened, none of which caused any injury to any resident. The manager is in the process of drawing up an annual development plan and a quality assurance system. Sovereign Court DS0000000495.V259258.R01.S.doc Version 5.0 Page 22 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X X 3 3 3 Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 X 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X X X X X 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 X 17 Standard No 31 32 33 34 35 36 Score X 2 3 2 3 X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Sovereign Court Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 X 3 X X 3 X DS0000000495.V259258.R01.S.doc Version 5.0 Page 23 NO 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 YA34 Regulation 19 Requirement Criminal Record Bureau checks on staff must be held in the home and made available for inspection (after which they may be removed). Timescale for action 31/10/05 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 YA32 YA19 Good Practice Recommendations At least 50 of care staff should hold N.V.Q. level two in social care by the end of 2005. The home should seriously consider the emotional benefits for residents of having a house pet, such as a cat. Sovereign Court DS0000000495.V259258.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Cramlington Area Office Northumbria House Manor Walks Cramlington Northumberland NE23 6UR 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 Sovereign Court DS0000000495.V259258.R01.S.doc Version 5.0 Page 25 - 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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