Random inspection report
Care homes for older people
Name: Address: Spencefield Grange Davenport Road Leicester LE5 6SD one star adequate service 23/11/2009 The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Ruth Wood Date: 0 4 0 3 2 0 1 0 Information about the care home
Name of care home: Address: Spencefield Grange Davenport Road Leicester LE5 6SD 01162418118 01162418118 Debbie@hicare.co.uk www.hicare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : HiCare Limited care home 63 Number of places (if applicable): Under 65 Over 65 0 0 63 0 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category physical disability Conditions of registration: 63 63 0 63 The maximum number of service users who can be accommodated is 63 The registered person may provide the following categories of service only: Care Home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Dementia - Code DE Mental Disorder, excluding learning disability or dementia - Code MD Old age, not falling within any other category - Code OP Physical Disability - Code PD Date of last inspection Brief description of the care home The home provides accommodation for up to 63 people and is owned by Hicare Limited. It is located in a quiet suburb on the outskirts of the city of Leicester and has
Care Homes for Older People Page 2 of 11 2 3 1 1 2 0 0 9 Brief description of the care home access to a regular bus service. The building is a modern purpose built service offering accommodation on ground and first floor level. Bedrooms on the first floor are accessed by a shaft lift. There is ample car parking facilities to the front and side of the home. At the rear of the home there is an extended patio terrace with garden furniture and ornate water fountain. The garden has level access for people with impaired mobility. There are suitable facilities to support people with physical disabilities such as handrails. Specialist equipment for the prevention of pressure sores is also available through the district nursing service. A copy of the most recent inspection report is available in the reception area. The fees for 2009 to 2010 are from £430 to £470. Care Homes for Older People Page 3 of 11 What we found:
This was a focused random inspection, looking at the services ongoing response to particular requirements made at the key inspection on 23/11/2010. Two inspectors visited the home between 09:30 and 14:00. The requirements we focused on were made in relation to people receiving support with eating and drinking, ensuring risk to service users health and safety is appropriately managed and documented and the service ensuring that staffing levels are sufficient to meet the needs of people living in the home. A special management team is currently working with the managers at Spencefield Grange; this includes the companys operations manager and two of the companys directors. We outlined the focus of the inspection to the management team and the inspection included discussion with the team and with the deputy manager of the home. The service had previously sent the Commission information about how it is meeting a requirement made at the key inspection on 23/11/09 to ensure that those people who need support with eating and drinking receive it at a time of their choosing from suitably trained and competent staff. As part of this information they said that they had identified five people who need support with eating and drinking. At the inspection visit we asked to see these peoples care records and looked at the care plan in place in relation to each persons eating and drinking needs. A requirement was also made at the key inspection that how risks to service users health and safety should be managed, are clearly recorded. We looked at the risk assessments in place for the five people. We were given a copy of the staffing rota for the week of the inspection visit and asked the deputy manager to speak to us about how the service had assessed and decided on the level of staffing required. A review of staffing levels has taken place and currently additional management and administrative staff are in place and are engaged in updating care plans and training and monitoring the competence of staff members. An additional activities organiser has been employed and the service is considering employing an administrator to free up managers time to allow them to spend more time on the floor. The rota showed that an additional care staff member is deployed at lunch times. We observed that one senior staff member was responsible for the administration of medication at lunchtime and that she was not interrupted when performing this task and was not asked to perform any other duties. We directly observed the five people whose care plans we had reviewed, during the lunchtime period, together with another person identified as sometimes requiring help with eating and drinking. Two of these people ate their meals without requiring support. Two people were directly supported to eat their meals by a staff member sitting alongside each of them throughout the whole meal. One person was supported to eat their meal by a succession of five care staff. One person did not receive direct support from a staff member to eat, did not eat anything and left the table. They were brought back to the table later and at the end of our observations had only eaten their soup course. The
Care Homes for Older People Page 4 of 11 management team agreed that support for this person at meal times, could be better coordinated. What the care home does well: What they could do better:
The service is working hard to meet the requirements made at the key inspection and no new requirements or recommendations were made following this inspection. We did
Care Homes for Older People Page 5 of 11 discuss the improvements already made in documentation and practice and areas where this may be further improved. The management team agreed to review the care plans of the people we identified to ensure that information in the main care plan and in the summary was consistent in all cases and that they contained sufficient information for staff about how to support and encourage people to eat. Each persons daily food intake was recorded and we suggested that the format of this recording should be modified so that staff can add more detail about the exact type and quantity of food eaten. The management team agreed that they would do this. Our observations of mealtimes were that some people had to wait a long time before their meal was served (up to three quarters of an hour). This was confirmed when speaking with one person, whose support in relation to this area we looked at in detail. They said that because of the delays, eating was not always a pleasant experience. This person and other service users we spoke to confirmed that the food itself was of good quality and the meal we observed looked and smelled appetising. We discussed with the management team, options that may improve the mealtime experience for people and they agreed to explore how this could be improved so that people did not have to wait too long for their food and that all the people that needed support, received it in a timely and consistent way. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Older People Page 6 of 11 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements
These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action 1 7 13 The registered person must ensure that clear and detailed information is recorded about how risks to service users health and safety should be managed This is to ensure that staff know what action they should take to ensure the safety and well-being of service users. 01/03/2010 2 7 14 The registered person must 15/03/2010 ensure that each service users written assessment of need is kept under review and updated when their needs change This is to ensure that staff have access to an accurate and up to date record of a service users current needs 3 7 15 The registered person must ensure that care plans give detailed information about how each service users identified needs should be met. This is to ensure that each service users individual needs are met consistently 15/03/2010 Care Homes for Older People Page 7 of 11 Outstanding statutory requirements
These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action 4 7 15 The registered person must 31/03/2009 ensure that how to meet each aspect of a persons health and personal care is outlined in detail in their care plan This is to ensure that all of a persons needs are met consistently by the staff team. 5 12 16 The registered person should 31/03/2010 review the opportunities for activity and social interaction available for service users with dementia in the home. This is to ensure that suitable opportunities for social interaction and activity are available for all people living in the home and to ensure no service user becomes socially isolated. 6 15 12 The registered person must 15/01/2010 ensure that those service users who need support with eating and drinking receive this from a suitably trained and competent staff member at a time of their choosing. This is to ensure that all service users receive adequate nutrition and hydration. 7 30 18 The registered person must 30/04/2010 make suitable arrangements to ensure that all staff receive training in the conditions associated with
Page 8 of 11 Care Homes for Older People Outstanding statutory requirements
These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action mental ill health This is to ensure that all staff have the necessary knowledge and understanding to meet peoples needs 8 30 18 The registered person must 31/03/2010 make suitable arrangements to ensure that all staff receive training related to the implementation of the Mental Capacity Act and the Deprivation of Liberty Standards. This is to ensure the privacy and dignity of the people living in the home. Care Homes for Older People Page 9 of 11 Requirements and recommendations from this inspection:
Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours.
No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set.
No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service.
No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 10 of 11 Reader Information
Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 11 of 11 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
