CARE HOMES FOR OLDER PEOPLE
The Leys 63 Booth Rise Boothville Northampton Northants NN3 6HP Lead Inspector
Chris Wroe Unannounced Inspection 31st January 2006 11:20 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 The Leys DS0000012843.V281270.R01.S.doc Version 5.1 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. The Leys DS0000012843.V281270.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service The Leys Address 63 Booth Rise Boothville Northampton Northants NN3 6HP 01604 642030 01604 670028 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 Sheila Samuels Mrs Carolyn Melva Shiers Care Home 18 Category(ies) of Old age, not falling within any other category registration, with number (18), Physical disability over 65 years of age (2) of places The Leys DS0000012843.V281270.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. 3. 4. 5. 6. 7. 8. The home limits its services to the following Service User Categories No person falling within the category OP can be admitted where there are 18 persons of category OP already in the home. No person falling in the category PD (E) can be admitted where there are 2 persons of category PD (E) already in the home Total number of Service Users in the home must not exceed 18 To enable the home to admit persons who are in the category old age (OP) To limit the number of persons to be admitted under the category OP To limit the number of persons to be admitted under the category PD (E) To limit the number of persons accommodated in the home Date of last inspection 27th July 2005 Brief Description of the Service: The Leys is situated on the outskirts of Northampton, with good road access. The home offers single and shared room accommodation to 18 service users. The home has a large lounge and dining room, and a conservatory area. Two single bedrooms are situated on the first floor, accessed by stairs or a stair lift. The home has a large garden, which is accessible to residents. The Leys DS0000012843.V281270.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place on a weekday, 31st January 2006, starting at 11.20am and lasting for four hours. Carolyn Shiers, manager of the home, was present during the inspection. The inspector spoke with six residents during the inspection, all of whom gave positive views about the home. Comments made include: ‘The staff are very good’. ‘I feel very comfortable here. I’ve got everything I need.’ The main method of inspection used was ‘case tracking’, which involved selecting three residents and tracking the care they receive through checking records, talking with the residents, looking round the home and observing care practices. At the last inspection, almost all of the key standards were checked. At this inspection, the inspector checked the remaining key standards, and looked at whether action required at the last inspection had been carried out. The following paragraphs relate only to aspects checked or raised with the inspector during this inspection: What the service does well:
Medication administration is mainly carried out well, thereby protecting residents’ welfare. Policies are in place and members of staff have had relevant training. Residents who are able to and wish to can administer their own medication. Good systems are in place to look after residents’ ‘pocket money’, with safeguards in place to ensure that all money spent one behalf of residents is recorded. Residents described to the inspector ways in which they were encouraged to have a good lifestyle, with different activities available for them to join in with. Although a detailed inspection of the premises was not carried out, all areas seen during the inspection were found to be clean and tidy. The Leys DS0000012843.V281270.R01.S.doc Version 5.1 Page 6 What has improved since the last inspection? What they could do better:
There were no aspects from the key standards identified at this inspection for which the home was required to take action to make improvements. Improvements could be made in recording of the administration of prescribed creams. The manager has attempted to remind staff to record this, but staff may benefit from a review of the process relating to administration of creams, to ensure that residents’ wellbeing is safeguarded.
The Leys DS0000012843.V281270.R01.S.doc Version 5.1 Page 7 The manager currently works a number of care shifts in the home, during which she also has to fulfil her managerial responsibilities and complete paperwork. In order that the manager and other staff do not become further stressed by this situation, potentially to the detriment of residents, the owner is strongly urged to consider reducing or stopping the care shifts the manager is asked to do. Members of staff are currently asked to attend training outside their working hours, without pay. In order to recognise the commitment that staff are giving to the home in developing their skills through training, the owner is strongly urged to provide three paid training days per year for members of staff. 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. The Leys DS0000012843.V281270.R01.S.doc Version 5.1 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 The Leys DS0000012843.V281270.R01.S.doc Version 5.1 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): All applicable key standards under this section were checked at the last inspection. EVIDENCE: The Leys DS0000012843.V281270.R01.S.doc Version 5.1 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): 9 Residents’ wellbeing is mainly protected by medication administration systems. EVIDENCE: There are good policies in place in the home relating to the administration of medication for residents. Residents are enabled to administer their own medication if they choose to and are able to, with appropriate risk assessments carried out to ensure their safety. Members of staff have had relevant training and understood the importance of following procedures. There is detailed information in care plans about medication and evidence that reviews of medication are regularly carried out by GPs. Residents spoken with said they were comfortable with the way in which medication was given out, and that they felt safe. There were some gaps noted in the recording of administration of prescribed creams and another medicine not contained in the dispensing box. It is recommended that a review of the processes relating to administration of creams is undertaken, to ensure that residents’ wellbeing is safeguarded.
The Leys DS0000012843.V281270.R01.S.doc Version 5.1 Page 11 The Leys DS0000012843.V281270.R01.S.doc Version 5.1 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): All applicable key standards under this section were checked at the last inspection. EVIDENCE: Although all aspects were checked at the last inspection, residents told the inspector about ways in which they were enabled to continue to have a good lifestyle in the home. One resident talked about taking part in regular bingo sessions, and another showed the inspector a newsletter to which they had contributed an article about their life. The Leys DS0000012843.V281270.R01.S.doc Version 5.1 Page 13 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): All applicable key standards under this section were checked at the last inspection. EVIDENCE: The Leys DS0000012843.V281270.R01.S.doc Version 5.1 Page 14 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): All applicable key standards under this section were checked at the last inspection. EVIDENCE: Although all key standards were checked at the last inspection, the inspector noted that all areas of the home seen at this inspection were clean and tidy. The Leys DS0000012843.V281270.R01.S.doc Version 5.1 Page 15 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, 30 Residents’ welfare is mainly protected by staffing arrangements in the home. EVIDENCE: One recommendation made at the last inspection had not been followed up, and remains an issue. The care manager continues to work care shifts in the home on three afternoons. During this time, however, she also has to fulfil her duties as manager and complete relevant paperwork. This means that the manager and the other member of staff on duty are both stretched and feel under stress. Whilst residents are not at immediate risk from this arrangement, the effect is that less time is able to be spent with residents, participating in activities and stimulation. In order to ensure that residents are not detrimentally affected, it is strongly recommended that the owner consider reducing or stopping the care shifts the manager is asked to do. Any care undertaken by the manager should be in addition to that done by paid care staff on duty. A range of ongoing training opportunities are provided to staff in the home. However, members of staff are currently asked to attend training outside their working hours, without pay. In order to recognise the commitment that staff are giving to the home and to resident, in developing their skills through training, it is strongly recommended that the owner provide three paid training days per year for members of staff.
The Leys DS0000012843.V281270.R01.S.doc Version 5.1 Page 16 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): 35 Residents benefit from safe handling of their finances in the home. EVIDENCE: Good systems are in place to look after residents’ ‘pocket money’, with safeguards in place to ensure that all money spent one behalf of residents is recorded. Residents spoken with said that they felt their money was well looked after, and appropriately spent, and that they felt able to ask for things they needed. Members of staff were aware of the home’s policy not to accept gifts or money from residents (above a nominal amount), in order to safeguard residents who may be vulnerable. The Leys DS0000012843.V281270.R01.S.doc Version 5.1 Page 17 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 X X X X HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X x X X X X X X X STAFFING Standard No Score 27 3 28 X 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X 3 X X X The Leys DS0000012843.V281270.R01.S.doc Version 5.1 Page 18 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 3 Refer to Standard OP9 OP27 OP30 Good Practice Recommendations It is recommended that a review of the processes relating to administration of creams is undertaken, to ensure that residents’ wellbeing is safeguarded. It is strongly recommended that the owner consider reducing or stopping the care shifts the manager is asked to do. It is strongly recommended that the owner provide three paid training days per year for members of staff. The Leys DS0000012843.V281270.R01.S.doc Version 5.1 Page 19 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
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