Inspection on 28/12/05 for The Limes Rest Homes

This inspection was carried out on 28th December 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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

The Limes Rest Homes 25/09/08

The Limes Rest Homes 14/07/06

The Limes Rest Homes 22/08/05

The Limes Rest Homes 20/01/05

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

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

CARE HOMES FOR OLDER PEOPLE The Limes Rest Homes 75-79 Cartland Road Stirchley Birmingham West Midlands B30 2SD Lead Inspector Kulwant Ghuman Unannounced Inspection 28th December 2005 10:00 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 Limes Rest Homes DS0000062017.V275089.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 Limes Rest Homes DS0000062017.V275089.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service The Limes Rest Homes Address 75-79 Cartland Road Stirchley Birmingham West Midlands B30 2SD 0121 443 1789 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) First Care Services Ltd Miss Eileen Isobell Murphy Care Home 28 Category(ies) of Dementia - over 65 years of age (28), Old age, registration, with number not falling within any other category (28) of places The Limes Rest Homes DS0000062017.V275089.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. That the registration category is 28 older people with dementia (OP). That a washing machine with a sluice cycle is made available in the home within 12 months or when one of the existing machines needs replacing, which ever is earlier. That a commode pot washer/disinfector is installed at the same time as the sluice cycle washing machine. Ramped access to the patio area is provided from the lounge and dining room by April 2005. The patio area near the laundry needs to be risk assessed and made safer for service users by April 2005. All service users will be supplied with lockable piece of furniture within six months of change of registration. The fluorescent strip lighting in the corridors to be replaced with lighting more domestic in style by August 2005. Orientation signage appropriate to the needs of the service users to be in place by March 2005. An additional socket and light switch to be provided in room 23 by 31st November 2004. All service users to be provided with furniture as detailed in the National Minimum Standards for Older People by June 2005. The home must adhere to a laundry policy which ensures that soiled laundry is not transported through the dining area when meals are served or consumed. All radiators to be risk assessed and guarded or replaced with LST radiators where guarding is not appropriate by 1st December 2004. That Eileen Murphy successfully undertakes the Registered Managers Award or equivalent by April 2005. The home can provide care for two named people under 65 years of age for reasons of dementia and 1 named person under 65 years for reasons of physical disability. The Limes Rest Homes DS0000062017.V275089.R01.S.doc Version 5.1 Page 5 Date of last inspection 22nd August 2005 Brief Description of the Service: The Limes is a care home providing personal care and accommodation for 28 people who are elderly and physically dependent due to old age. It is a private home owned by First Care Services Ltd. The home is situated in Cartland Road, Stirchley, Birmingham and is close to local amenities. The Limes is situated on a busy bus route but it is set behind a small front garden. It consists of three two-storey adjoining houses that have gradually been incorporated over the years. There are several lounges including one for smoking, a separate dining room and an attractive rear garden with patio, lawn and flower beds which provides an additional facility for residents to enjoy during the summer months. There is a large car park to the rear of the building. There are twenty single and four twin-bedded rooms. Some bedrooms have en-suite facilities and there are assisted bathing facilities in the home. There is a passenger lift and a stair lift. On the ground floor there is the kitchen where meals are prepared and a laundry. The Limes Rest Homes DS0000062017.V275089.R01.S.doc Version 5.1 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. One inspector carried out this unannounced inspection during part of a day during December 2005. This was the second statutory visit for the home for 2005/2006. To get a full overview of the home this report should be read in conjunction with the report of August 2005. During the inspection a partial tour of the home was carried out, some documents were sampled two of the 26 residents in the home were spoken with. The residents appeared to be well cared for. What the service does well: What has improved since the last inspection? There continued to be good investment in the home with one of the lounges being gutted, redecorated, re-carpeted and new furniture having been brought. The other lounges had also been redecorated. The laundry area had been re-organised, a sluice cycle washing machine had been installed and the laundry floor re-laid. The re-organisation of the laundry area and hair dressing facility meant that the two functions were separated and the hair dressing facility was in the process of being decorated with appropriate posters. The Limes Rest Homes DS0000062017.V275089.R01.S.doc Version 5.1 Page 7 A commode pot washer had been installed in the home. Some of the residents’ bedrooms had been redecorated with new beds and new carpets. 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. The Limes Rest Homes DS0000062017.V275089.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 Limes Rest Homes DS0000062017.V275089.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): 1,2,3,5 There was information available for prospective residents about the facilities and services in the home enabling an informed decision about admission to be made. Residents were assessed prior to admission to the home and a contract was completed at the point of admission to the home. EVIDENCE: The home had updated the statement of purpose to ensure that the language used in it was easily understood. One resident file was sampled in depth at this inspection and it included a terms and conditions of residence at the home that had been completed at the point of admission to the home. An assessment of the resident had been carried out by the home prior to admission to the home and there was evidence that a visit had been made to the home by the resident before moving in. The Limes Rest Homes DS0000062017.V275089.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): Residents care needs were being assessed and information provided for the staff enabling them to meet the needs of the residents. EVIDENCE: The daily living summary contained some very good evidence of the needs, likes and dislikes of the resident. There was lots of information available in the assessments carried out by the home indicating risks such as nutrition, tissue viability and falls. The manager needed to ensure that where a risk had been identified by these assessments there was a strategy in place on how to manage the risks. This information then needed to be transferred to the daily living summary to ensure that all risk assessments were cross-referenced to the care plans. There was evidence that the home was reviewing the care plans on a regular basis. The home needed to ensure that the documentation evidenced where residents or their representatives had been involved in drawing up the care plans or reviews undertaken regarding the care provided at the home. The Limes Rest Homes DS0000062017.V275089.R01.S.doc Version 5.1 Page 11 The health care needs of the residents were being met by the home. The input residents received from the GP, district nurses, optician, dentist and chiropodist evidenced this. The manager needed to ensure that staff were consistent in meeting the needs of the residents. Examination of the daily notes of one resident showed that although it had been identified that dentures needed to be removed at night this was not always happening. During discussions with the manager it was noted that some residents were having to pay for taxis to travel to hospital appointments because it was not possible to book hospital transport for appointments before 9am or because of difficulties the home was experiencing in making contact with the hospital transport sections. The home was advised to write to the appropriate authorities to raise the problems being experienced as it was not appropriate that residents pay to attend appointments. The medication practices were not assessed during this inspection however it was noted that the manager was carrying out regular audits and any discrepancies were being raised with the staff on an individual basis and at staff meetings. Accidents were being recorded as required and a monthly audit of unexplained bruises was being undertaken by the manager to look for any trends or explanations for the bruises. Staff were seen to observe residents privacy by knocking on bedroom doors, ensuring residents had keys to bedroom doors where no risk was identified and that staff enabled residents to bathe unassisted after ensuring that the water temperatures were safe. The Limes Rest Homes DS0000062017.V275089.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): 12,13,14 There were no rigid rules or routines in the home and residents could spend their time as they chose. There were some organised activities for those residents who wished to take part. Residents were enabled to exercise choice and control over their lives. EVIDENCE: There were no rigid rules or routines in evidence at the home. Residents’ preferences for going to bed and getting up in the morning were documented. Residents were observed to be able to sit in a variety of communal spaces or remain in their bedrooms if preferred. Bedroom doors were alarmed to alert staff to bedroom doors being opened at night time and during the day if any of the residents were wandering into other people’s bedrooms. At the time of the inspection there was one visitor to the home. Relatives had been invited to join the residents at the home’s Christmas party. There were visits from the local churches and church services were held in the home. There were a variety of activities in the home including exercise to music, reminiscence, videos and card games. Residents were taken out to the local The Limes Rest Homes DS0000062017.V275089.R01.S.doc Version 5.1 Page 13 shops if they wished and some residents had been to Weston-super-Mare for the day during the summer. Residents were enabled to make choices regarding when they got up, went to bed, where they sat and whether they had visitors. Residents were given a choice of bath or shower and the amount of assistance with personal care that they wanted. The Limes Rest Homes DS0000062017.V275089.R01.S.doc Version 5.1 Page 14 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): 16,18 There were appropriate complaint and adult protection procedures in the home to inform staff and residents what actions needed to be taken if any issues arose in the home. EVIDENCE: There had been no complaints made to the home since the last inspection and no complaints had been lodged with the CSCI regarding the home. There was a suitable complaints procedure available in the home. There had been no issues of adult protection raised regarding the home. There were adult protection, whistle blowing and restraint procedures in the home. The most up to date multi-agency guidelines on adult protection were accessible in the home. Some staff had undertaken adult protection training and others were planning to attend in the following year. The recruitment procedures in the home safeguarded the residents by ensuring that only suitable individuals were appointed in the home. The Limes Rest Homes DS0000062017.V275089.R01.S.doc Version 5.1 Page 15 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): 19,20,21,23,24,25,26 Recent investment had significantly improved the appearance of this home creating a comfortable and safe environment for those living there. Residents were able to exercise choice in where they spent their time as all areas of the home and garden were accessible to them. EVIDENCE: The home was found to be homely and comfortable and several areas of the home had been redecorated. There was a maintenance programme in place for continued decoration and improvement of the facilities in the home. There were two lounges, one of which had been completely refurbished, a smoking area, dining room and foyer area where residents were able to sit quietly or watch television. There were adequate numbers of bathing and toilet facilities throughout the home. All had been fitted with appropriate privacy locks. The Limes Rest Homes DS0000062017.V275089.R01.S.doc Version 5.1 Page 16 There was a passenger lift and stair lift available in the home. There were other adaptations available in the home including a call system, two mobile hoists, assisted bathing facilities and grab rails in toilets. Not all bedrooms were inspected during this inspection but the five bedrooms seen were clean and comfortable. The owners were replacing beds and carpets as required. The manager had undertaken an audit of bedroom furniture and lockable cabinets had been bought for bedrooms that needed one. Not all bedrooms had two chairs and a table although these were available if required. The home was centrally heated and all radiators had been guarded. At the time of the inspection some areas of the home were found to be cold. Some radiators had been turned down or off, but in other areas the radiators were cold. The owner agreed that this would be attended to the following day and in the interim additional heaters would be used to heat up bedrooms that felt cool and additional bedding would be provided for residents that required it. There was an odour control issue in one of the bedrooms however, the home was due to change the carpet within the next few days. In general, the odour control in the home was well managed and the home was maintained to a good level of cleanliness. The Limes Rest Homes DS0000062017.V275089.R01.S.doc Version 5.1 Page 17 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): 27,28,29,30 Staffing levels and competencies were such that the needs of the residents could be safely met. The recruitment procedures were good and safeguarded the residents. EVIDENCE: Examination of the rotas showed that there were 4 care staff on duty during the day in addition to the manager or deputy manager. In addition to the care staff there were dedicated catering, cleaning and laundry staff on duty each day. There was a mix of genders in the staff group reflecting the resident group. There was also a mix of different age groups in the staff team. Two staff files were sampled on this occasion. Both these files contained the information required to ensure that only suitable individuals were appointed to work at the home except one could not evidence that a POVA check had been undertaken before the individual was employed although there was evidence on file to show that it was being processed by the umbrella body. The majority of staff had achieved NVQ level 2 (although some were awaiting certificates) and some staff were undertaking NVQ level 3. Staff were undertaking mandatory training as required. Staff were undertaking an induction programme however, the home was advised to access the induction programme form the Skills for Care website to ensure that all areas required were covered during the induction period. The Limes Rest Homes DS0000062017.V275089.R01.S.doc Version 5.1 Page 18 The work books needed to be completed and kept as a record of the staff training and achievement of basic level skills. The home had developed a training matrix as a tool to enable them to track the training undertaken by staff and training that was required. The Limes Rest Homes DS0000062017.V275089.R01.S.doc Version 5.1 Page 19 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): 31,32,33,35,36 The home is operated in the best interests of residents and the manager ensured the smooth running of the home in a competent manner. EVIDENCE: The service provided by the home continued to improve under the leadership of the current management team and proprietors who worked well as a team. The manager had completed her NVQ level 4 and RMA but was awaiting the certificate. The homes’ documentation was well organised and easy to access. The home was run with the residents needs in mind and the ethos in the home was one of openness and inclusiveness. Examination of the records of expenses undertaken on behalf of residents by the home showed that there was good management with receipts being The Limes Rest Homes DS0000062017.V275089.R01.S.doc Version 5.1 Page 20 numbered and two signatures for all expenditures. There was a record of all items in safe keeping. The staff had recently started to fund raise for residents and records were set being set up at the time of the inspection. The home had a quality assurance that was externally verified and scored well in most areas. Staff were being supervised and was on track to achieve a minimum of 6 sessions a year. The Limes Rest Homes DS0000062017.V275089.R01.S.doc Version 5.1 Page 21 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 3 3 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 3 3 2 2 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 2 X X The Limes Rest Homes DS0000062017.V275089.R01.S.doc Version 5.1 Page 22 Are there any outstanding requirements from the last inspection? Yes 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 OP3 Regulation 14(1)(a)& (b) Requirement Timescale for action 01/02/06 2. OP7 13(1)(c) The registered manager must ensure that residents have been assessed by a suitably qualified or trained person and the home obtains a copy of the assessment before admitting the resident. (Previous timescale given 01/10/05. Compliance not assessed at this visit.) The registered person must 01/02/06 ensure that service user risk assessment indicate all risks and strategies for managing them. (Previous timescale of 01/04/05 and 01/11/05 not met.) The strategies for managing the risks must be cross referenced to the care plan. The registered person must 01/02/05 ensure that the resident or their representative is involved in formulating the care plans. The registered person must 01/02/05 ensure that the staff follow instructions given to meet the needs of the residents. Adequate curtains must be in 01/02/06 place in the showers. (Previous DS0000062017.V275089.R01.S.doc Version 5.1 3. OP7 15(1) & 15(2)(c) 12(1)(a) 4. OP7 5. OP10 12(4)(a) The Limes Rest Homes Page 23 6. OP15 7. OP22 8. OP25 9. OP26 10. OP29 11. OP30 timescale given 01/10/05. Compliance not assessed at this visit.) 17(2)Sch4 Choices must be introduced into (13) the menus at lunchtimes. (Previous timescale given 01/11/05. Compliance not assessed at this visit.) 23(2)(n) The registered manager must ensure that all call points are accessible to staff and residents in the case of an emergency. (Previous timescale given 01/11/05. Compliance not assessed at this visit.) 23(2)(p) The registered person must ensure that all areas of the home are maintained at an adequate level of heating. 13(3) The registered manager must ensure that the food in the freezers is dated. (Previous timescale given 01/11/05. Compliance not assessed at this visit.) 19 The registered manager must Sch 2(4) ensure that all proof of recruitment checks is safely stored on the files. 18(1)(a) The registered person must ensure that the induction programme covers all the areas set down by Skills for Care. 01/02/06 01/02/06 29/12/05 01/02/06 01/02/06 01/03/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations The Limes Rest Homes DS0000062017.V275089.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Birmingham Office 1st Floor Ladywood House 45-46 Stephenson Street Birmingham B2 4UZ 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 The Limes Rest Homes DS0000062017.V275089.R01.S.doc Version 5.1 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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