Care Home: Ingersley Court

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What the care home does well The manager, who has been in post since August 2009, has put procedures in place to deal with issues she has identified as requiring attention so ensuring quality of the service will improve for the people who live in the home. Staff provide support for the people who live in the home in a manner that ensures their privacy and dignity is maintained. We saw that the people living in the home were comfortable with the staff who working with them. The information about how the home works and who it is for, known as the statement of purpose and service user guide, has been updated to reflect the changes to the management of the home and the changes to the contact details for the Care Quality Commission. There are processes in place for when new people wish to come to live at the home. These processes help to make sure that people`s needs are checked before they move in so that staff have enough information to be able to meet those needs once the person moves in to Ingersley Court. Some of the plans of care for the people who live in the home reflect their changing needs and are reviewed to show any changes. Information about the people`s healthcare needs has been updated and shows how these needs are being met by the home. This helps to make sure that people living at Ingersley Court stay as healthy as possible. There is a programme of activities which are appropriate to the age of the people who live in the home and this includes involvement with the local community. People who live in the home are supported to maintain contact with family and friends. There are procedures in place that ensure people can raise concerns and complaints and that their concerns and worries will be listened to and acted upon. The general decor and appearance of the home, both inside and outside, is well maintained so ensuring people live in comfortable and safe surroundings. Improvements to the overall management of the home will make sure that the care needs of the people living there are met in the way they prefer. What has improved since the last inspection? The information we were sent before our visit, which was completed by the previous manager for the home, told us that improvements at the home have been made by changing the care plan format so it is now more person centred with regular reviews involving the person whose plan it is and their relatives. This ensures that they have a say in how their care is to be provided. Other improvements have been that people living at Ingersley Court are involved in recruiting new staff so they can have a say in who will be providing care and support for them.Improvements to the environment in the home have continued with redecoration, replacing carpets and furniture. This helps to keep Ingersley Court comfortable and safe for the people living there. Progress has been made in staff completing their national vocational qualifications (NVQs). These are nationally recognised awards for people working in social care and show that staff are competent to provide good quality care for the people living in the home. What the care home could do better: Plans of care should be available when people move into the home so staff know how their care needs are to be met. Staff training on health and safety issues including protection of vulnerable adults, moving and handling, fire safety must be updated so staff have the skills and knowledge to care for the people who live in the home. Key inspection report Care homes for older people Name: Address: Ingersley Court Lowther Street Off Church Street Bollington Cheshire SK10 5QA     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home 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 full review a ‘key’ inspection. Lead inspector: Val Flannery     Date: 0 4 0 9 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 27 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought 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 The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) 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. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Ingersley Court Lowther Street Off Church Street Bollington Cheshire SK10 5QA 01625574233 01625573196 zena.meyer@clsgroup.org.uk www.clsgroup.org.uk CLS Care Services Limited Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Type of registration: Number of places registered: care home 34 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The registered person may provide the following category 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: Old age, not falling within any other category - Code OP. The maximum number of service users who can be accommodated is: 34. Date of last inspection Brief description of the care home Ingersley Court is a purpose-built care home for older people. It is run by the CLS Group, a not for profit organisation based in Cheshire and Wigan. The home is located in the village of Bollington and within reach of local facilities such as shops, churches and other community amenities. Macclesfield town centre is approximately five miles away. Ingersley Court is a three- storey building (basement, ground and first floor). The Care Homes for Older People Page 4 of 27 Over 65 34 0 Brief description of the care home people who live in the home are accommodated on the ground and first floors only. Access between floors is via a passenger lift or the stairs. There are 33 bedrooms in the home. Nineteen of the bedrooms have en-suite facilities and the remaining bedrooms have wash hand basins fitted. There is generous communal space of 4 lounges, 2 dining rooms and a sitting area in the reception. Ingersley Court has a number of separate toilets and bathrooms. Various aids and adaptations have been provided for the people who live in the home and require support with their mobility. There are a number of flats attached to the home. These are occupied by tenants who sometimes come into the home during the day for a meal or company. Accommodation fees for the home range from £490 to £530 per week, depending on the accommodation provided. Please contact the manager for more information on accomodation fees and other charges. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The overall quality rating for the home is two stars. This means that the people who live in the home experience good quality outcomes. This visit took place on the 4 September 2009. It was carried out by one inspector and took a total of 6 hours. The report will say we when referring to what we did and what we found because it is written on behalf of the Care Quality Commission. During our visit we spoke with the people who live in the home, the manager and staff. We looked around the premises and looked at various records held by the home. The visit was just one part of the inspection. The home manager had completed a questionnaire to provide up to date information about the home. CQC questionnaires were made available to the people who live in the home and to the staff so they could tell us what they think about it. Care Homes for Older People Page 6 of 27 The last inspection of this home was completed on the 7 September 2007. Care Homes for Older People Page 7 of 27 What the care home does well: What has improved since the last inspection? The information we were sent before our visit, which was completed by the previous manager for the home, told us that improvements at the home have been made by changing the care plan format so it is now more person centred with regular reviews involving the person whose plan it is and their relatives. This ensures that they have a say in how their care is to be provided. Other improvements have been that people living at Ingersley Court are involved in recruiting new staff so they can have a say in who will be providing care and support for them. Care Homes for Older People Page 8 of 27 Improvements to the environment in the home have continued with redecoration, replacing carpets and furniture. This helps to keep Ingersley Court comfortable and safe for the people living there. Progress has been made in staff completing their national vocational qualifications (NVQs). These are nationally recognised awards for people working in social care and show that staff are competent to provide good quality care for the people living in the home. What they could do better: 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 on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 9 of 27 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have their needs assessed by staff from the home before they move there, so they know their needs can be met when they move into Ingersley Court. Evidence: CLS Care Services, the organisation that runs the home, has a process and appropriate documents to be used when new people may wish to move into the home. This includes visits to meet new people and to check what their care needs are to see whether these can be met at the home. During our visit we saw the assessment of need for two people who live in the home; these had been carried out by staff from the home before the person moved in to Ingersley Court. We also saw a copy of the assessment of need for one of the people that had been provided by the care manager from Cheshire East Council. Two of the people spoken with said their relatives had visited the home on their behalf and had made a good choice. We saw a copy of Welcome - A Guide for New Residents, which is provided for the people who live in the home and is kept in their bedrooms. The document, which Care Homes for Older People Page 11 of 27 Evidence: includes the information about how the home works, who it is for and its aim, has been updated to show the new contact details for the Care Quality Commission and the qualifications and experience of the new manager. This means that people in the home and those interested in moving in have accurate up to date information about the home. Care Homes for Older People Page 12 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The staff were knowledgeable about the care needs of the people living at the home and knew how to meet them although some of the care plans we saw were still in the process of being completed. Staff were making sure that peoples healthcare needs were being monitored and met to make sure that they were as healthy as possible. Evidence: We looked at the care folders, which included plans of care, for three of the people who live in the home to check how their care needs were being met. Two of the people whose plans we looked at had recently moved into the home and the other person had lived there for some months at the time of our visit. The plans of care for the person who has lived in the home for some time showed how they wished to be supported with personal care by staff. The level of support they needed with tasks such as dressing, using the bathroom and toilet and with their mobility had been recorded. We also saw records to show that the care plan had been reviewed with this person and that the person had signed the record of the review. Care Homes for Older People Page 13 of 27 Evidence: The plans of care for the two people who had recently moved into the home were not fully completed and did not show how they wished to be supported with tasks such as personal care and their mobility. We saw limited information about the support they needed with personal care tasks in their initial care needs assessment and support plan. We were told that care plans are usually completed within three or four days of the person coming to live in the home. The plans of care we saw showed how the healthcare needs of the people were being monitored and the action taken by staff to address any concerns. This included doctors and hospital appointments and contact with other healthcare professionals. One of the people who lives in the home told us that doctors and nurse are always in and out of the home. Another person said they had requested a visit from the doctor and they came within a few hours. We saw the district nurse visiting one of the people who lives in the home. We saw staff give out medications to the people who live there. We were told that none of the people manage their own medication. During our visit we saw the room where the medication is kept, we were told that this room is kept locked when not in use. CLS have provided policies and procedures on the administration of medication. The staff training records seen during the visit showed that staff have received training on the administration of medication to help make sure that they give it safely, without making errors. However, the training records did not show if staff were receiving refresher training on medication awareness. We saw staff support the people who live in the home with personal care tasks, moving about the home and getting ready to go on an outing. The support offered was carried out in a discreet and respectful manner and ensured the privacy and dignity of the person was maintained. For example, we saw staff close the doors to the bathrooms and bedrooms to maintain peoples privacy and saw them encourage the people to be as independent as possible. Care Homes for Older People Page 14 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff are available to support people with their daily routines and with activities so the people living in the home are able to take part in their chosen activities. Evidence: On the day of our visit, we saw a group of people who live in the home being supported by staff to go on a barge trip. We saw a list of activities for September on display in the home as well as a portfolio of local events and places of interest to visit. We saw the large room which is used as an activity room contained lots of board games, a large wide screen television and a computer for use by the people who live in the home. We spoke with the people who live in the home and they told us there is always something going on. They told us that the activities coordinator is very good at arranging things. We saw a number of relatives visiting the home and people who live there told us that their families and friends can visit as they wish. One person told us that their relatives visit every day as they do not live far away. We were also told by people who live there that Ingersley Court is well known in Bollington and that it is the only place they would live. Care Homes for Older People Page 15 of 27 Evidence: On the day of our visit there was a relief cook in the kitchen as the regular cook was off work. The mealtime we saw was relaxed and unrushed and staff were seen supporting people with their meal. One person we spoke with said the food was good most of the time. They told us that they are offered choices at meal times and one person said they can choose to have their meals in their bedrooms. We were told that people with special diets, for example, people with diabetes are catered for. Care Homes for Older People Page 16 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are clear complaints policies and procedures for raising concerns so the people living at Ingersley Court can be confident their concerns will be listened to and acted upon. Arrangements have been made for staff to receive updated training about safeguarding adults so they know what to do to protect the people living at the home from abuse and harm. Evidence: We saw the record of complaints received by the home during our visit. There was one complaint recorded where one member of staff had made a complaint about another staff member. The issues raised were managed under Staffing Policies and Procedures. We saw a copy of the folder Welcome - a guide for residents, a copy of which is kept in the bedrooms of the people who live in the home. Included in the folder is the complaints procedure which has been updated to show the new contact details for the Care Quality Commission. The people we spoke with during our visit said they would talk to staff if they had any worries or concerns. The manager for the home, who had been in post since the beginning of August 2009, told us that staff training is not up to date. We saw the staff training records which included information about staff training about safeguarding adults. This showed that a number of staff require updated training and that the manager had arranged for this Care Homes for Older People Page 17 of 27 Evidence: to be completed by 2 October 2009 for 14 members of staff. Staff told us during our visit that they have not received a lot training during the last few years but the current manager had arranged for them to update their training on safeguarding adults and other areas. Care Homes for Older People Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Ingersley Court is well maintained which means that the people living there do so in comfortable, safe surroundings that are suitable for their needs. Evidence: Ingersley Court is in a quiet area in the village of Bollington which is approximately three miles from the town of Macclesfield. It is within walking distance of shops, public house, church and other local facilities. During our visit we looked around the home including bedrooms and communal areas. The home was clean, tidy and there were no bad odours. All the bedrooms are single and contain hand-washing facilities. In addition a number of bedrooms have en suite toilets. There are sufficient shared toilets and bathing facilities to meet the needs of the people who live in the home. We saw three bedrooms during our visit; these were clean, warm and well decorated and contained personal possessions of the person occupying the room. We spoke with people who live in the home who told us that they are happy with the bedrooms and that they are kept clean and tidy by the cleaners. We saw lifting aids for people with mobility problems which included bath and toilet aids, grab rails and wheelchairs. The laundry is located in the basement of the home so soiled clothing and bedding does not have to be transferred through food Care Homes for Older People Page 19 of 27 Evidence: preparation areas. This helps to make sure that infection is not spread through the home. There are areas to the front and rear of the home where the people who live there can sit out. This includes a balcony area which is located on the first floor. Care Homes for Older People Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Although over half the staff have achieved a nationally recognised qualification in care they have not received up to date training on health and safety matters so may not be able to provide the safe and appropriate support that people who live in the home need. Evidence: During our visit to Ingersley Court we saw staff talking with and supporting the people who live in the home with personal care, eating and drinking and moving about the home. We saw the people living in the home communicate with staff and they were relaxed in their company. We spoke with the people who live in the home who told us that staff were kind and caring and that they are looked after very well. The staffing rota we saw showed that there is normally one care team leader and three care assistants on duty during the day/afternoon/evening and one care team leader and one care assistant on waking night duty. In addition there are domestic and kitchen staff, the activity coordinator, maintenance assistant and office staff on duty during the day. The staff training list we saw during the inspection, which had been compiled by the previous manager, showed that staff training on safeguarding adults, moving and handling and fire safety is not up to date. We saw a record of ten training sessions for Care Homes for Older People Page 21 of 27 Evidence: staff covering safeguarding adults, moving and handling, fire safety and infection control that the current manager has arranged for September, October and November. Staff we spoke with during our visit told us that they had not received much training and supervision over the last year or so. They thought that things have improved since the current manager arrived. We saw one member of staff going into a supervision session with the manager. The information we were sent before our visit to the home to provide us with up to date information about the home, showed that ten staff at the home have achieved a national vocational qualification (NVQ) at level 2 or above. The NVQ is a nationally recognised qualification for staff working in the field of care and shows they are competent to provide good quality care and support for the people living at the home. Care Homes for Older People Page 22 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff are supervised and the home is managed to make sure that the health, safety and wellbeing of the people living at Ingersley Court is being maintained. Evidence: The manager for the home has been in post since August 2009. She has worked for CLS Care Services since 1991 and has seventeen years experience of managing care homes for older people. She has an NVQ Level 4 and the Registered Managers Award and is also a manual handling instructor. She has undertaken training in order to update her knowledge and skills in managing a care home for older people. The manager had identified that a number of issues, for example, staff training were not up to date and has taken action to deal with these issues. We spoke with staff who said the manager has started to make improvements in staff training and supervision to provide them with the skills to do their jobs. They also said she is approachable and offers them support and advice on care and staff related issues. We saw records to show that fire safety checks are carried out including weekly Care Homes for Older People Page 23 of 27 Evidence: checks on the fire alarm system, monthly checks on the emergency lights and a certificate of maintenance on the fire alarm system. We also saw a fire risk assessment for the home, service records for the hoists, lift service certificate and a record of tests carried out on portable appliances. These checks all show that the home is a safe place for people to live and work. Care Homes for Older People Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R 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, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 27 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, Care Homes 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 1 7 The plans of care that show how the care needs of the people who are moving into the home are to be met should be completed before they arrive so staff have the information they need to provide appropriate care. Procedures should be in place to ensure staff receive regular refresher training on safeguarding adults from abuse and harm so they will have up to date knowledge about how to protect the people who live at Ingersley Court. 2 18 Care Homes for Older People Page 26 of 27 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. 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