Care Home: Neale Court

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What the care home does well The home is in a quiet part of North Hykeham, providing peace and quiet for the residents while being close to facilities. Each flat has kitchen and en-suite facilities to help people lead an independent lifestyle with privacy and dignity. Two visitors commented upon this as their reason for choosing the home. Care plans have a lot of information for staff to read and be able to care for service users. People are cared for in a clean and comfortable environment and the home is decorated to a good standard. All people spoken with made positive comments about the care they received; one survey form mentioned that the staff group was well trained and knowledgeable about the people living at the home and how they prefer to be cared for. Staff work hard to give people and their families activities, including shows and dinner parties and these are much appreciated. There is a very stable staff group, enabling good knowledge of individual needs. People are encouraged to make choices about their daily lifestyles and individual likes and dislikes are catered for. What has improved since the last inspection? Care plans are now in more detail and contain more information to enable staff to meet the needs of people. The home now has a training record and plan. There is a procedure for people wishing to self-medicate. Recruitment procedures have been reviewed. What the care home could do better: On the day of the inspection no requirements or recommendations were identified. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Neale Court Neale Road North Hykeham Lincs LN6 9UA     The quality rating for this care home is:   three star excellent service 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 assessment of the service. We call this a ‘key’ inspection. Lead inspector: Julie Western     Date: 2 1 0 5 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. 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 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 25 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI 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 25 Information about the care home Name of care home: Address: Neale Court Neale Road North Hykeham Lincs LN6 9UA 01522682201 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) : LACE Housing Limited care home 23 Number of places (if applicable): Under 65 Over 65 23 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home 0 Neale Court is a care home providing personal care and accommodation for up to twenty-three older people. The home is owned and operated by LACE Housing Ltd, which is a voluntary organisation. The home also has a day centre facility attached to it, which is operated by the North Hykeham Day Centre group. Residents at the home are able to attend the day centre if they choose to and the home provides the mid-day meals. The home is located in a quiet cul-de-sac in a residential area of North Hykeham. There are local shops and community facilities close by. Neale Court was registered in nineteen ninety-three and is a purpose built two story building. The accommodation comprises of a communal lounge area, a sunroom, communal dining room and two assisted bathrooms. All of the private accommodation consists of self-contained bed-sits, which comprise of a kitchenette, en-suite bath or shower room with toilet. The home has a lift, which serves both floors of the home. Care Homes for Older People Page 4 of 25 Brief description of the care home The home is set in well-maintained secure gardens. There is open parking for fifteen cars at the front of the home. A copy of the homes statement of purpose is available to all prospective residents when they visit the home for the first time. The Care Quality Commissions last report is also available on the notice board in the entrance. The homes current weekly fees are £378 to £425. Care Homes for Older People Page 5 of 25 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: three star excellent 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: This was an unannounced visit and it formed part of a key inspection, focusing on key standards, which have the potential to affect the health, safety and welfare of people who use the service. Throughout this report the terms we and us refer to The Care Quality Commission [CQC]. The visit lasted approximately three hours and we took into account previous information held by us including the previous inspection report, their service history and records of any incidents that we had been notified of since the last inspection. Before we made our visit the provider had returned the Annual Quality Assurance Assessment (AQAA). This gave us information about their own assessment of how well they are meeting standards and their plans to improve aspects of the service. We sent Care Homes for Older People Page 6 of 25 out surveys to people before we visited the service. The main method used to carry out the inspection is called case tracking. This includes following the care of a sample of four people through their records and assessing their care. We spoke to two people who use the service and saw rooms of those people who said we could and to one staff member. The manager and deputy manager were present throughout the visit and the general outcomes of the visit were discussed with them. What the care home does well: What has improved since the last inspection? 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 set out 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 8 of 25 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 9 of 25 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use this service have good information about the home in order to make an informed decision about whether the service is right for them. The home does not provide intermediate care. Evidence: The deputy manager confirmed that she or the manager always visited prospective residents at home or in a care setting such as a hospital to undertake a thorough assessment of all their care needs. Records we saw confirmed this. We saw written admission documentation that was comprehensive and clear, giving staff the information they needed to meet the needs of people. The statement of purpose we saw was very comprehensive and contained terms and conditions and contracts. The service user guide we saw was comprehensive and contained useful information for the service user. It was in large print. Care Homes for Older People Page 10 of 25 Evidence: A resident we spoke with described how he had visited for the day before he was sure he wanted to move in permanently. A relative told us that this home had been chosen because it was the best of the ones we saw. A staff member described the admission process and the importance of making new residents and their families welcomed. Care Homes for Older People Page 11 of 25 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans are very detailed, ensuring that the care needs of people can be met. Staff treat people they care for with respect for their dignity and privacy. Evidence: Care plans we saw were well indexed and contained good information about the health and personal care needs of people. They contained clear risk assessments and mental capacity assessments and were completed with people and their families present. They were reviewed regularly and signed where possible by people or their relatives or advocates. There is also a check-it system whereby carers monitor and record nightly checks, which are printed out and analysed the following morning. We saw a medication policy that was clear and comprehensive. The pharmacist visited regularly, the last visit being on 25/03/2009 and no issues were identified. People received regular visits from district nurses, Macmillan nurses, CPNs and other agencies involved with their care. Two visiting care professionals said the standard of care was high and the staff were knowledgeable about people. Staff were quick to address any issues relating to health. Care Homes for Older People Page 12 of 25 Evidence: We saw staff carrying out their duties with kindness and sensitivity towards people, especially when attending to their personal needs. People live in separate flats with their own doorbells, which staff ring before they enter and mail is delivered directly to their flats. Comments from residents included I still have my independence and They will only attend when needed but otherwise I lead my own life. Care Homes for Older People Page 13 of 25 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. Social activities are regular and are tailored to suit the needs of individual residents. People have a choice of meals from a balanced and varied menu. Evidence: A previous inspection found that the home has an activities programme organised by a staff member, with all other staff assisting. This programme is displayed on a notice board near the entrance and is also in the service user guides in each flat. The preinspection questionnaire showed that activities take place in the home and outings are also undertaken. There is a variety of activities for residents including entertainers, indoor games such as board and card games and trips to local garden centres, pubs and shops. On the day of the inspection there was a memory discussion about schooldays in the main lounge. People we spoke with all said they had a choice of whether or not to take part. Some told us they preferred to sit in a quiet lounge instead. One resident, who is a Jehovahs witness, attended sessions two or three times a week. People we spoke with all said they enjoyed the meals served and were seen enjoying the mid-day meal. Comments about the food included lovely, gorgeous, meat beautifully tender and wonderful. One said that if they wanted a change from the main meal they were always offered something else. The menu for Care Homes for Older People Page 14 of 25 Evidence: the week was displayed on the notice board and offered alternative choices of meals. A cook was seen in the morning asking each resident for their choice of main meal. Of the three cooks, two have National Vocational qualifications at level two and one at level three. The cook on duty on the day of the inspection was knowledgeable about the nutritional needs of service users and described cooking for people on various diets. The kitchen also provides meals for the day centre attached to the home. One of the cooks organises dinner parties for residents and their families twice a year and these are very popular; one relative said Its lovely to eat as a family. Care Homes for Older People Page 15 of 25 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. The procedures for addressing complaints and for protection from abuse are clear. People and their families are confident that their comments and concerns will be listened to. Evidence: People spoken with said they did not wish to complain but knew how to make a complaint. The home had an up to date copy of the Local Authority adult protection procedures and staff members said they had read it. The training programme showed that there was a rolling training course for staff on POVA and safeguarding adults. Staff members spoken with knew what to do in the event of a serious concern.The manager said that residents and their families were regularly asked for their views regarding the running of the home.Visitors spoken with said that they were given information on how to make complaints. Since the last inspection there had been no complaints. Staff spoken with confirmed that they had received training in safeguarding adults. Care Homes for Older People Page 16 of 25 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. People live in a comfortable and pleasant environment with both private and communal space that is suitable for their needs. Evidence: Overall, the standard of decoration internal was good and afforded residents a great degree of comfort. The garden was well maintained and offered a pleasant place for people to sit out in good weather. Staff described how any maintenance issues were addressed quickly by the maintenance personnel, who were based at the head office in Lincoln. Recent improvements have included the decoration of the entrance hall, communal lounge, dining room and conservatory including new carpets, and the redecoration of some residents rooms including carpets. There were safety notices around the building to prevent the spread of infection and COSHH regulations were observed throughout. The most recent visit from the Environmental Health Officer found no issues of concern and the service had been awarded five stars, the maximum for the EHO awards scheme. The building smelled clean and fresh throughout. People we spoke with said they enjoyed being independent in their own flats and one said The best bit for me is that Care Homes for Older People Page 17 of 25 Evidence: you dont have to sit in that lounge!. Care Homes for Older People Page 18 of 25 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff numbers are in sufficient quantity for them to be able to care for people. Staff members are suitably trained, qualified and competent. Evidence: The daily staff rota showed that there was a minimum of 3 staff at all times for 24 people. In addition there was the manager, administrator, cook, assistant, two domestics and a full time gardener. One resident said theyre all kind and patient, even when theyre busy they still have time for a word with us The manager said that four members of staff have recently achieved the National Vocational Qualification, a recognised qualification, at Level 3, with three staff members working towards Level 3 and two working towards Level 4. The most recent staff member to be employed described how she had an interview, gave three references and underwent CRB/POVA checks. She was still undertaking the induction course, which is the nationally recognised Skills For Care course. Staff records confirmed this. Staff training records demonstrated that statutory training has been undertaken and that staff received regular supervision. There were minutes of regular staff meetings. We saw records that showed very little staff turnover and staff spoken with confirmed this. Care Homes for Older People Page 19 of 25 Care Homes for Older People Page 20 of 25 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. The home is well managed and the health, safety and welfare of people are promoted. The views of people are listened to and they are involved in decisions affecting them. Evidence: The manager has been in post for 12 years and has worked in the care profession for over 40, working for the L.C.C.E organisation for 15 of these. She is a registered nurse and has the NVQ Level 4 Diploma and the Registered Managers Award. People we spoke with all made positive comments about the way the manager ran the home, finding her approachable and supportive. One resident said She always finds time to speak to you. The policies and procedures manual is entitled Cared 4 and contains good, up to date information for staff. There is a sound quality assurance procedure and the findings of the returned surveys are discussed with the regional manager, who visits regularly, and then acted upon. Health and safety policies were well documented and showed a clear commitment to ensuring the wellbeing of people. We saw policies and procedures Care Homes for Older People Page 21 of 25 Evidence: relating to fire safety and these showed that fire alarms, drills and regular checks have been undertaken. The homes pre-inspection questionnaire showed that maintenance and service histories of all aids and adaptations are carried out regularly. Care Homes for Older People Page 22 of 25 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 23 of 25 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 Care Homes for Older People Page 24 of 25 Helpline: Telephone: 03000 616161 or Textphone: or 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) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 25 of 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. 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!