Care Home: Ruckland Court Care Home

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What the care home does well The acting manager and staff provide the people with conscientious, friendly and affectionate care, which is appreciated by all of those living at the home. The activities organised and provided are varied, suitable and enjoyed by many of the people to keep them occupied and happy living at the home. Visitors feel welcomed and included at all times, as do others in the local community who visit and use the day centre facilities. The staff training is very comprehensive and gives staff the knowledge and ability to care safely and well for the people. The quality assurance undertaken by the acting manager and providers keeps the people and staff informed and involved and makes people feel valued and very much part of the running of the home. What has improved since the last inspection? No requirements or recommendations were set at the last inspection. However, people said that the acting manager has made improvements to the service since she came into the post, which have helped to make their lives more comfortable and enjoyable. What the care home could do better: As at previous inspections of this service, no requirements or recommendations were necessary. The acting manager is meeting, and in some instances exceeding, the National Minimum Standards. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Ruckland Court Care Home Ruckland Avenue Lincoln Lincs LN1 3TP     The quality rating for this care home is:   two star good 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: Vanessa Gent     Date: 3 0 0 4 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 26 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 26 Information about the care home Name of care home: Address: Ruckland Court Care Home Ruckland Avenue Lincoln Lincs LN1 3TP 01522530217 01522513371 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): LACE Housing Limited Name of registered manager (if applicable) Mrs Fay Naylor Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of people who can be accommodated is: 50 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 are within the following categories: Old age, not falling within any other category - Code OP Date of last inspection Brief description of the care home Ruckland Court is a purpose-built care home providing personal care for up to fifty people over 65 years of age, located in a residential area north of the City of Lincoln, easily reached by public transport. It is owned by a charity, LACE Housing. The accommodation consists of thirty-three single flats, containing a bed-cum-sitting room, kitchenette, shower and toilet. A further eleven single flats have a separate bedroom. There are three double flats with similar accommodation to the single flats Care Homes for Older People Page 4 of 26 care home 50 Over 65 50 0 Brief description of the care home with a separate lounge, for married couples or people who choose to share. Each flat has a lockable front door. Newspapers, mail and groceries are delivered directly to each flat. Communally, the home has two lounges and a dining room. Besides the ensuite shower room in each flat, there are three bathrooms, each with a hoist and a toilet. A Day Centre is run on the same premises and people at the home can attend the day centre along with people who live in the community. There is a small shop and hairdressing salon on-site. The home is surrounded by gardens, with a secure, central courtyard area with raised flowerbeds, a fishpond and seating for people to enjoy, weather permitting. There is a car park at the front of the property. The philosophy of care is to help the residents maintain their independence as far as possible by allowing them to make personal choices within their capabilities and their activities of daily living. The weekly fees are between £351 and £486. People pay for their own hairdressing and chiropody, personal items and food for personal consumption. Information about these costs as well as the day-to-day operation of the home, can be found in the statement of purpose and service user guide. These, and a copy of the last inspection report are available to people who live there and for those interested in coming to live at the home. Care Homes for Older People Page 5 of 26 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 quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. An unannounced visit was made to the home as part of our key inspection. It started at 10:45 and lasted five hours. The acting manager completed a self-assessment questionnaire called the Annual Quality Assurance Assessment (AQAA). The information we received from this, as well as that which we hold about the service, was used to plan the visit and produce this report. Care Homes for Older People Page 6 of 26 The main method of inspection we used was called case-tracking. This involved choosing three residents, to check that their health, safety and welfare needs were fully met and that they were supported to maintain their dignity, autonomy and choice. We did this by looking at their personal records, known as care plans, chatting with them, the care staff, any visitors and observing care practices. Our visit to the home focused on whether key standards had been met and how people felt about the service provided. We looked at general house records and staff records and the way care was given to the people. We looked around the home and sampled the lunch meal that was served to and taken by the people who live there. We spoke with the deputy manager, staff on duty and several people in the lounge and their own rooms, including those whose care we were following closely. People talked about their experience of living at the home. Any comments we received are mentioned in the main body of this report. The deputy manager was present throughout our inspection visit. 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 26 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 26 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 enough information for them to decide if they want to live at the home. The initial assessment process helps the care team to know that they can meet each new persons individual needs. Evidence: We saw the statement of purpose and service user guide. They were up-to-date and comprehensive documents. We were told that along with a copy of the latest inspection report, they are given to anyone interested in moving into the home. People told us that they had been given a copy when they showed interest in moving into the home, so that they were confident in their decision about moving in. One person told us they were very nervous about moving into a care home, but that they need not have worried as they are very comfortable and happy and still independent. To me, its not a home but my home. Care Homes for Older People Page 10 of 26 Evidence: The care plans we looked showed that pre-admission assessments were completed with everyone who chose to come to live at the home. People and a relative confirmed that they were visited by the acting manager and asked questions about themselves before they decided to live at the home. The acting manager does not provide an intermediate care service. Care Homes for Older People Page 11 of 26 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. Peoples needs and wishes are met by clear care plans and liaison with healthcare professionals and others. They are looked after with dignity and respect by a caring and thoughtful staff team. Evidence: We looked at the care plans of three people who live at the home. They were all written in the first person to make them more personalised and we were shown that this is currently being developed further. We saw, and people confirmed, that they had an input into creating and reviewing the care plans with the persons designated keyworker, and a relative where this was requested. The acting manager told us, in her self-assessment, that healthcare professionals such as district nurses and tissue viability nurses are called for advice and treatment without delay. People at the home confirmed this. One person said, Theyre really good. If Im poorly, they call the doctor straight away and I get the treatment I need without having to wait. A visitor said they call them if their partner is not well, and Care Homes for Older People Page 12 of 26 Evidence: always chat with them whenever they come to visit, to keep them updated on any changes. We saw that each person had a lockable medicine cabinet in their flat and they were encouraged to look after their own medicines. People told us that they were helped with taking their medicines if they want or need but are encouraged to manage if they prefer. We watched a staff member giving out medications in the afternoon and saw that the process in place helped to keep people safe. We saw that the supplying pharmacist checks the medication practices regularly. Their last report showed that there have been no outstanding issues relating to how they order, store or administer the medications to the residents. The deputy manager told us that staff who administer the medications are all trained; staff and their training certificates confirmed this. People said that the staff were always very respectful and helped them to maintain their dignity at all times. The acting manager, in her self-assessment, said that everyone had a private telephone with its own number in their room if they wanted, that mail was delivered unopened to each persons mailbox and that if the doctor visited, the person was seen in private in their own flat. We saw that there was a friendly, pleasant and easy rapport between staff and the people who live at the home, which indicated that this was normal at the home. A person said, If you need time, theyre there. We couldnt get better. Theyre marvellous. Care Homes for Older People Page 13 of 26 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have varied activities, full autonomy and flexible choice in their lives. The meals provided are nutritious, well-balanced, homemade and appetising. Evidence: People told us and we saw that a wide variety of activities was available throughout the week. People who live at the home can also join in with the activities organised in the day centre. The deputy manager said that they were members of the charity National Provision of Activities for Older People to help them improve further the provision of activities. She also told us that they were waiting to go online with a web-cam so that people could contact their families easily. People told us that visitors are always very welcome. We were unable to speak with visitors as the acting manager had appropriately shut the home to people from outside because of a communal infection. We were told that if visitors come to see people from a distance, they may be able to stay overnight in the guest flat and they can have meals with the person they are visiting, at a separate table. People told us they are always consulted on their choice and wishes for every aspect of Care Homes for Older People Page 14 of 26 Evidence: the home. They have their own meetings which are documented and also run daily coffee mornings where people can discuss issues and have their say in the running of the home. Everyone we spoke with said, The food is marvellous, really good. The acting manager, in her self assessment, said, we source local products whenever possible. The food is excellent, menus varied, choice abundant. For evidence of this, see the comments book, quality surveys and ask at the residents meetings. All the people we spoke with confirmed this. The meal we sampled looked and smelt appetising, was tasty and was made from fresh ingredients. The kitchen staff showed that they care about the food they prepare, that as much as possible is home-made, that most ingredients are fresh produce and that they love cooking and making the dishes from scratch for the people to enjoy. The kitchen staff said and showed they were all happy in their work. After the meal was finished and the catering work done, some of the kitchen staff were working together on a training course they were in the process of completing. Care Homes for Older People Page 15 of 26 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. People feel able to voice any concerns, are taken notice of and are protected by staff who are trained to prevent abuse and who are committed and caring. Evidence: People told us that they have never had any concerns or complaints about the service but if they were not happy with anything, they would go to the acting manager, deputy manager or any of the staff and things would be resolved. People said, Theyre very good here; Ive no complaints. Theres a lovely rapport between the staff and the residents. Theyre very considerate. A good team is everything and theyve got a very good team of staff here. Theyre marvellous. You can ask them anything. They always do their best. The acting manager told us, in her self assessment, that they had received two complaints since the last inspection. She said that both had been appropriately investigated within the required timescale. Neither of the complaints was upheld. No complaints had come to us during that time. Staff told us they have all had training to keep the people safe, to understand about giving people the capacity to make decisions for themselves and about how to prevent anyone being deprived of their liberty. Their staff files confirmed that training in these aspects of care have been undertaken by all of them, and one person we spoke with Care Homes for Older People Page 16 of 26 Evidence: demonstrated the application of their knowledge of this. Care Homes for Older People Page 17 of 26 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 accommodation that is clean, comfortable, private and well-maintained. This makes them feel that they are safe, cared for as they wish and that they are at home. Evidence: People told us that the housekeepers always keep the home spotlessly clean and tidy and that it always smelt pleasant. They said, I love living in my own flat. For me, its not A home; its MY home. Its lovely having your own front door and bathroom. Im very settled and happy here. One person told us that the bleepers do not always work properly and some people are kept waiting a long time. Other people said they do not have to wait long at all. The deputy manager acknowledged that not all the call system buzzers were working properly but that they were working on a new system and that they were waiting for engineers to come to make the system more efficient. The accommodation consists of thirty-three single and three double occupancy flats, all of them with a kitchenette and bathroom, mostly with showers. Eleven of the single and all of the double flats have the sitting room separate to the bedroom. Communally, there are two lounges, one dining room and three extra bathrooms, each Care Homes for Older People Page 18 of 26 Evidence: with a hoist for people who cannot manage to bath in their own bathrooms. Outside, in the centre of the quadrangle that makes up the building, there was an enclosed, secure garden where the residents can sit, weather permitting. It was well maintained and full of colourful flowers and plants and a fishpond. People said they liked the garden and that it was an attractive area. One of the residents tends it himself with pride and enjoyment. There was a large car park in front of the property. The people at the home shared the use of two ambulance-style vehicles with wheelchair access with the day centre so that they can go on trips to places of interest. The Fire Safety Officers report of 17th July 2008 found that everything pertaining to fire safety was satisfactory. Because of the nature of the individual flats, the Environmental Health Officer, on 12th March 2009, assessed only the hygiene of the kitchen and communal areas. The acting manager and staff achieved a five-star award for their food hygiene standards. Care Homes for Older People Page 19 of 26 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. Enough staff are on duty to enable them to give people ample opportunity to engage with them and receive the attention they need. Staff are recruited, inducted and trained well enough to meet the peoples needs and wishes at all time and care for them safely. Evidence: Staff told us, I love working here. Its my second home. I love my job. Theres nothing worse than having to rush but we have enough people on duty to have time to spend with the residents without feeling rushed. We work in teams. Each team has a group of residents for whom we are keyworkers, so we know the clients well. We have bonded together with each other and with the residents. Most people told us they dont have to wait long for call bells to be answered. One person said, Even during the infection outbreak at the home, when the staff were under greater pressure, they still managed to answer the bells without fuss or keeping people waiting long. A recently employed person told us that they were given lots of support when they joined the staff team. They said, A senior always takes any new staff under their wing. Staff files confirmed that all new staff are recruited safely to protect the people Care Homes for Older People Page 20 of 26 Evidence: at all times, with all the information obtained that is required by law. Staff told us, and the acting manager confirmed in her self assessment, that most of them have passed or are taking nationally-recognised qualifications to help them care better and more safely for the people who live at the home. The acting manager showed that she was an equal opportunities employer by employing people who she and the other staff were giving lots of encouragement, to reach their full potential in their work and to help them to take exams to further their knowledge and interest. One of the people said they love their job and are very happy at the home. Staff told us that these people are doing well in their studies and blossoming. The training matrix we saw showed that staff are well supported in their learning to improve their knowledge in caring for the people. Staff said that the training was plentiful and appropriate. Their certificates confirmed this. Staff also spoke knowledgeably about how well they know the people to whom they give care and their needs. The deputy manager told us that some of the staff who have left since the last inspection of the home have gone on to do their nurses training. Care Homes for Older People Page 21 of 26 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 run for the benefit, enjoyment and safety, and in the best interest of the people who live there and the staff. The residents feel safe and enjoy living at the home. Evidence: The acting manager has worked in care for many years and at Ruckland Court since 1993. She is awaiting her interview with us to be registered as the manager and is waiting for the results of the Registered Managers Award that she recently completed. The acting manager showed that she was an equal opportunities employer by employing people who she and the other staff were encouraging to reach their full potential in their work, helping them to take exams to further their knowledge and interest. One of the people said they love their job and are very happy at the home. Staff told us that these people are doing well in their studies and blossoming. Care Homes for Older People Page 22 of 26 Evidence: People told us that the acting manager is very approachable, visiting them and chatting with them to check that they continue to be happy, settled and satisfied with their care. Staff told us that they get on well with the acting manager and that she is very supportive of them at all times. One person said, Fays really good; we are all well-looked after. A staff member said, I never thought I would do as well as I have; the managers given me confidence that I didnt have before and Im achieving things I never thought I was capable of. A person from the company visits the home every month, interviews the people, staff and manager and writes a report of their findings. The acting manager gives out questionnaires and surveys regularly to people who live at the home, visitors and staff, asking for their opinion of how the care is given, how the home is run and how satisfied they are with the service provided. The people have regular Residents meetings and daily coffee mornings, to discuss matters and decide on any changes they would like made. Any monies belonging to individual people that was kept by the acting manager, was kept in separate money envelopes with clear records that we looked at for the people whose care we were following closely. Staff told us that they are gradually getting more regular one-to-one meetings with the acting manager or a senior staff member. This, they said, would help to support them better to improve their ways of working. The acting manager, in her self assessment, said, supervisions happen but are not always documented; improvement needed - under review. Supervision workshop attended by manager and supervisors. We saw that health and safety is taken seriously, both by the reports from the Fire Safety and Environmental Health officer, the maintenance of the home and the measures in place to keep the home safe and hygienic for the people who live there. Some of the people who have visited their relatives whilst they were living at Ruckland Court have written notes of appreciation, some of the comments from which include, Its always difficult for children to place parents in care but I know it was the right thing to do as she has been safe, warm and cared for happily living in her lovely flat. It was a mercy she was not sent into hospital where we are sure the care could not have matched Rucklands. We are sure Ruckland was the best place for her to spend her last months. Care Homes for Older People Page 23 of 26 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 24 of 26 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 25 of 26 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. 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