Inspection on 27/07/09 for Hylands The

This is the latest available inspection report for this service, carried out on 27th July 2009.

CQC found this care home to be providing an Good service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Hylands The 29/01/07

Hylands The 09/02/06

Hylands The 21/09/05

Hylands The 08/12/04

Hylands The 08/07/04

Similar services:

Abbey The

Snydale Care Home

Hawkhills

Larchfield Manor

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 16/02/2010.

Key inspection report CARE HOMES FOR OLDER PEOPLE Hylands The The Crescent Filey North Yorkshire YO14 9JR Lead Inspector Pauline O`Rourke Key Unannounced Inspection 27th July 2009 10:00 DS0000007742.V376700.R01.S.do c Version 5.2 Page 1 This report is a review of the 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. 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. Hylands The DS0000007742.V376700.R01.S.doc Version 5.2 Page 2 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 Hylands The DS0000007742.V376700.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hylands The Address The Crescent Filey North Yorkshire YO14 9JR Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01723 515213 01723 516279 info@hylands.co.uk Mr Anthony Rhoden Mrs Diane-Marie Rhoden Mrs Diane-Marie Rhoden Care Home 46 Category(ies) of Old age, not falling within any other category registration, with number (46) of places Hylands The DS0000007742.V376700.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 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: 46. 25th March 2009 2. Date of last inspection Brief Description of the Service: The Hylands is a large former hotel occupying a prominent and elevated position overlooking the seafront of the town. It has been adapted to provide accommodation and care for a maximum of 46 older people. The home provides single and shared accommodation, many rooms having ensuite facilities. There is a passenger lift to each floor. Staffing cover is provided 24 hours a day. Leisure and recreational facilities are offered in the home, and people can also make use of the facilities in Filey itself. The Hylands is owned by Mr and Mrs Rhoden and managed by Mrs Rhoden. Hylands The DS0000007742.V376700.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is two star – good service. This means the people who use this service experience good quality outcomes The Care Quality Commission inspects homes at a frequency determined by how the home has been risk assessed. The inspection process has now become a cycle of activity rather than a series of one-off events. Information is gathered from a variety of sources, one being a site visit. More information about the inspection process can be found on our website www.cqc.org.uk We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations - but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. The key inspection has used information from different sources to provide evidence for this report. These sources include: · · Reviewing information that has been received about the home since the last inspection. A random inspection carried out by two inspectors on the 4th June 2009. A visit to the home by one inspector that lasted for five hours. During the visit to the home twelve people who live there, two staff and one health professional were spoken with. Care records relating to four people, six staff members and the management activities of the home were inspected. Care practices were observed, where appropriate, and time was also spent watching the general activity within the home. This enabled the inspector to gain an insight of what life is like at The Hylands for the people living there. Information about the Hylands is provided in a Statement of Purpose and a Service User Guide. A copy of the last inspection report is also available on request. The weekly fee is £355 and does not include items such as personal toiletries, hairdressing, newspapers and chiropody. This information was provided on the 27th July 2009. The Registered Manager was available for feedback at the close of the visit. Hylands The DS0000007742.V376700.R01.S.doc Version 5.2 Page 6 What the service does well: People living at The Hylands are able to choose how they spend their day. Several people are very independent and treat the home more as a hotel, organising their own activities. Those who require more support have similar choices but these are more dependent on the demands on the staff within the home. People spoken with said that they enjoyed the choice of communal areas and appreciated that there was not a television in each room. This gives them the chance to read and enjoy discussions about the news and local events. “The staff are always respectful and cheerful” “We like this lounge because there’s no television and we can have a chat” “Dianne and Tony are wonderful nothing is too much trouble for them” What has improved since the last inspection? At the previous inspection it was noted that several people living in the home manage their own medications. At that time none of them had a risk assessment in place. This document has now been provided and it identifies that the individual understands their responsibilities in relation to the safe storage of the medicines whilst in their possession. It also identifies that they understand the consequences of not taking the medicines. The registered person has also provided proper storage in place for use with controlled drugs. It was also noted that staff had been employed in the home without proper employment checks. At this inspection those checks had been implemented and all staff had a current CRB disclosure. The manager is aware that any future staff need to have two written references. As part of the annual inspection process information is requested in the form of an Annual Quality Assurance Assessment. This information was provided at the same time as their improvement plan. The manager has re-established the quality assurance process within the home to ensure that the quality of the service remains stable. Along with this a quarterly newsletter will be produced to keep the people living in the home informed of what is happening. The case files have been improved to include more detail about the help and support required by people in the home. Hylands The DS0000007742.V376700.R01.S.doc Version 5.2 Page 7 Staff have started receiving supervision again and this will give them the opportunity to discuss their role and identify any training needs they may have. The Service User Guide has been improved and now contains information an equality and diversity statement that outlines the different strands of the larger community whose needs could be met at The Hylands. 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. Hylands The DS0000007742.V376700.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Hylands The DS0000007742.V376700.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 3, standard 6 does not apply. People using the 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 who decide to use this service can be assured their needs will be met. EVIDENCE: Five case files were seen and all of them contained an assessment of need carried out by the registered manager or by the funding authority. The assessment information included brief information about the help and support they would require. A member of staff said that the information provided before someone came in to the home was an initial guide and a fuller assessment was carried out when they had been in the home for a few weeks. An information guide was seen during this inspection and it contained some of the information necessary to allow people to gain an understanding of what Hylands The DS0000007742.V376700.R01.S.doc Version 5.2 Page 10 The Hylands had to offer. This document has recently been improved by including an equality and diversity statement that outlines the different strands of the larger community whose needs can be met at The Hylands. Hylands The DS0000007742.V376700.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 People using the 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 receive the care and support they need. The staff provide support in a sensitive way that promotes the independence and dignity of the people who live at The Hylands. EVIDENCE: Five case files were seen and each of them contained a care plan. The senior staff are currently updating all the care plans to include more descriptive detail of the support and help required by the individual. People spoken with were not always aware of these plans but they said that they received the help and support they required. A member of staff said that the plans are reviewed monthly. The daily records are comprehensively maintained and contain information that helps inform the monthly review of the care plan. The daily Hylands The DS0000007742.V376700.R01.S.doc Version 5.2 Page 12 records are completed at least three times a day and more if someones needs change. The key worker system is in place. People spoken with said that they were registered with the local GP surgery and are able to see the doctor on request. There was evidence in the daily records of when the doctor or district nurse had last visited. Evidence was also available to show that people had accessed dental, chiropody, and optical services as necessary. A district nurse spoken with said that the staff always followed their advice and worked with them in the care of their patients. The staff are also very good and seeking advice. Medication is provided in monitored dosage boxes. The medication was found to be stored securely and staff that dispense the medication have received distance-learning training in the safe handling of medicines. The administration and recording of medicines was found to be accurate. Three people manage their own medication, and they have been provided with lockable facilities in their rooms. There were risk assessments in place to ensure people continue to manage their own medication safely. There is suitable storage for controlled drugs although there were no controlled drugs on the premises. Throughout the visit staff were observed treating the people in the home with respect, using their preferred names and talking to them discreetly about their personal care needs. The people in the home said ‘the staff here are wonderful’ and ‘they work very hard but will do anything for you’. The interactions were relaxed and friendly and it was clear that all staff respected them. Hylands The DS0000007742.V376700.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 People using the 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 are encouraged to make decisions about their daily life and staff provide appropriate support and encouragement for them to remain independent EVIDENCE: People in the home are able to follow their own routine and this was evident throughout the visit. Activities are organised by staff but people did not always want to join in. People spoken with said that the staff encouraged them to continue with the social activities they had before moving in to the home. On the morning of the inspection a discussion was held with people sitting in the lounge and they said that staff spend time with them when possible and in one of the other lounges the staff were organising an activity. People spoken with also said they could follow their own routine throughout the day and staff supported them to do this. There is a visitor’s policy in place, and they are welcomed anytime. Hylands The DS0000007742.V376700.R01.S.doc Version 5.2 Page 14 People moving in to The Hylands can bring their own furniture and other personal possessions if they wish. Information is available about advocacy Alliance and other external agencies that may provide extra support if they require it. The home works with a six-week menu offering a choice at the breakfast and tea meals and a set lunch meal. An alternative is offered at this meal rather than a direct choice. They also cater to likes and dislikes as one person enjoys fish and requests it everyday. Lunch is three courses and the meal observed was relaxed and it was not rushed. People spoken with thought the food was alright. Hylands The DS0000007742.V376700.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 People using the 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 who live at The Hylands and their representatives are able to express their concerns through the complaints procedure and are protected from abuse, so their rights are protected EVIDENCE: There is a complaints policy in place. People spoken with said that if they had any concerns or complaints they would tell a member of staff. The Commission has received one complaint in the last twelve months about The Hylands and resulted in a random inspection. The complaint was not upheld. There is an Adult Protection Policy in place and staff were aware of their responsibilities if they suspected anyone was abusing someone using the service. Staff are thoroughly checked prior to them being deployed in the home to ensure they are suitable to work with vulnerable people. The staff records checked contained current Criminal Records Bureau disclosure and/or a POVAFIRST check. Hylands The DS0000007742.V376700.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 People using the 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 standard of the environment within the home is good, providing people with a homely place in which to live. EVIDENCE: The home was clean, pleasant and hygienic. The home is reasonably decorated and there is a continuous programme of redecoration in place. People living in the home said they were pleased with their own bedroom accommodation and the communal areas. Several people said they enjoyed using the areas where there was no television as it allowed for group discussions to develop. There is a CCTV system in place for use in the corridors to assist staff to keep people safe. The system does not operate in anyones bedroom. There are six Hylands The DS0000007742.V376700.R01.S.doc Version 5.2 Page 17 different lounge areas that people can access. Some people prefer to use their own accommodation as a bed sitting room and spend the majority of the time in their rooms. There is a paved area to the front of the home that faces directly onto the sea where people can sit when they wish. There is a large statue of a bear outside the home and this has been a focus of attention for visitors and people spoken with were proud of their bear. Hylands The DS0000007742.V376700.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 People using the 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, that have been thoroughly vetted prior to the commencement of their employment, support people. EVIDENCE: The home is adequately staffed with three carers on duty from seven in the morning until ten at night, and then there are two night staff awake. A team of ancillary staff supports the care staff. Currently there are 7 of the staff team who have or are working towards the National Vocational Qualifications in Care level two. Staff receive the statutory required training. People spoken to said that the staff are very good and the lasses are pretty helpful and the staff are very helpful and nice Staff spoken with said that they had completed distance-learning courses in Equality and Diversity, Dementia Care, Infection Control and The Safe Handling of Medication. The staff files for six people were seen. Each file contained the necessary documentation as required by the Care Homes Regulations 2001. The registered manager has ensured that all the staff have a current Criminal Hylands The DS0000007742.V376700.R01.S.doc Version 5.2 Page 19 Records Bureau disclosure and all new staff will also have two written references. The files also contained more information about the level of training completed and there was now evidence that formal supervisions have been re-introduced. Hylands The DS0000007742.V376700.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 People using the 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 home that is well managed and systems are in place to protect their health and safety. EVIDENCE: The Registered Manager is experienced and has a National Vocational Qualification level 4 in management. Four senior carers support her with the management functions when the Registered Manager is not available. There has been an improvement in the supporting paperwork since the last inspection. The Annual Quality Assessment Assurance form was returned to Hylands The DS0000007742.V376700.R01.S.doc Version 5.2 Page 21 the Commission following the previous inspection. The certificate of registration is displayed in the home. The quality assurance system has been re-introduced and this includes quarterly newsletters, regular surveys to people living in the home, relatives and other professionals. The information gathered will be used in developing the service provided at The Hylands. Where necessary people are supported with their personal monies. The records checked along with monies held were accurate and up to date. The health and safety records showed that proper attention is given to providing a safe and secure environment in which people can live. Hylands The DS0000007742.V376700.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Hylands The DS0000007742.V376700.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Hylands The DS0000007742.V376700.R01.S.doc Version 5.2 Page 24 Care Quality Commission Care Quality Commission Yorkshire & Humberside Region Citygate Gallowgate Newcastle Upon Tyne NE1 4PA National Enquiry Line: 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. 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. Hylands The DS0000007742.V376700.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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!