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Inspection on 12/05/10 for Phylward House

Also see our care home review for Phylward House for more information

This is the latest available inspection report for this service, carried out on 12th May 2010.

CQC found this care home to be providing an Excellent 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Each person living at the home has their own care plan and record of their care. This is based around the company`s assessment and care planning documentation. The record we looked at showed that a full assessment and introductory process had been completed before the person moved in. This included visits to the home to meet people and make sure it was the right place for the person to live. We looked at people`s care records which showed that people take part in lots of different activities and events. People enjoy activities such as bowling,cycling,rebound(trampoline) going out for coffee,meals and pub lunches and going to the theatre. People also have the opportunity to have hydrotherapy sessions and also attend various adult education centres. People living at the home also do therapeutic employment. People enjoy going on holiday two people were away in Blackpool at the time of this inspection. Other holidays have been arranged such as a caravan holiday in Northumberland. The care record we looked at also showed that people have involvement from other health professionals, such as their dentist, optician and doctors. The medication storage arrangements and recording we looked at showed us that medication is being managed safely by the home. There have been no recent complaints or safeguarding incidents at the home. Staff we spoke to had received safeguarding training and knew how to report any concerns. One staff has received the train the trainer in safeguarding. This means that the member of staff has the skills to train other staff in this area. We held a discussion with the manager about how staff are able to recognise when someone is unhappy when some people are unable to verbally communicate. We were informed that staff are clear when someone is unhappy by observing people`s body language. During our visit the home was found to be clean and tidy and provided people with a homely and comfortable place to live. We checked a random selection of maintenance certificates and found that all but one was up to date. We checked one recent recruitment record and found that all the appropriate checks and information had been obtained before the staff member started to work in the home. Therecords also showed that appropriate induction and ongoing training had been arranged. Discussions with the manager and the rota confirmed that staff levels are arranged with people`s routines and preferences in mind,as much as possible. We found that the home has an appropriate management structure in place. The manager is appropriately qualified and experienced and is supported by an assistant manager. We received five surveys from people living at the home. People confirmed that they were asked if they wanted to move to the home, and that they received enough information. One person confirmed that they were able to make decisions about what they do each day. One said usually and one said sometimes. Two people confirmed that they knew who to speak to if they were unhappy and knew how to make a complaint. One person said they did not know how to make a complaint. People confirmed that the home was always fresh and clean. People confirmed that the care staff and manager treat them well. Two people did not respond to any of the questions asked. When asked what does the home do well? People made the following comments: "Looks after me well." "Supporting service users who are unwell they always try to take us out for different activities". When asked what could the home do better? One person said, "Staff getting along better". Another said, "Don`t know." Nine surveys were returned from staff who work at the home. On the whole surveys were positive. These are some of the comments made by staff who work at the home. When asked what does the home do well? Staff said, "Good activities for service users. Staff ratio good. Good food, good menu. Give service users the choice with what they do and what they eat." "Caters for the individual service users needs well. Offering a wide range of different activities, foods and social outings." "Phylward House offers a warm and welcoming environment and provides an excellent person centred service. The team are committed and well trained to meet the diverse and changing needs of the service users." "Understands service users and relates well to them. Provides care and support appropriate to each one." "Personal care and day care support." "Day to day living of service users. Regular meetings and updates. Training needs/updates when required." "Look after physical needs of service users." "Ensure the services we provide are person centred. Offer a good range of activities and events, which meet the needs of each individual. Offer relevant training usually quickly after a need is identified. Good staff support/information sharing through regular SDS(supervision and development sessions) and team meetings." "At the moment the home does not do anything well." When asked what could the home do better? Staff said, "Recruitment and retention as we seem to be always short of good quality staff." "Improve staff to client ratio. More social activities ie outings to pubs,shopping activities. The things you and I would do. Improve communication ie care plans etc. More opportunity for clients to go on holiday and not to have excuses example staff level. Clients go on 7 day holiday and not just 5 or 4 days". "Have more staff for activities." "Staffing has always been an issue through either illness or staff leaving. It would be niceto have a full staff team who know and understand their job roles to help each shift run smoothly." "Heating - service users are always cold due to poor heating." "Recruitment and retention of staff can present issues. Also the timescale between interviewing and a start date being offered seems to be lengthy." "Better cook as staff who cannot cook are sometimes on as we have not got a cook yet". When asked is there anything else you would like to tell us? Staff said, "Good manager team, good training, nice work colleagues." "The registered manager should be able to manage the service ie budgets, decision making. The day unit would benefit from a senior support worker on a daily basis."

What the care home could do better:

There have been problems with the heating at the home. The manager informed us that the organisation has this in hand as they are currently looking at a new heating system. The staff complement at the home are down by two full time support workers and two staff are on long term sick. The home employs a cook although no cleaners are employed. The manager said that the support staff do all the cleaning and laundry. This must put pressure on staff as they do not have a full complement of staff. The needs of people living at the home are complex and people do have high dependency needs. The organisation may want to look at the current staffing levels at the home to see if any improvements can be made to ensure that people`s care needs are not compomised, due to staff having to carry out other duties aswell as providing personal care. This makes sure that people`s care needs are met at all times. We looked at fire records and saw that the last test was carried out on the 30th April 2010, although we were told that a test had been carrried out at the weekend, but had not been recorded. The home needs to follow the guidance as specified by North Yorkshire Fire and Rescue Service. This makes sure that people living at the home are kept safe at all times. We feel that Phylward House continues to provide good and excellent outcomes for the people who live there, although we have made two recommendations as a result of this random inspection.

Random inspection report Care homes for adults (18-65 years) Name: Address: Phylward House 9 Cavendish Avenue Harrogate North Yorkshire HG2 8HX three star excellent service The quality rating for this care home is: The rating was made on: 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 review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Irene Ward Date: 1 2 0 5 2 0 1 0 Information about the care home Name of care home: Address: Phylward House 9 Cavendish Avenue Harrogate North Yorkshire HG2 8HX 01423502644 01423522810 Telephone number: Fax number: Email address: Provider web address: www.wilfward.org.uk Name of registered provider(s): Name of registered manager (if applicable) Miss Nicola Mary Spencer Type of registration: Number of places registered: Conditions of registration: Category(ies) : The Wilf Ward Family Trust care home 9 Number of places (if applicable): Under 65 Over 65 0 learning disability Conditions of registration: 9 Registered for 9 Service Users with Learning Disability some or all of whom may also have a Physical Disability Date of last inspection Brief description of the care home Phylward House is registered to provide long-term accommodation to 9 younger adults who have a learning disability and/or a physical disability. Miss Nicola Mary Spencer is the Registered Manager and it is owned by the Wilf Ward Family Trust a registered charity. Phylward House is a large detached building standing in its own grounds. It is situated in a residential area of the town. A former private dwelling house it has been extended and adapted to provide accommodation for a maximum of nine service users. It occupies three floors. The lower two provide the accommodation and facilities for the service users. The upper floor is used for staff accommodation and Care Homes for Adults (18-65 years) Page 2 of 9 Brief description of the care home administrative purposes. A day care unit is housed within the main building. This is separately staffed and managed. Information about the service is available on request and it can be provided in a variety of formats. On the 29th June 2007 the cost to the residents was between £108.95 and £143.60 per week, this is determined through a financial assessment. This covers the accommodation costs, the local health authority and social services departments meet the cost of the personal care. They and their carer are informed of this cost prior to their admission. . Care Homes for Adults (18-65 years) Page 3 of 9 What we found: This was an announced inspection of the Phylward House. The visit was completed on 12th May 2010 by one inspector. The homes staff and the people living there knew that we were going to visit on this day. This was to make sure people were in at the time we visited.During our visit we looked at a selection of records, looked round some parts of the building and talked to some of the people who live at the home and the staff who work there. Before our visit we looked at all of the information we had about the service and asked the home to complete an annual quality assurance assessment. This is a self-assessment that tells us about the home. We also sent out surveys to people who live and work at the home. We used all of this information to plan our inspection visit and have included it in this report where appropriate. What the care home does well: Each person living at the home has their own care plan and record of their care. This is based around the companys assessment and care planning documentation. The record we looked at showed that a full assessment and introductory process had been completed before the person moved in. This included visits to the home to meet people and make sure it was the right place for the person to live. We looked at peoples care records which showed that people take part in lots of different activities and events. People enjoy activities such as bowling,cycling,rebound(trampoline) going out for coffee,meals and pub lunches and going to the theatre. People also have the opportunity to have hydrotherapy sessions and also attend various adult education centres. People living at the home also do therapeutic employment. People enjoy going on holiday two people were away in Blackpool at the time of this inspection. Other holidays have been arranged such as a caravan holiday in Northumberland. The care record we looked at also showed that people have involvement from other health professionals, such as their dentist, optician and doctors. The medication storage arrangements and recording we looked at showed us that medication is being managed safely by the home. There have been no recent complaints or safeguarding incidents at the home. Staff we spoke to had received safeguarding training and knew how to report any concerns. One staff has received the train the trainer in safeguarding. This means that the member of staff has the skills to train other staff in this area. We held a discussion with the manager about how staff are able to recognise when someone is unhappy when some people are unable to verbally communicate. We were informed that staff are clear when someone is unhappy by observing peoples body language. During our visit the home was found to be clean and tidy and provided people with a homely and comfortable place to live. We checked a random selection of maintenance certificates and found that all but one was up to date. We checked one recent recruitment record and found that all the appropriate checks and information had been obtained before the staff member started to work in the home. The Care Homes for Adults (18-65 years) Page 4 of 9 records also showed that appropriate induction and ongoing training had been arranged. Discussions with the manager and the rota confirmed that staff levels are arranged with peoples routines and preferences in mind,as much as possible. We found that the home has an appropriate management structure in place. The manager is appropriately qualified and experienced and is supported by an assistant manager. We received five surveys from people living at the home. People confirmed that they were asked if they wanted to move to the home, and that they received enough information. One person confirmed that they were able to make decisions about what they do each day. One said usually and one said sometimes. Two people confirmed that they knew who to speak to if they were unhappy and knew how to make a complaint. One person said they did not know how to make a complaint. People confirmed that the home was always fresh and clean. People confirmed that the care staff and manager treat them well. Two people did not respond to any of the questions asked. When asked what does the home do well? People made the following comments: Looks after me well. Supporting service users who are unwell they always try to take us out for different activities. When asked what could the home do better? One person said, Staff getting along better. Another said, Dont know. Nine surveys were returned from staff who work at the home. On the whole surveys were positive. These are some of the comments made by staff who work at the home. When asked what does the home do well? Staff said, Good activities for service users. Staff ratio good. Good food, good menu. Give service users the choice with what they do and what they eat. Caters for the individual service users needs well. Offering a wide range of different activities, foods and social outings. Phylward House offers a warm and welcoming environment and provides an excellent person centred service. The team are committed and well trained to meet the diverse and changing needs of the service users. Understands service users and relates well to them. Provides care and support appropriate to each one. Personal care and day care support. Day to day living of service users. Regular meetings and updates. Training needs/updates when required. Look after physical needs of service users. Ensure the services we provide are person centred. Offer a good range of activities and events, which meet the needs of each individual. Offer relevant training usually quickly after a need is identified. Good staff support/information sharing through regular SDS(supervision and development sessions) and team meetings. At the moment the home does not do anything well. When asked what could the home do better? Staff said, Recruitment and retention as we seem to be always short of good quality staff. Improve staff to client ratio. More social activities ie outings to pubs,shopping activities. The things you and I would do. Improve communication ie care plans etc. More opportunity for clients to go on holiday and not to have excuses example staff level. Clients go on 7 day holiday and not just 5 or 4 days. Have more staff for activities. Staffing has always been an issue through either illness or staff leaving. It would be nice Care Homes for Adults (18-65 years) Page 5 of 9 to have a full staff team who know and understand their job roles to help each shift run smoothly. Heating - service users are always cold due to poor heating. Recruitment and retention of staff can present issues. Also the timescale between interviewing and a start date being offered seems to be lengthy. Better cook as staff who cannot cook are sometimes on as we have not got a cook yet. When asked is there anything else you would like to tell us? Staff said, Good manager team, good training, nice work colleagues. The registered manager should be able to manage the service ie budgets, decision making. The day unit would benefit from a senior support worker on a daily basis. 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 2. Care Homes for Adults (18-65 years) Page 6 of 9 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 7 of 9 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, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 33 The home should review the current staffing levels to make sure that the home has an effective staff team,with sufficient numbers and complimentary skills to support people who live at the home. This makes sure that people are supported with their care needs at all times. Fire records should be kept up to date as required by North Yorkshire Fire and Rescue Service. This makes sure that the health,safety and welfare of people living at the home is protected. 2 42 Care Homes for Adults (18-65 years) Page 8 of 9 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or got 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 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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