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Inspection on 21/11/08 for Summerfield Residential Home

Also see our care home review for Summerfield Residential Home for more information

This is the latest available inspection report for this service, carried out on 21st November 2008.

CSCI 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

The home is well managed and people that live and work at the home feel valued and enjoy a friendly and relaxed atmosphere. The home has an open door policy and encourage people to tell them what they think about the service. There are regular meeting arranged for people living at the home and quality assurance survey questionnaires are sent out at regular intervals. The home has established close working relationships with other health care professional to make sure people`s health care needs are met and they have access to the full range of NHS services. The home has an ongoing programme of refurbishment and renewal and the providers, manager and staff take a great deal of pride in providing people with a clean, comfortable and safe environment. Comments from people living at the home and/or their relatives included the following "the home is always kept clean and tidy and the staff are kind, considerate and very friendly" and "Summerfield is like home from home with caring staff and excellent food."

What has improved since the last inspection?

A new care system has been implemented since the last inspection visit, which covers all aspects of people`s personal, health and social care needs. The home now sends out survey questionnaires to people using the service, their relatives. The surveys give people the opportunity to express their views of the service and is an important part of the quality assurance monitoring process.

What the care home could do better:

A stock control system must be put in place for PRN (as and when required) medication and a new controlled drugs cabinet purchased so that people can be confident that their medication is being administered and stored correctly. Recruitment and selection procedures must followed at all times so that people can be confident they are being cared for by staff that are suitable to work in the caring profession. As part of the quality assurance process survey questionnaires should be be sent out to other health care professionals so that they can comments on how the home is meeting stated aims and objectives.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Summerfield Residential Home 94 Skipton Road Silsden Keighley West Yorkshire BD20 9DA     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: Stephen Marsh     Date: 2 1 1 1 2 0 0 8 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. the things that people have said are important to them: They reflect 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 27 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.csci.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Summerfield Residential Home 94 Skipton Road Silsden Keighley West Yorkshire BD20 9DA 01535653219 01535657611 shorsfall@summerfield1807.fsnet.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Lee Samantha Lee Type of registration: Number of places registered: Mr Stephen Horsfall care home 32 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category physical disability Additional conditions: Date of last inspection Brief description of the care home Summerfield Residential Home is located in the Aire Valley on the outskirts of Silsden and within easy reach of Keighley, Ikley and Skipton. The home provides personal and social care for up to thirty-two men and women over the age of 65. The home stands in its own grounds with pleasant gardens and there is a car parking area. Accommodation is provided in twenty-six single and three double bedrooms. Communal areas consist of three comfortable lounges, two conservatories and a dining room situated on the ground floor of the building. The nearest shops and other local facilities are within walking distance and the home is on a bus route. The home has produced a residents handbook (service user guide), which is available to all people Care Homes for Older People Page 4 of 27 Over 65 4 25 3 0 0 0 Brief description of the care home considering using the service. The handbook is comprehensive and includes a section on frequently asked questions and an A - Z of the facilities and activities provided at the home. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: 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: The quality rating for this service is three star (3). This means that people that use the service experience excellent quality outcomes. The inspection process included looking at information we have received about the service since the last key inspection, as well as this unannounced visit to the home, which was carried out between 09:30 and 16:30 hrs. The methods we used included looking at records, observing staff at work, talking to people living at the home and visitors, talking to staff and looking around the property. Before the visit we had provided some people living at the home, their relatives,staff and other health care professionals with survey questionnaires so that they could share Care Homes for Older People Page 6 of 27 their views of the service with us. We received three questionnaires back from people living at the home, five from relatives, three from staff and three from health care professionals. The information they provided has been used as evidence in the body of the report. The home had also completed and returned their Annual Quality Assurance Assessment (AQAA) form and the information provided has also been used as evidence in the body of the report. The AQAA is a self assessment form that focuses on how well outcomes are being met for people using the service. It also gives us some numerical information about the service. The purpose of the visit was to assess what progress the home had made in meeting the requirements made in the last inspection report and the impact of any changes in the quality of life experienced by people living at the home. We have recently improved our practice when making requirements to improve national consistency. Some requirements from previous inspections may have been deleted or carried forward as recommendations, but only when it is considered that people that use the service 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. No requirements or recommendations have been made as a result of this inspection. Feedback was given to the manager at the end of the visit. The fees for the service currently range from 390:00 to 475:00 pounds per week. Details of the exact charges can be obtained by contacting the manager. 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.csci.org.uk. You can get Care Homes for Older People Page 8 of 27 printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 27 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The admission process is thorough and people will not be admitted unless staff are able to meet their needs. People are provided with good information about the service and are encouraged to visit and see the facilities at first hand before deciding if the home is right for them. Evidence: The information provided about the service is good and helps people decide if the home can meet their needs. At the current time the information is only available in English but the manager confirmed that it would be made available in different languages and formats on request. Records show that peoples needs are always assessed before they move into Summerfield either in their own home or temporary place of residence. Needs Care Homes for Older People Page 11 of 27 Evidence: identified during this pre-admission assessment visit form the basis for the initial care plan, which is completed on admission. People are invited to visit the home before admission to see at first hand the facilities provided, meet the staff and other people living there and stay for a meal if they wish to do so. People are also able to move in to the home on a trial period if they are still undecided. This is good practice and shows that people are supported through the admission process. The home tries not to admit people on an emergency basis however if this is unavoidable a full assessment of their needs is completed on the day of admission. People admitted for respite care are asked to complete a questionnaire about their experience of living at the home, which is used for quality assurance monitoring purposes. Feedback from people shows that they feel the information they received about the home before admission was very good and the initial visit was helpful and informative. One person recently admitted said that she and her family had chosen the home because of its reputation for providing good quality care and facilities. She confirmed that she had not been disappointed with her choice and would have no hesitation in recommending the home to anyone considering respite or long-term care. Feedback from people also clearly shows that they feel there is a good mix of skills within the staff team and staff had a good understanding of their needs. Care Homes for Older People Page 12 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care records provide accurate and up to date information, which means that people receive the level of care and support they require to meet their personal, health and social care needs Evidence: A new care planning system has been implemented since the last inspection visit, which covers all aspects of peoples personal, health and social care needs. Care plans are drawn up with the involvement of the person using the service and/or their relatives and forms the basis for the care to be provided. Moving and handling and nutritional assessments are routinely carried out for all new admissions and risk assessments are completed where areas of potential risk to peoples general health and welfare are identified. All people living at the home are registered with a general practitioner and are supported in having access to the full range of NHS services. The input of other health Care Homes for Older People Page 13 of 27 Evidence: care professionals is clearly recorded in the documentation available. This shows that staff are seeking advice if they concerns about peoples health. People confirmed that they were happy with the care and support they received and said that staff always treated them with kindness and respect. Comments included we are very well cared for and the staff will do anything to help you and staff look after us very well -- I have no complaints at all about care provided. Feedback from relatives shows that they are also pleased with the standard of care and facilities provided and were always kept informed of any significant changes in peoples general health. We reviewed the medication system in place and found that overall medicines are managed safely. However, a stock control system is required for PRN (as and when required) medication and a new controlled drug cabinet is required to meet current legislation. A discrepancies in the stock control figure for a controlled drug was also discussed with the manager and immediate action was taken to resolve the matter. Information provided in the self assessment form shows that the home plan to provide staff with more training on medication in the next twelve months. Survey questionnaires returned by health care professionals show that they feel the home manages medicines well and seek advice if they have any concerns. People living at the home can therefore be confident that medication is being administered as prescribed. Care Homes for Older People Page 14 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are offered the opportunity to take part in a varied range of social and leisure activities that take account of their preferences and abilities. Evidence: The manager confirmed that people are encouraged to make choices and decisions about how they spend their time whilst living at the home. Peoples personal interests are recorded in their care plan and wherever possible they are supported by staff to follow their own daily routines. The home continues to have strong links with the local community especially schools and church groups and the Methodist Church holds a service at the home on a monthly basis. Some people also enjoy going to the weekly coffee morning held at the local church and people from all denominations are supported in attending their chosen place of worship. Entertainers visit the home on a regular basis and themed evenings are held, which family and friends are invited to attend. Outings are arranged in line with peoples wishes and special occasions are celebrated throughout the year. The home organises Care Homes for Older People Page 15 of 27 Evidence: fund raising events and has an amenities fund, which is spent on social and leisure activities. The Providers also fund some entertainment and outings and information provided in the self assessment form shows that they would like to employ a designated activities co-ordinator within the next twelve months. People told us that they were very pleased with the level of activities and outings made available to them. Comments included I enjoy joining in activities and there is always something to do if you want to join in. People spoken with said that they were able to see visitors in their own rooms if they wished to do so and family and friends were always made to feel welcome and offered light refreshments when they visited. We observed the lunchtime meal served in the main dining room. The meal served was good both in quality and presentation. Tables were nicely set, the meal was unhurried and the atmosphere was relaxed with lots of friendly banter between staff and individual people. People spoken with confirmed that the food is always good and their preferences are taken in to account when menus are planned. Comments included there is always a good choice at meal time and I have no complaints at all about the standard of meals provided. Feedback from relatives also confirmed that they are very pleased with the standard of meals provided. Comments included All the meals look appetising and mealtimes are enjoyed as social occasions and the food prepared is varied and from local suppliers. Care Homes for Older People Page 16 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are suitable systems in place to make sure that complaints are dealt with appropriately and people are protected from abuse. Evidence: There is a clear complaints procedure in place and information provided in the self assessment form shows that no complaints have been received since the last inspection visit. People living at the home said that they were aware of the complaints procedure and would have no problem at all in approaching the manager or registered provider if they had any concerns about the standard of care being provided. Adult protection (safeguarding) policies and procedures are in place and training records provided by the manager show that the majority of staff have received training in the recognition and reporting of allegations of abuse. information provided in the self assessment form also shows that further training is planned within the next year, including refresher training for staff that have already attended the course. The manager confirmed that the home operates a zero tolerance approach when dealing with complaints and safeguarding issues. Feedback from staff indicates that they are aware of the homes policy on whistle Care Homes for Older People Page 17 of 27 Evidence: blowing and knew what to do if they suspected that people were being abused or working practices at the home were not in the best interest of the people living there. Care Homes for Older People Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is decorated to a high standard and provides a comfortable, safe and very pleasant place for people to live. Evidence: The home provide accommodation for thirty-two people in both single and double bedrooms situated on both floors of the building. The majority of the bedroom are single and have en-suite facilities available. There are passenger lifts available to assist people with mobility problems access the accommodation and facilities on the first floor of the building. A discussion was held with the manager about the door locks fitted to some bedroom doors as it would be difficult to enter the rooms in an emergency if someone left their key in the lock. The manager agreed to review the type of lock fitted and if necessary take action to address this matter. Communal lounges and a dining room/conservatory are located on the ground floor close to toilet facilities.Both the bedrooms and communal areas are decorated and furnished to a high standard and there is an ongoing programme of refurbishment and renewal. It is apparent when talking with the manager and staff that they take a great deal of pride in providing people with quality accommodation and keeping the home Care Homes for Older People Page 19 of 27 Evidence: clean and tidy. People living at the home said that they were very satisfied with the standard of accommodation and pleased that they had chosen to live at Summerfield. Comments included I feel very at home at Summerfield -- it has such a warm friendly atmosphere and the rooms are very well decorated and furnished and kept spotlessly clean. Feedback from relatives also shows that they are very pleased with the standard of decor and furnishings. Comments included the home is very well decorated and the lounges are bright, and comfortable as are the bedrooms and the home is well maintained with good private and communal facilities. Care Homes for Older People Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are sufficient staff employed to make sure peoples needs are met and staff are supported in developing the skills and knowledge they need to care for people properly. Evidence: The home has a thorough staff recruitment and selection procedure, which includes obtaining at least two written references and a Criminal Record Bureau (CRB) before new staff start work. This makes sure only people suitable to work in the caring profession are employed. All staff are provided with written job descriptions, which outlines their roles and responsibilities and terms and conditions of employment. We reviewed the recruitment files and found that generally the recruitment policy was being followed although in one instance the procedure had not been as thorough as it should have been. The manager is aware of this and confirmed that in future staff would not be employed until all employment checks had been completed. The staff rota showed that sufficient care staff are employed on day and night duty to meet peoples needs and the home has a stable staff team and a relatively low staff turnover, which helps to make sure people receive continuity of care. Care Homes for Older People Page 21 of 27 Evidence: To support the care staff the home employs catering and housekeeping staff to make sure that peoples dietry needs are met and the home is clean, tidy and free from offensive odours. The manager confirmed that all new staff receive induction training in line with the Skills for Care Common Induction Standards. These are nationally agreed induction standards designed to help new staff get the skills and knowledge they need to care for people. Following induction there is an expectation that staff will study for a National Vocational Qualification (NVQ) at level two or three above depending on the post they hold. Information provided in the self assessment form indicates that the majority of staff have achieved or are working toward a NVQ. This shows that the home is committed to making sure that people are cared for by skilled and experienced staff. Feedback from staff indicates that they are generally happy with the level and standard of training provided and were encouraged to take up training opportunities. Staff also felt that the training the receive helps them understand the individual needs of people living at the home and keeps them up to date with new ways of working. All training provided at the home is funded by the registered provider. Care Homes for Older People Page 22 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management structure in place makes sure that the home is well managed and run in the best interest of the people living there. Evidence: Summerfield Residential Home is a family run business. Mrs Samantha Lee has worked at the home for a number of years and has been the registered manager for about seven years. Her father is the registered provider. Mrs Lee has many years experience in the caring profession and has achieved a National Vocational Qualification at level four in Social Care, which is recognised qualification for the post she holds. Feedback from staff and people living at the home shows that the manager and provider are approachable and operate an open door policy, which means that they are able to speak to them at any time if they have any concerns. Comments from people included the manager is in the home nearly every day and is very easy to talk to if Care Homes for Older People Page 23 of 27 Evidence: you have a problem and the manager is very friendly and makes sure we are well cared for. Feedback from staff show that they have one-to-one supervision with the manager on a regular basis and feel well supported by the senior management team. Comments included it is very easy to approach management with any problems and senior staff provide good leadership and staff work well as a team. Staff meetings are held to make sure there are clear channels of communication within the home. There is a range of quality assurance monitoring measures in place including sending out survey questionnaires to people using the service, their relatives. The surveys give people the opportunity to express their views of the service and is an important part of the quality assurance monitoring process. We recommended to the manager that survey questionnaires are also sent out to other health care professional so that they could also comments on how the home is meeting stated aims and objectives. The home does not hold money in safekeeping for anyone living there but invoices people for any services provided, which are not included in the fees. Information provided in the self-assessment form completed by the manager shows that policies and procedures are in place to make sure staff follow safe working practices and all equipment is serviced in line with manufacturers guidelines. people can therefore be sure that their health and safety is not being compromised. Care Homes for Older People Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 33 As part of the quality assurance process survey questionnaires should be be sent out to other health care professionals so that they can comments on how the home is meeting stated aims and objectives. Care Homes for Older People Page 26 of 27 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.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 27 of 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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