Inspection on 12/10/09 for Symphony House

This is the latest available inspection report for this service, carried out on 12th October 2009.

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.

Other inspections for this house

Symphony House 04/10/06

Symphony House 22/12/05

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

Extracts from inspection reports are licensed from CQC, this page was updated on 17/02/2010.

Key inspection report Care homes for older people Name: Address: Symphony House 43 / 45 Queens Park Parade Northampton NN2 6LP     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home 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 full review a ‘key’ inspection. Lead inspector: Catherine Perrins     Date: 1 2 1 0 2 0 0 9 This is a review of 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. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. Care Homes for Older People Page 2 of 25 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. 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 Care Homes for Older People Page 3 of 25 Information about the care home Name of care home: Address: Symphony House 43 / 45 Queens Park Parade Northampton NN2 6LP 01604722772 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: dsweeks@ukonline.co.uk Symphony Care Ltd care home 25 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Symphony Care Home is registered to provide personal care with nursing to male and female service users who fall within the following categories:- Old age, not falling within any other category (OP) 25 The maximum number of persons to be accomodated at Symphony House is 25 To accommodate the person named in application number V34225 who is under the age of 60 years To accommodate the person named in application number V34226 who is under the age of 60 years Date of last inspection Brief description of the care home The home is situated in a residential area of Northampton, close to local shops and amenities. Accommodation is provided in a Victorian house that has been extended and has recently been refurbished by its new owners to a very high standard. All rooms have ensuite facilities and are single occupancy. It provides facilities for the elderly frail and for the terminally ill. 2 8 1 0 2 0 0 8 0 Over 65 25 Care Homes for Older People Page 4 of 25 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is three star. This means the people who use this service experience excellent quality outcomes. This was an unannounced key inspection which means that we focused on the key national standards. The key standards are those considered by the Commission to have the most impact on outcomes for residents. As part of the preparation for this inspection a period of three hours was spent reviewing the information that CQC has about this service. We looked at all the information that we have received, or asked for, since the last key inspection or annual service review. This included: Care Homes for Older People Page 5 of 25 The annual quality assurance assessment (AQAA) that was sent to us by the service. The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the service. Information we have about how the service has managed any complaints. What the service has told us about things that have happened in the service, these are called notifications and are a legal requirement. The previous key inspection and the results of any other visits that we have made to the service in the last 12 months. Relevant information from other organisations. The inspection visit lasted eight hours during the morning and afternoon of a weekday. During the inspection four people were case tracked. This involves looking in detail at all aspects of their care and experiences at the Symphony House, including looking as their individual plans of care and other records, talking to them and talking to their care staff. Because some of the people living at Symphony House were not able to tell us about their experiences we also used observations of peoples state of well being and how they interacted with staff members and others. A sample of staff files were also viewed as part of the inspection. The registered manager was present for the inspection. The next inspection of this service will be based on the Fess and Frequency Regulations 2007 and the assessment of risk of the service. Further clarity will become evident as the new registration and inspection system under the Health and Social Care Act 2008 is confirmed. Care Homes for Older People Page 6 of 25 What the care home does well: What has improved since the last inspection? All medication is administered, recorded and stored appropriately. Care Homes for Older People Page 7 of 25 Staff receive regular supervision sessions and appraisal to ensure that they are doing their jobs in the right way. A newsletter has been introduced to inform people of the activities on offer. Some of the outside areas have been given attention to make them more attractive. 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. Care Homes for Older People Page 8 of 25 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 25 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are given good information and their needs are thoroughly assessed before they move in to ensure that Symphony House is right for them. Evidence: The home has a statement of purpose and service user guide which give people good information about the home and the services it offers. The manager explained that these are available in other formats, such as large print, on request and that further information and pictures of the home can be viewed on the homes website. Records show that peoples needs are assessed before they move to Symphony House to make sure that the home is right for them. Advice was given to the manager to ensure that initial assessments are clearly dated to show when each part of the assessment was completed. The manager explained that people are able to visit the home before they move in to Care Homes for Older People Page 10 of 25 Evidence: help them decide if it is the right move for them. If they are not able to visit, their relatives or friends can do so on their behalf. A relative explained that she had looked at six or seven homes and that Symphony House was by far superior. Care Homes for Older People Page 11 of 25 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can feel confident that the home will meet their health and personal care needs in a way that respects their preferences and maintains their dignity. Evidence: Each person who lives at the home has an individual plan of care. This contains their care plans and other information that staff need to care for people in the right way. Care plans seen covered areas such as maintaining safe environment, maintaining dignity and privacy, mobility, dementia, personal hygiene, diet, continence and pressure care. They contained detail about peoples preferences such as what time they liked to get up and go to bed. There was evidence of people being helped to make choices such as what clothes they wanted to wear. Records show that people have been assessed to find out if they are at risk of developing pressure sores. Where a risk is identified measures are in place to reduce the risk, such as provision of specialist equipment and helping people to change position regularly. Detailed records show that where people have sores these are Care Homes for Older People Page 12 of 25 Evidence: closely monitored and advice sought from medical professionals where required. A specialist nurse who visits the home to advise on pressure care spoke very highly of the home saying that the manager had a very good knowledge of how to successfully care for people with pressure area needs. She described the home as quite an amazing place. Recognised assessments and screening tools are used to assess people for the risk of falls, moving and handling and nutrition. The manager described the progress made by one person who was admitted to the home severely malnourished, and how, given the appropriate care and support with eating and drinking, he had now put on weight. Records show that his weight had increased by just over two stone in the year since his admission. A relative commented I cannot fault the care xxxx looks so much better and goes on to tell us that the home gives people their dignity back and lets them live as if at home. Care plans contained details about how peoples health and well being should be promoted, for example, giving details of how to monitor for and prevent urinary tract infections. The manager explained that the home has plenty of lifting equipment and other specialist items to ensure that staff have everything that they need to care for people in the right way. A relative commented that the home had good equipment. The administration of medication is well managed with all entries on the medication record being signed to show that people are receiving their medication as prescribed. All medication is stored appropriately. Care Homes for Older People Page 13 of 25 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples quality of life is enhanced by a good range of activities available tailored to their preferences and interests. Evidence: The home offers a range of activities that people can join in if they wish to. Leaflets on display in the home detail the activities available for that month and invite families and friends to attend. Activities in October included bulb planting, newsround discussion of current affairs, Egyptian dancers, Christmas crafts, bingo, singing, , motivation session and a family meeting. One person told us that the home has good activities - we had belly dancers the other day, my granddaughter joined in. A relative comments in a satsifaction survey issued by the home in July 2009 that the home is very good at mental stimulation, programme constantly changing. Records show that each of the organised activities is evaluated with people being asked to give feedback. The manager explained that this feedback is used to plan future activities. The home holds monthly restaurant evenings. The manager explained that the larger lounge area is set up like a restaurant and people are able to invite their family Care Homes for Older People Page 14 of 25 Evidence: and friends to dine with them. The most recent restaurant evening held was based on an Italian theme. Comments from relatives who attended included outstanding service with lots of conversation and humourand cannot put into words how much we enjoyed this experience of sharing a meal with mum in suitable surroundings and outstanding quality of food, well presented and very tasty. Staff are amazing and deserve the credits due to them for all hard work and efforts The manager explained that consideration is given to the room layout to allow some people to dine around a large table and others to have a table for two. The manager told us that a group of people who live at the home recently went to the theatre, travelling there in a fleet of taxis. People also told us that they had enjoyed the garden party held at the home in the summer. Each person who lives at the home has a life histories which contained photographs and detailed the significant events in their lives. These can then be used to encourage further conversations and reminiscence as well as giving staff an enhanced understanding of the person. A calm atmosphere was noted in the home throughout the inspection with people appearing happy and relaxed. People are able to chose where they spend their time with some people preferring to sit in the lounge whilst others spend time in their rooms. The manager explained that people are encouraged to come to the dining room for lunch but that if they wish they can have meals in their rooms. People told us that the food is good. Staff explained that the home has a four weekly menu that incorporates peoples preferences as much as possible. People have a choice of two main courses but staff explained that if someone does not like what is on the menu something of their choice is prepared. Staff told us that the manager will go out to the supermarket to buy specific items if someone wants something in particular. One person for example enjoys Yorkshire tea. The menus seen looked varied and nutritious. Records show that at meal times staff are allocated specific tasks, such as helping someone cut up their food or assisting someone to eat. The manager explained that this ensures that people receive the support that they require. One member of staff is responsible for answering call bells over the meal time to ensure that the staff who are assisting people to eat can do so uninterrupted. Staff were seen helping people in a kind and sensitive manner. Care Homes for Older People Page 15 of 25 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are protected by the homes policies, procedures and practices. Evidence: The home has a complaints procedure which outlines what people should do if they wish to raise a concern about the home and the response that they can expect. The manager said that the home has received one complaint since the last inspection. This was investigated and found to be unsubstantiated. The manager explained that despite the complaint being unsubstantiated, he met with each staff member within a week of the complaint to discuss what could be learnt from the issues raised by the complaint. The home has not made any alerts to the local authority under the locally agreed Safeguarding Adults procedure. Staff spoken to were aware of how to raise any concerns that they may have and their responsibilities to safeguard people from harm. No evidence was seen during the inspection to suggest that anyone living in the home had any restrictions placed on their liberty. People were able to move around the home as they wished and portable call bells meant that they were able to request assistance from staff whenever they needed it. Care Homes for Older People Page 16 of 25 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People enjoy a clean, well equipped, maintained and furnished place to live that is homely and comfortable and is tailored to individuals choices and needs. Evidence: The homes statement of purpose states that the home intends to provide accommodation that aims to be equal to what one would expect at home. People who live at the home, their relatives and staff told us that the Symphony House was peoples home. All areas of the home were clean and pleasantly decorated. Flowers, ornaments and antique furniture make the communal areas feel homely. Attention has been given to the layout of the furniture. One person who lives there commented that they liked the fact that people do not all sit around the edge of the room. Having different seating areas allowed people to socialise or enjoy privacy as they wished. Communal areas consist of two large lounges, both with dining areas. An enclosed courtyard garden leads from one lounge and has a gazebo and various seating areas. Hanging baskets and pots make this an attractive place for people to sit in the warmer weather. The home has twenty five bedrooms all of which have an en suite toilet. Some have Care Homes for Older People Page 17 of 25 Evidence: an en suite shower or bath. Bedrooms seen varied in size with some being very spacious, the different sizes are reflected in the homes fees. All of the bedrooms seen had been made personal with possessions and personal effects. It was noted that the mirror in one persons room had been hung at a low height to ensure that she was able to see it from where she liked to sit. Each person has a name plate on their bedroom door with a photograph on to help people identify their bedroom. The manager explained that attention had been given to make sure that the photographs were personal to that person, being for example, with a family member. The home has two communal shower rooms and a bathroom with a bath that can be used by people with limited mobility. There is also a hair salon, kitchen and laundry room. The laundry room was clean and organised to ensure that peoples clothes were looked after. The manager explained that if anyones clothing does ever get lost or damaged the home replace the item at no cost to the individual. Thought has been given to peoples experience within the home, for example the manager explained how the bins have been relocated because they were visible from the lounge window. Care Homes for Older People Page 18 of 25 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefit from a competent and caring staff team who know their needs and preferences well. Evidence: The staff who work at the home know the people who live there well. The manager explained that the staff team is very stable with the majority of staff having worked at the home for over three years. The manager explained that the home does not use agency or temporary staff. A visiting professional commented that the manager is always teaching his staff and motivates them well. The manager has a qualification in training so if able to deliver a lot of training to the staff team to ensure that they have the skills and knowledge to care for and support people in the right way. Staff commented that communication between the staff team was good and that everything is done properly. Staff told us that they had an induction when they first started working at the home which included working alongside an experienced colleague to make sure that they had all of the information that they need to do their job in the right way. Care Homes for Older People Page 19 of 25 Evidence: Records show that staff receive training such as food hygiene, safeguarding of adults, dementia care, infection control, fire safety and moving and handling. Staff spoken to were very positive about the home and their role in providing care and support for people. People living at the home spoke highly of the staff. One person told us I have been really happy here. The staff are very good and come quickly if you ring the bell. Records show that staff have regular supervision sessions with the manager and six monthly assessments to ensure that they are doing the job in the right way and to help them develop new skills and knowledge. The recruitment of staff is well managed with all of the necessary pre recruitment checks being carried out to ensure that staff are suitable to work with older people. Care Homes for Older People Page 20 of 25 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience 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 efficient and well managed with a clear commitment to the best interests of the people who live there. Evidence: Throughout the inspection the manager showed an excellent understanding of the needs and preferences of the people who live in the home. Discussions with him, and observations, demonstrated a very high level of commitment to the home and the people who live there and the desire to see the home continue to develop and improve. During the inspection the manager described various improvements and developments that were planned such as having a notice board with pictures of all of the staff in the foyer to help people living at the home and visitors remember staff names. Staff spoke highly of the manager saying that he had a very good attention to detail. Care Homes for Older People Page 21 of 25 Evidence: The results of a survey carried out by the home in July 2009 showed a very good level of satisfaction. One relative commented for the first time since 2006 I now feel able to go away from home for a whole day or a holiday. I think that says it all. The home conducts regular residents meetings, the minutes of which are available in large print. This gives people to opportunity to discuss menus, activities and how the home is run. Records show that the manager conducts a thorough medication audit every three months. Records show that the necessary safety checks such as fire checks, checks on the water system and portable appliance testing have all been carried out recently. Hoists and lifting equipment has been serviced as per manufacturers recommendations. Care Homes for Older People Page 22 of 25 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 23 of 25 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 24 of 25 Helpline: Telephone: 03000 616161 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. Care Homes for Older People Page 25 of 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!