Key inspection report
Care homes for older people
Name: Address: The Grove Marine Villa Road Knottingley West Yorks WF11 8ER The quality rating for this care home is:
two star good 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: Tony Railton
Date: 1 6 1 2 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 27 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) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home
Name of care home: Address: The Grove Marine Villa Road Knottingley West Yorks WF11 8ER 01977674981 01977677571 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Eldercare (Halifax) Ltd Name of registered manager (if applicable) Mrs Sylvia Margaret Clark Type of registration: Number of places registered: care home 28 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 28 The registered person may provide the following categories of service only: Care Home with nursing - Code N To service users of the following gender; Either Whose primary cre needs on admission to the home are within the following categories: Old age not falling within any other category - code OP, maximum number of places, 28 Date of last inspection Brief description of the care home The Grove provides personal and nursing care for up to 28 older people. Accommodation is provided on two floors and there is specialist equipment such as nursing beds, hoists, and bathing facilities and a passenger lift is also provided. Set back in its own grounds there is parking to the front and side of the home. The main entrance is to the side and there is a large lounge conservatory overlooking the front garden and there is a smaller lounge to the side of a large dining room. Care Homes for Older People
Page 4 of 27 Over 65 28 0 Brief description of the care home Bedrooms are personalised and people are surrounded by their own possessions. People living in the home are supported by ordinary community based healthcare services including local General Practitioners, District Nurses, Physiotherapists and the Palliative Care Nurses. Activities are arranged on a daily basis and people are encouraged to be part of their local community. There are local shops nearby that include a supermarket, public house and post office. Visitors to the home are welcome and include local councillors, Clergy, local brass band and schools. On the day of the visit the Registered Manager said the fees for living in the home ranged from £296.00 to £438.60 per week. Other information bout the services provided can be obtained from the home and in particular the Statement of Purpose and Service User Guide. The Grove is on a main bus route and only a few minutes away from the rail station and the A1/M and M62 link roads. 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: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This is an overview of what the inspector found during the inspection. Following this visit the service has been given a Two Star rating which means people living in the home experience good quality outcomes. This was the first visit by the Commission since the new owners of the home were registered earlier this year. The visit started at 10.00 and ended at 14.00. During the visit there was the opportunity to speak to most people living in the home, the Registered Manager, Nurses, carers, cook, domestics, activities coordinator and visitors. Some peoples records were seen and included, assessments, care plans, reviews, daily and medical records. Some staff records were seen and included application forms, references, police and POVA (Protection of Vulnerable Adults List) checks. Staff training records were also seen and in particular the staff training MATRIX. Other information considered included the Annual Quality Assurance Assessment (AQAA), sent to us by the service before the visit. The record of complaints was seen, and the Regulation 26 Care Homes for Older People
Page 6 of 27 monthly providers visit reports and the maintenance records. This was a very positive and enjoyable visit and the inspector would like to thank the people living in the home, the manager and staff team for their hospitality and cooperation throughout the visit. Care Homes for Older People Page 7 of 27 What the care home does well: What has improved since the last inspection? To make sure peoples healthcare needs are fully met staff have received training on the Mental Capacity Act and Deprivation of Liberty Assessments. To maintain and Care Homes for Older People
Page 8 of 27 improve care standards within the home more staff now has a National Vocational Qualification at Levels 2, 3 and 4. This practice is to be commended. To improve and maintain healthcare provision for people living in the home Nurses now have Intermediate Leadership and Management qualification. This practice is also to be commended. Although the home does not administer peoples monies Independent Advocates are used to protect peoples financial interests when needed. This practice is to be commended. For the comfort and benefit of people living in the home and of those caring for them some new specialist Profiling beds have been provided. Some peoples bedrooms have been redecorated and refurbished and some are now provided with en-suite facilities. Other improvements include the provision of replacement windows to the older part of the building. This investment is also to be commended. 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 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. To make sure the service can meet peoples personal care and support needs these are assessed before coming to live in the home. Evidence: A sample of peoples records show their personal and healthcare needs are identified before coming to live in the home. The assessments show people and their relatives are fully involved in the assessment process. However, some assessments were not signed by people or their relatives to show they are involved and have a say in how they are to be supported. Some people come to the home from hospital and records show information is provided regarding their healthcare needs. To make sure peoples needs are fully identified the pre admission assessments are very comprehensive and include personal needs and choices, nutritional assessment and dietary needs, sight, hearing and communication, oral health and foot care, mobility and dexterity and history of falls.
Care Homes for Older People Page 11 of 27 Evidence: The assessments also include, peoples medication usage, continence, risk of pressure sores, and any mental health problems. The registered Manager said the assessments are holistic and look at every aspect of peoples personal and healthcare needs, including the involvement of other healthcare professionals such as tissue viability nurses or Palliative Care Team. Peoples records also show there is a social history completed making staff aware of peoples cultural backgrounds, spiritual needs, hobbies and preferences. 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. Peoples health and personal care needs are set out in an individual plan of care and they are protected by the way their medicines are dealt with. Evidence: To make sure people are protected by the way medicines are dealt with there is a Medication Administration Policy for staff to follow. To further protect people living in the home the training records show staff are trained in how to give medicines safely. Discussion with the nurses show they check the medicines regularly to make sure they are stored, administered and recorded properly. The Registered Manager also said they check the medicines to make sure they are correct. The Regulation 26, monthly providers visit reports also show a sample of peoples medicines are checked regularly. To make sure peoples care needs are fully met the Annual Quality Assurance Assessment shows nurses attend the local hospice Palliative Care Forum and attend End of Life training to help in caring for people who are very poorly. The way people want to be cared for and supported is set out in their individual plan of care. The dates on the reviews show the plan of care is looked at regularly and
Care Homes for Older People Page 13 of 27 Evidence: amended to reflect and show peoples changing care and support needs. A sample of peoples medical records show some of their healthcare needs are met by visiting professionals such as Physiotherapists, District Nurses, Tissue Viability and continence Nurses. The minutes of reviews show people and their relatives are involved and have a say in how they are supported. However, some of these are not signed to show they agree to the way they are to be cared for. People are treated with dignity and their privacy is respected as on the day of the visit visiting District Nurses asked someone living in the home if they would like to receive their treatment in the privacy of their own room. People living in the home appeared to be relaxed and happy. One person said they have everything they need and are well cared for. Another said they want for nothing and the staff are brilliant. Another said they have been very poorly but the staff looked after them very well indeed. People were observed during the visit being treated with dignity and having their wishes respected. However, the daily records dont contain many descriptive words to reflect and show this or any decisions they make about how they live their day to day lives. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People find the lifestyle experienced matches their expectations and they have a choice of a varied and balanced diet. Evidence: People enjoy a range of activities organised on a daily basis. Discussion with the Activities Coordinator found there are group activities, seasonal celebrations, and birthday parties. The photographs displayed show people enjoying activities within the home such as music and movement, and arts and crafts. The records show people enjoyed garden parties and coffee mornings this year which included visits from local Councillors including the Mayor. The Annual Quality Assurance Assessment also shows people enjoy visits to the local shops, community centres, and shopping trips. The Activities Co-ordinator confirmed that people also have one to one Social Sessions and Pampering Sessions. The care staff and Registered Manager confirmed that one to one time is encouraged and is an important part of their work. This practice is to be commended. However, the daily records and record of activities do not reflect this good one to one work. People living in the home said they have plenty to do and are looking forward to the Christmas celebrations. Discussion with a visiting hairdresser found they have been coming to the home for a number of years and enjoy visiting as there is always a
Care Homes for Older People Page 15 of 27 Evidence: warm welcome and a relaxed homely atmosphere. The minutes of the residents meetings show they have the opportunity to comment on the menu and the quality of the meals provided. Peoples records show their choices and preferences, likes and dislikes with regard to menu. One person said the meals are very good and another said they have plenty to eat. One person says they have a choice and can have something else if they dont like anything. The records show the home has a Gold Standard Award for food safety and preparation following a visit from the Local Authority Environmental Health Department. The Cook and kitchen staff is to be commended for maintaining such a high standard of food preparation for people living in the home. To make sure the standard of meals remain high the records show all kitchen staff has a National Vocational Qualification. A sample of peoples records show Nutritional Screening assessments are completed to make sure people receive the nutrition they need and require. Staff training records show that Nurses and carers have training in the nutritional needs of older people. This good practice is to be commended. 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. People know what they say will be taken seriously and acted upon and people are protected from any kind of abuse. Evidence: The minutes of the residents and staff meetings show people have the opportunity to comment on the running of the home and the services provided. The satisfaction surveys show people and their relatives know how to make a complaint. Discussion with people living in the home shows they know who to see if they have any concerns. People spoken to say they have never had to make a complaint, and on person said if they have any problems they just tell staff and its sorted right away. To make sure people know how to make a complaint the complaints policy and procedure is displayed in the home. The records show no complaints have been received by the Commission about the service. To make sure people are protected from any kind of abuse there is a Safeguarding Policy and Procedure for staff to follow that contains the Wakefield Local Authority Protocols. Records show the service has made one Safeguarding referral to the local authority this year. Discussion with the Registered Manager and records of the Safeguarding referral show that this was appropriately dealt with and people remained safe. To keep people safe records show all staff has Safeguarding training, and discussion with staff found they have a good understanding of what constituted abuse and how to report it.
Care Homes for Older People Page 17 of 27 Evidence: Peoples best interests are protected as on the day of the visit there was the opportunity to speak to a visiting independent advocate who had been asked to visit as because of issues around the estate of one person living in the home. This practice is to be commended. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a relaxed homely environment that is comfortable, clean and safe. Evidence: On the day of the visit people were observed relaxing in the lounges, dining room and their own bedrooms. For the benefit of people living in the home and to prevent any opportunity for cross infection all areas of the home are clean and free from any unpleasant odours. Discussion with the domestics found they have all the equipment they need and require to carry out their duties effectively. To keep people safe records show they have COSHH (Control of Substances Hazardous to Health) training. To further protect people records show domestics have a National Vocational Qualification in good housekeeping. This practice is to be commended as it is over and above the recommended National Minimum Standards. The Registered Manger and staff team are to be commended for maintaining such a high standard of cleanliness for people living in the home. To further protect people and promote their health, safety and wellbeing, the maintenance records show the fire alarms and emergency lighting are checked regularly. To make sure people remain safe the records show other equipment such as hoists, passenger lift and pressure relieving mattresses are also checked on a regular basis. The regulation 26 monthly providers report shows Health and Safety issues are looked
Care Homes for Older People Page 19 of 27 Evidence: at regularly and action taken to make sure the environment remains safe. The registered Manager said there have been a number of improvements to the environment since the last visit. These improvements included replacement windows to the front of the building, redecoration and refurbishment of some bedrooms. For the comfort and benefit of people living in the home and those caring for them ten new Profiling beds have been provided and one bedroom provided with an en-suite wet room. A tour of the premises confirmed this and these improvements are to be commended. However, throughout the building it was noted that the joining of corridor carpets was with black tape and although safe was unsightly and was not in keeping with the high standards set by the rest of the home. The Registered Manager said there are plans to replace the corridor carpets. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples personal and healthcare needs are met by staff that are trained and qualified and they are protected by the way staff are recruited and selected. Evidence: The Registered Manager said that there is always enough staff planned to be on duty to meet peoples care and support needs. The staffing rota confirmed this. On the day of the visit enough staff was observed to be available to meet the needs of people in a relaxed and unhurried manner. To make sure peoples nursing needs are met records show there is a Level 1 nurse on duty at all times. The Registered Manager, who is also a Registered Level 1 Nurse, says they are supernumerary and available to cover in emergencies. For the benefit of people living in the home and meeting their nursing needs the practice of having the Registered Manager off rota and supernumerary is to be commended. To make sure peoples care and support needs are met records show they are supported by trained and qualified staff. Nearly all staff has a National Vocational Qualification at Levels 1, 2 and 3. This practice is to be commended. Records also show the Nurses as well has been registered with the Nursing and Midwifery Council have an Intermediate Leadership and Management qualification. This practice is also to be commended in maintaining high standards of care within the home. To keep people safe records show staff have Moving and Handling, Food Hygiene, First Aid, Infection Control, and Health and Safety training. To make sure peoples mental health needs are fully met records show staff also have Mental
Care Homes for Older People Page 21 of 27 Evidence: Capacity Act and Deprivation of Liberty training. Records also show staff has training in the prevention of pressure sores, and the nutritional needs of older people, and in caring for those with Dementia. The minutes of the staff meetings and supervision notes show they have the opportunity to comment on the running of the home and the services provided. To fully meet the needs of people living in the home requiring specialist care the minutes of the Palliative Care Forum shows nurses have close links with Pontefract Hospice and are kept up to date with modern trends in caring for people requiring end of days care and support. Throughout the visit positive relationships were observed being fostered between those living in the home and those caring for them. People living in the home say they are well cared for and happy. One person said the staff is wonderful, another said staff are brilliant and they want for nothing. Another person nursed in bed said they are the staff are very good and they are well cared for. People are protected by the way staff are recruited and selected as a sample of records show references, police and POVA (Protection of Vulnerable Adults List) checks are taken up before they are employed. Staff working in the home said they are happy, feel supported and enjoy their work. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a well managed home that is run in their best interests and where their health, safety and wellbeing is promoted and protected. Evidence: Records show the care management systems in the home are good and peoples care and support needs are met and they have a say in what they do and what happens to them. People are protected by they way staff are managed and they are supported by a trained, qualified and dedicate staff team. Records show the views of people living in the home, their relatives and other visitors are sought through satisfaction surveys. However, the Registered Manager said the information gathered has yet to be collated and a report provided showing what people said and any changes made to the way the home runs as a result of their comments. The Registered Manager said the home does not administer any service users finances. The Annual Quality Assurance Assessment confirmed this. The maintenance records and staff training records and in particular the training MATRIX shows peoples Health, Safety and Well-being is promoted and protected.
Care Homes for Older People Page 23 of 27 Evidence: The information sent to us and in particular the AQAA (Annual Quality Assurance Assessment) shows to make sure people are protected there are health and safety policies and procedures for staff to follow, that are updated regularly. 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 3 To show people are involved and have a say in how they are to be cared for and supported signatures should be obtained whenever possible to show their or their relatives involvement. It is acknowledged that people have a say in what they do and their choices and preferences are respected, however, the daily records would benefit from an increase in the use of descriptive words to show and reflect this. It is acknowledged that people make decisions about what they do and how they live their daily lives, however, these should be reflected in the daily records, or plan of care. To keep the home looking homely and comfortable the remedial work needed on the corridor carpets should be completed as soon as is practicable. The information gathered through quality assurance satisfaction surveys should be collated and a report provided showing what people said about the home and the quality of services provided. It should also highlight any changes to the way the home runs as a result of peoples comments.
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