Inspection on 01/06/10 for York House

This is the latest available inspection report for this service, carried out on 1st June 2010.

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

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

Other inspections for this house

York House 20/01/10

York House 01/12/08

York House 21/08/07

York House 14/11/06

York House 31/01/06

York House 04/07/05

York House 01/02/05

York House 26/08/04

York House 30/03/04

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Queensmount

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Belma

Hunters Care Centre

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Extracts from inspection reports are licensed from CQC, this page was updated on 09/06/2011.

Key inspection report Care homes for older people Name: Address: York House 8-10 Cauldon Avenue Swanage Dorset BH19 1PQ     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: John Hurley     Date: 0 1 0 6 2 0 1 0 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 24 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 24 Information about the care home Name of care home: Address: York House 8-10 Cauldon Avenue Swanage Dorset BH19 1PQ 01929425588 01929425588 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mrs Maxine Valerie Toni Jacqueline Wylie,Mr Richard Graham Wylie Name of registered manager (if applicable) Mrs Margaret Street Type of registration: Number of places registered: care home 34 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home York House is a large, older style, detached property that overlooks a recreational/garden area and is close to the seafront. The home is approximately a mile from Swanage town centre, which has a G.P surgery, community hospital, shop, banks, a post office and places of worship. Accommodation is provided over three floors, all are serviced by a passenger lift. All communal lounges and dining areas are on the ground floor, also the kitchen and managers office. There are 30 bedrooms in the home; 20 have en suite toilet facilities. Two rooms are registered for use as shared rooms. A maximum of 34 service users can be Care Homes for Older People Page 4 of 24 2 1 0 1 2 0 1 0 0 Over 65 34 Brief description of the care home accommodated in the category OP (older persons). Mr and Mrs Wylie are the registered providers and have owned York House since Novemeber 1986. The registered manager is Mrs Street, who is supported by a two deputy managers and a team of care and household staff. The gardens and grounds are well tended with garden furniture available so that residents can sit outside in good weather. There is car parking space at the front of the house for use by visitors. Laundering of clothing and household linen is carried out at the home and arrangements are made for chiropodists, opticians and other health and social care professionals to visit individual residents. The fee range quoted in the service user guide at the time of inspection was £455 to £515 per person per week. Up to date fee information may be obtained from the service. Information regarding the subjects Value for Money and Fair Terms in Contracts can be obtained from the web link: www.oft.gov.uk Care Homes for Older People Page 5 of 24 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: The inspection was undertaken on the 1st of June 2010. The focus of the inspection was to look at relevant key standards under the Commission for Social Care Inspection (now the Care Quality Commission) Inspecting for Better Lives 2 Framework. This focuses on outcomes for residents and measures the quality of the service under four headings; these are excellent, good adequate and poor. The judgment descriptors for the seven sections are given in the individual outcome groups and these are collated to give an overall rating for the quality of the service provided. We looked at three selected care files in detail, the staff files, undertook a tour of the building and looked at all the documentation relevant to the running of a care home. Care Homes for Older People Page 6 of 24 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 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 7 of 24 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 8 of 24 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. The home provides good information with regards to the services on offer. More could be done to ensure that the initial assessment of need is more detailed so that the home can be confident it can meet the needs of the prospective resident. Evidence: We sampled the service user guide and found that it describes the home and the facilities on offer in relation to the accommodation. It sets out the aims and objectives in relation to meeting peoples needs through care planning and ongoing assessment, key terms and conditions in relation to taking up residency and an abridged version of the complaints procedure. We looked at a sample of the pre admission assessments that had been carried out in relation to some of the people who had taken up residency to establish how the home had carried out the required needs assessment. The recording evidenced that an assessment of need had been made prior to the person entering the home. These Care Homes for Older People Page 9 of 24 Evidence: assessments was much improved over previous inspections and now covered areas such as medication, falls risk assessment, health and personal care. However in two peoples initial assessments we found that mental health issues were noted but not fully explored. In one case the assessment and care plan on discharge from hospital was for the person to be refereed to a Community psychiatric Nurse but this had yet to be achieved. The registered manager accepted this observation and made a commitment to looking at this issue in further assessments. Furthermore once this oversight was discussed they made immediate arrangements to rectify the situation. The resident in question informed us that they were very happy at the home and considered their needs were being met well. Where the home had not carried out its own assessment it had obtained other professionals assessments of need with which to establish if the home could met the documented need. The home does not provide intermediate care. Care Homes for Older People Page 10 of 24 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. The care plans and associated documents continue to improve and demonstrate how the home meets the needs of those who live at the home. The home has good systems for the administration of medication. Evidence: We looked at three peoples care plans in order to establish if the home had made improvements. We found that the care planning system has been revised in between inspections and now contained good guidance for staff to assist people. Building on the information from the initial and once the person begins to settle in the staff begin to gather information such as a social history assessment and further information on the likes and dislikes of the individual. This is now clearly documented in the files relating to individual care. The information observed regarding risk assessments is now better documented in areas such as falls and nutritional screening but some issues regarding mental health issues need to be more robust for example one person is noted as having aggressive behavior where the recorded guidance to staff is to speak to a senior on duty, but not what to do if this happens. It was further noted that Care Homes for Older People Page 11 of 24 Evidence: the home was using a generic risk assessment for mental health issues where it would be more appropriate, and person centered, to use a individual risk assessment. Having said through discussion with staff we established that those staff who carrying out these assessments now have a better understanding of how to carryout and work with risks in order to provide a safe environment for people who live at the home. The care files demonstrate the other health care professionals such as doctors and district nurses visit the home and provide on going assistance to those who live there. With the exception of the individual discussed under the heading Choice of Home health care professionals are called in as and when needed. The registered manager informed us that they have a good working relationship with these professionals. The staff we spoke with were clear as to the help people needed. People who live at the home informed us that staff meet their needs in a way that suits them. We looked at the Medication Administration Record (MAR) and found that they were being maintained reasonably well. For the people who self medicate at the home the staff have introduced a more robust risk assessment to ensure peoples safety. The home now has an up to date homely remedies policy and there is clear evidence that individuals doctors are consulted about the use of homely remedies. All MAR sheets and medication held by the home is regularly audited by senior staff. We observed the staff interaction with the residents during our inspection and found it to be both empathetic and respectful. Care Homes for Older People Page 12 of 24 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. Those who live at the home have opportunities to have their social and recreational needs met. Visitors are welcomed and individuals are assisted with maintaining contact with relatives and friends. Evidence: People who use the service were observed in a number of different locations. They choose when to get up and when to retire. They have free access to their bedroom and communal facilities. Those who use the service are able to meet privately with visitors in their rooms. Those who were spoken with and could articulate their views indicated that they were happy with their life in the home and confirmed that the staff support them in following their preferred lifestyle. On the day of the inspection activities were available for those who wanted to join in. The people who we spoke with confirmed that there is plenty to do if you want to. We were informed by staff and residents that some people access the local community either on a one to one basis (with staff) or independently. We were informed by those who use the service that the food was always good and that choices were available. People told us that the staff knew peoples likes and Care Homes for Older People Page 13 of 24 Evidence: dislikes and as such were able to cater for their needs. Care Homes for Older People Page 14 of 24 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. The home has both formal and informal systems in place to ensure that the views of those who use the service are listened too. Evidence: The people who use the service informed us that they know who to speak to if they are unhappy and wish to complain. They informed us that they can speak with staff and are confident that issues will be addressed, this view was also supported by visiting relatives. The homes management have formal systems in place for recording complaints. there has been no complaints raised since the last inspection to either the home or the regulator. Care Homes for Older People Page 15 of 24 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. Residents benefit from comfortable and well maintained surroundings. Residents can personalise their private space. Residents benefit from a home that is generally maintained in a clean and tidy condition. Evidence: We were informed by those that live at the home that they can bring personal possessions with them into the home. We looked at a sample of the bedrooms and found that they had been personalised with pictures, furniture and photographs to reflect the individuals taste. We looked around the premises to see what improvements had been made since the last inspection. We found that the front door is now locked meaning a safer environment, the signing in book is used for all visitors. We found the home was clean and infection control practices were being adhered too. We looked in a number of peoples rooms and noted that windows had there opening restricted, radiators and associated pipe work has now been covered with risk Care Homes for Older People Page 16 of 24 Evidence: assessments available to cover other areas of the home. There was evidence of regular checks of fire escapes and the fire alarm procedures. From carrying out a tour of the building it was clear that there continues to be some inward investment into the environment. There are a range of adaptations and aids available in the home to help maximise independence where possible. Care Homes for Older People Page 17 of 24 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 enough staff to meet peoples needs. People living in the home were confident that they were well looked after. The recruitment procedures in place to protect people from the risk of unsuitable staff working at the home. Evidence: On the day of the inspection the staff were observed meeting the needs of the residents in a professional and respectful manner. We talked with the staff on duty who were knowledgeable with regards to how to meet the assessed needs of the resident group. The residents themselves confirmed that the staff meet their individual needs in a way that suits them. They further commented that if they use the call system a member of staff will attend to them without to much delay. The staff files that were sampled contained sufficient detail with which to establish the prospective employees suitability for the job, all requirements as set out in the National minimum standards are now being adhered to. We spoke with staff who confirmed that they had received an induction into the care home where the needs of the resident group were explained. The home uses distance learning materials to Care Homes for Older People Page 18 of 24 Evidence: support the staffs induction. Statutory training is documented evidencing that staff have opportunities to learn and develop. The staff have started to receive regular training with regards to the tasks they perform and many improvements have been made with regards to the way senior staff support other staff at the home. Through discussion with the registered manager and through looking at the needs of the people who live at the home we consider that it would be helpful if more staff have opportunities to develop their knowledge in relation to the mental health issues and the psychiatry of old age. Care Homes for Older People Page 19 of 24 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. The management team at the service provide good and positive leadership. The staff group are formally supervised and their work appraised. Evidence: The management team have made significant progress in meeting the requirements set at the last inspection. Although there is still more work to be done this inspection notes continued improvement in service delivery. However systems need to be developed to ensure that all information available to those carrying out initial assessments and reviews is robustly scrutinized to ensure that people do not have unmet needs. (this is in relation to mental health needs) The records inspected were well organised, well maintained and kept up to date. Records inspected included the complaints log, accidents, medication, staff files, rotas, fire logbook, training records, safety checks and maintenance. Fire safety equipment has been serviced and tested as required. Staff have been provided with regular fire safety training. Equipment servicing records have been appropriately maintained. The feedback from the people Care Homes for Older People Page 20 of 24 Evidence: who use the service confirmed that they continue to feel a sense of belonging living at the home and gave examples of how staff do that little it extra to help out. They informed us that they can raise issues with the management, can identify who the manager is and are confident that issues are dealt with promptly and effectively. The staff files evidence that staff are receiving supervision and so management have a formal way of ensuring standards are being consistently applied, peoples needs are being met in a consistent manner and issues such as falls are being robustly addressed. As already discussed risk assessments have been improved in relation to the environment so that the health and safety of those who live and work at the home is not compromised. The home operates a comprehensive system of quality audits to ensure that people are provided with a safe and comfortable environment these include reviewing Personal Emergency Evacuation plans, weight monitoring charts, care plan audits to ensure that current standards are maintained. Care Homes for Older People Page 21 of 24 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 22 of 24 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 The registered manager should explore mental health issues more at the initial assessment stage to ensure that the staff have the necessary skills to meet the individuals needs. The registered manager needs to consider giving more detailed instruction to staff with regards to dealing with aggressive behavior. The registered manager should consider ensuring staff have opportunities to develop their knowledge with regards to mental health issues. 2 7 3 29 Care Homes for Older People Page 23 of 24 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. © 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. Care Homes for Older People Page 24 of 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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