Inspection on 14/04/10 for York House (York Way)

This is the latest available inspection report for this service, carried out on 14th April 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 (York Way) 09/01/07

York House (York Way) 20/12/05

York House (York Way) 14/06/05

York House (York Way) 12/11/04

York House (York Way) 10/06/04

Extracts from inspection reports are licensed from CQC, this page was updated on 18/06/2010.

Key inspection report Care homes for adults (18-65 years) Name: Address: York House (York Way) York House 180-182 York Way Watford Hertfordshire WD25 9RX 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: Patricia House Date: 1 4 0 4 2 0 1 0 This report is a review of the 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 stars – excellent  2 stars – good  1 star – adequate  0 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. They reflect the things that people have said are important to them: 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 Adults (18-65 years) Page 2 of 22 Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) 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 Adults (18-65 years) Page 3 of 22 Information about the care home Name of care home: Address: York House (York Way) York House 180-182 York Way Watford Hertfordshire WD25 9RX 01923676611 01923676611FP kilcullenhomes@fsmail.net Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Miss Caroline Dunne,Mr Michael Dunne Name of registered manager (if applicable) Miss Caroline Dunne Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 13 1 care home 13 mental disorder, excluding learning disability or dementia Additional conditions: The category MD(E) only applies while the named service user remains at the home. Date of last inspection A bit about the care home York House/York Way is a care home providing personal care and accommodation for 13 adults (18-65) with mental disorders but excluding learning disability or dementia. It is privately owned and the Registered Manager is also the joint Registered Provider. The home is made up of 2 adjoining semi-detached properties at 180 and 182 York Care Homes for Adults (18-65 years) Page 4 of 22 Way, which are linked internally. The home has recently been renovated throughout. All the homes bedrooms are singles with en-suite facilities. Each house has a bathroom and a staff sleeping-in room. House 182 also contains the Managers office and the main laundry room and staff have an office in house 180. There is a large, easily accessible, well-maintained garden to the rear of the building and ample car parking space to the front. York House is situated in Garston, near to bus routes and local shops and residents have easy access to the town of Watford, which has numerous facilities and good transport links. The homes Statement of Purpose, Service Users Guide and the last inspection report are displayed and copies are available on request. The current fees for the home are £545.16 per week. Care Homes for Adults (18-65 years) Page 5 of 22 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 Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home Care Homes for Adults (18-65 years) Page 6 of 22 How we did our inspection: This is what the inspector did when they were at the care home The information in this report is based on an unannounced inspection of the home, which took place over one day with one regulation inspector carrying out the work of the Commission. For the purposes of this report the Commission will be referred to as we. The registered manager was not on duty, but the acting manager was present throughout the inspection. We spoke with staff and residents. We visited all communal areas in the home and checked a variety of records. Before the inspection the manager had completed and returned to the Commission an annual self-assessment quality review, the Annual Quality Assurance Assessment, (the AQAA).This document included statistical information about the home and confirmation of policy reviews and equipment checks. We have also reviewed any other information we have received about this service since the last inspection. What the care home does well The residents we spoke with confirmed they enjoy living in the home and said the care staff always support them in the way they prefer. The staff team are well trained and continue to help the residents to make their own choices and remain as independent as possible. Care planning is thorough and residents are fully involved in these plans and in care reviews and updates. Care staff work as a team and are kept up to date with all current guidelines and legislation related to providing residential care, which in turn directly benefits people who use the service. Care Homes for Adults (18-65 years) Page 7 of 22 What has got better from the last inspection What the care home could do better If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Patricia House CQC East Citygate Gallowland Newcastle upon Tyne NE1 4PA If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.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 Adults (18-65 years) Page 8 of 22 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 22 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, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. 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 the person 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 who use the service are provided with appropriate information to enable them to decide if the home is right for them. Detailed assessments are completed to ensure all individual needs can be met at the home. Evidence: The home has a written Statement of Purpose and Service Users Guide which is displayed in the home. Copies are given to all residents and are available on request. We checked a selection of residents records and all contained detailed assessments, completed before the individual entered the home and contained written care needs summaries from referring agencies. This information ensures that services provided at the home are appropriate to meet individual needs. Initial care plans had been completed from this information so that care staff could be clear about how to meet individual needs. Care Homes for Adults (18-65 years) Page 10 of 22 Individual needs and choices 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 needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. 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 who use the service have their needs fully documented and can be sure that care staff will support them to remain as independent as possible. Evidence: We spoke with several residents during the visit and then tracked a selection of corresponding care plans. In all cases the planning was centred on the individual concerned and we saw evidence that the residents had been involved in completing their plans. Written details showed how people had chosen to spend their days and showed their preferences for how staff support them with their personal care. We saw details of how residents budget and handle their own money and saw details of the regular health checks which take place. Records of daily events and activities are recorded electronically for all residents. These records evidence how the care planning requirements are put into practice for each resident. Appropriate risk assessments were recorded, covering daily activities so that residents are able to safely remain as independent as possible. People we spoke with said they choose how they spend their days and most residents go out independently to the local Care Homes for Adults (18-65 years) Page 11 of 22 Evidence: shops and cafes. Care Homes for Adults (18-65 years) Page 12 of 22 Lifestyle 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 can take part in activities that are appropriate to their age and culture and 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 and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. 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. Procedures followed in the home ensure that people spend their days as they prefer and enjoy the food provided which helps to promote their well being. Evidence: The residents we spoke with demonstrated to us that they made their own decisions about how they spend their days. Some residents were out during the visit and some returned in the afternoon. Some residents had remained in the home and one was using the smoking room. One resident is enrolled at a local college and goes to the local library to use the computer. Another resident likes to paint and staff said they go to local shops to buy their own paint and materials. We saw evidence that residents go to the cinema and use local buses to go to the market in the town. The staff we spoke with confirmed that the residents sometimes go out in groups but that mostly people prefer to pursue their own activities. There is an arranged holiday for residents each year and last year residents went to Blackpool. Many of the residents also attend local day centres and one has a staff member to accompany them on these occasions. All the residents have their own mobile telephones for their own safety. Care Homes for Adults (18-65 years) Page 13 of 22 Evidence: The staff confirmed that visitors are welcomed at the home at all times and said that some families make regular visits to the home. Residents generally keep their own rooms clean and share the household tasks with staff. All bedrooms have locks on the doors and residents have their own keys. We noted that bedrooms were mostly locked during the inspection. Staff said that each bedroom has a lockable safe for personal belongings. The kitchen in the home has been completely refurbished and made more user friendly for the benefit of the residents. People are able to make drinks and snacks and said they are involved in choosing menus. We saw evidence that all appropriate food and appliance temperature checks are completed and records are kept of the food consumed by residents in line with Food Standards guidelines. One resident has recently chosen to follow a vegetarian diet and staff are supporting them in this wish. Staff said that no one has to have food or fluid records kept at present as residents are eating well and that weight checks show there are no concerns about nutrition. People we asked said they enjoy the food provided at the home and confirmed that staff treat them with respect at all times and always respect their privacy. Care Homes for Adults (18-65 years) Page 14 of 22 Personal and healthcare support 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 receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people 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. If people are approaching the end of their life, the care home will respect their choices and help them to 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. People who use the service have their health needs met in the way they prefer and procedures followed in the home ensure that the system for administering medication helps to protect residents from the risk of harm. Evidence: Care staff confirmed that none of the residents had any pressure sores or serious health needs at present. People we spoke with said they were happy with the support provided by staff and were mostly independent with personal care. We saw evidence that appropriate referrals and appointments were made for residents to see health professionals. We checked the system for storing and administrating medication during the inspection. Currently none of the residents administers their own medication and no controlled drugs are used in the home. Records were completed well and we found no errors in recording. We just recommended that two staff signatures are completed to confirm that any hand written instructions are correct. All staff receive training from an external company before they can administer medication in the home. The acting manager confirmed that staff competency to administer medication would be assessed and signed off annually. Care Homes for Adults (18-65 years) Page 15 of 22 Concerns, 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. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. 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 who use the service can be confident that any concern they might have will be listened to and that procedures followed in the home help to protect them from the risk of harm. Evidence: The home has written policies on Making a Complaint, Safeguarding and Whistle Blowing, which staff said they were aware of and aware of their implications. All care staff receive training in adult protection. Details about making a complaint are displayed in the home and the residents we asked said they would not hesitate to voice a concern if they had one. Care Homes for Adults (18-65 years) Page 16 of 22 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, comfortable, 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. People have enough privacy when using toilets and bathrooms. 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 who use the service benefit from living in a home which is well maintained and where procedures followed ensure they are protected from the risk of harm. Evidence: The facilities in the home have been completely altered and upgraded since the last inspection. Internal rooms have been altered and now provide more varied communal rooms and a brand new kitchen for the benefit of the residents. There is a new smoking room which only has outside access, although access is covered, and this room, whilst being pleasant to use, does not affect the non-smoking residents. There are now several lounges so that residents can choose to be with others or on their own on most occasions and the kitchen is now easier for residents to use. All but one of the bedrooms have a shower en-suite and there is a sink in the remaining room. There are also two additional bathrooms so that residents Can choose how they complete their personal care. All areas of the home were clean and well decorated during the visit. All communal bathrooms and toilets contained liquid soap and paper towels as recommended in current guidelines for good infection control. The home has a written policy on Infection Control and staff link with the local Health Protection Unit to ensure good practice is maintained. Care Homes for Adults (18-65 years) Page 17 of 22 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, qualified 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. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. 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 who use the service are supported by a competent and professional workforce and are protected by thorough recruitment practices. Evidence: During the inspection the acting manager and three care staff were on duty. Two care workers also sleep in the home at night. People we asked said they felt there were usually enough staff on duty to meet their needs and they praised the staff for the support they provided. We checked a selection of staff recruitment records and those seen contained a completed application form or C V. Some care workers are now employed on a selfemployed basis but we saw evidence that appropriate recruitment checks were in place. The manager is aware that employees who are students must provide evidence of their student and employment status. We saw evidence of the training courses which all staff at the home attend. These cover all the areas seen as essential to the role of support worker and all training has a basis of Equality and Diversity standards.. In addition the acting manager confirmed that all care staff undertake NVQ training. Currently two care workers have completed level 2 and 2 are completing level 3 NVQ. Care Homes for Adults (18-65 years) Page 18 of 22 Conduct and management of the 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 have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because 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. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. 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 who use the service benefit from living in a home which is well run and where their views are incorporated into the daily running of the home. Evidence: The acting manager who was on duty during the visit has now completed NVQ4 training and demonstrated a clear knowledge and understanding of current regulations and guidance for providing good residential care. The residents and staff we asked said the home is well managed and confirmed their views are always listened to. The home has a written policy on Quality Assurance and annual questionnaires are sent out to all residents, families and stakeholders. Comments from the returned surveys are checked and the acting manager said that changes could be made as a result of any issues raised. We saw no hazards or hazardous substances left accessible during the inspection and fire equipment has been regularly serviced. Records show that regular fire drills take place and accident and incident records are also well documented. Care Homes for Adults (18-65 years) Page 19 of 22 Are there any outstanding requirements from the last inspection? Yes  No  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 Adults (18-65 years) Page 20 of 22 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 Description 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 Description 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 Adults (18-65 years) Page 21 of 22 Helpline: Telephone: 03000 616161 or 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 Adults (18-65 years) Page 22 of 22 - 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. 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