Inspection on 22/08/06 for Anley Hall Nursing Home

This inspection was carried out on 22nd August 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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

Anley Hall Nursing Home 15/05/07

Anley Hall Nursing Home 20/12/05

Anley Hall Nursing Home 06/01/05

Anley Hall Nursing Home 17/06/04

Similar services:

Snydale Care Home

Abbey The

Whiteley House

Larchfield Manor

Hawkhills

Beeches The - North Yorkshire County Council

The Grove Waltham

Staveley Birk Leas Nursing Home

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Anley Hall Nursing Home Anley Hall Skipton Road Settle North Yorkshire BD24 9JU Lead Inspector John McGarva Key Unannounced Inspection 22nd August 2006 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Anley Hall Nursing Home DS0000027923.V308569.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Anley Hall Nursing Home DS0000027923.V308569.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Anley Hall Nursing Home Address Anley Hall Skipton Road Settle North Yorkshire BD24 9JU 01729 822268 01729 822123 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) www.anleyhall.co.uk Mr Malcolm Haigh Mrs Felicity Ann Kirby Care Home 47 Category(ies) of Dementia (47), Mental disorder, excluding registration, with number learning disability or dementia (47), Old age, of places not falling within any other category (47), Physical disability (47), Terminally ill (47) Anley Hall Nursing Home DS0000027923.V308569.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Age Range 45 years upwards Service Users to include up to 47(OP), up to 47(PD), up to 47 (DE), up to 47 (MD) and up to 47 (TI) up to a maximum of 47 Service Users 29th June 2005 Date of last inspection Brief Description of the Service: Anley Hall is a care home providing nursing care for up to 47 residents who are elderly and may suffer from; Dementia, Physical Disability or be Terminally Ill. It is a Georgian, circa 1830, stone built country house, previously a private dwelling and is situated in a rural setting on the outskirts of the market town of Settle in the Yorkshire Dales. There are two floors including ground floor and a vertical lift provides level access to the first floor. It retains many of its original features including high ceilings and chandeliers and has extensive gardens, which are well maintained. It was converted for its present use in 1986 / 87. The fees charged at 04/07/06 are £490 - £640 per week. Anley Hall Nursing Home DS0000027923.V308569.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report relates to an unannounced inspection that took place on Tuesday 22nd August 2006. The manager, Mrs Felicity Ann Kirby was available to assist with the process throughout. The inspection lasted 4.5 hrs (10.00 am to 3.30pm). There were 37 residents in the home and all were in receipt of nursing care. The inspection focused on some of the key standards as well as addressing issues, which were identified at the last inspection. The manager and staff spoken to provided information in an open and professional manner. An inspection of some areas of the premises took place, including bedrooms, lounge and dining areas, bathrooms and kitchen. Discussions took place with the manager, carers, and residents. What the service does well: The home provides a good quality of care in a homely and professional manner. All the staff works as a well-integrated team and the rapport between the staff and manager was observed to be very positive. Conversations with the staff and residents confirmed that this was the case. The input from the activities person is positive and subtle, adding real value to the quality of the resident’s experience in the home. Her focus on the memories, biographies, experiences and anniversaries of the residents is an important area of activity in the care of the older people. There are good systems of documentation in relation to care planning, policies and procedures. Anley Hall Nursing Home DS0000027923.V308569.R01.S.doc Version 5.2 Page 6 The care staff are now being encouraged to record the care they give in the daily record statements and this is a positive development both for the care staff and the residents. All residents spoken to indicated their contentment at the quality of the care provided by the nurses and care staff and also commented favourably on the quality of the food. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Anley Hall Nursing Home DS0000027923.V308569.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection Anley Hall Nursing Home DS0000027923.V308569.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The resident’s needs are sufficiently assessed prior to and after admission and these assessments provide the basis on which the care plans are developed. EVIDENCE: Evidence from the case tracked residents records confirmed that pre-admission assessment sheets are completed prior to admission. The manager or a senior nurse usually undertakes these either in hospital or the resident’s place of residence prior to admission. Later on a fuller assessment is undertaken which gives more comprehensive information upon which basis the care plan is developed. Intermediate Care (Standard 6) is not provided in this home. Anley Hall Nursing Home DS0000027923.V308569.R01.S.doc Version 5.2 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The resident’s needs are being met in a professional, sensitive and programmed manner. EVIDENCE: The home utilise the Kardex system of documentation and individual plastic folders are available for each of the residents and into which all information relating to them is located. The documentation includes admission details, assessments, care plans, daily statements, nutritional assessments and weight charts. The Waterlow assessments for risk from pressure sores are relevant and appropriately documented. Anley Hall Nursing Home DS0000027923.V308569.R01.S.doc Version 5.2 Page 10 There is a key worker system whereby the nursing and care staff is allocated a small group of residents to care for. Some of the care staff as well as the nursing staff are now contributing to the daily records of care and this will become more established in the future. There are five residents in the high banding for nursing care and thirty-one in the medium range with only in the lower banding. Nine of the residents are bedfast. There is one resident who is in receipt of enterostomy feeding through a stomach tube. (PEG). The medications are stored and administered in accordance with recommended practice. The seven-day satisfactorily. NOMAD blister pack system is used and is working Anley Hall Nursing Home DS0000027923.V308569.R01.S.doc Version 5.2 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is meeting the resident’s social and dietary needs in a sensitive and caring manner. The quality of the meals provided is good and commented on favourably by staff and residents alike. EVIDENCE: The resident’s routines of daily living are tailored to their needs and choice and there is an activities organiser for 20 hrs per week to assist with in social activities. The activities organiser’s work is important and particularly well appreciated both by the residents and staff spoken to during the inspection. The organiser makes it her job to identify those who may require a visit in their rooms and help, either with conversation or assistance with letters or other private matters. Anley Hall Nursing Home DS0000027923.V308569.R01.S.doc Version 5.2 Page 12 She has more recently been developing biographies of the residents so that the staff can relate to them on a more personal basis. Significant events in the resident’s life such as anniversaries, events, including deaths are important to be aware of as they can trigger responses, which may require sensitive intervention. Visitors can attend at any time they choose, day or night with drinks provided for them routinely and also meals when required. The residents were very complimentary about the quality of the food provided, and the staff spoken to also confirm that the meals were of consistently good quality. Entertainers are arranged on a regular basis and outings are also organised with the use of a mini–bus that is made available on request. Anley Hall Nursing Home DS0000027923.V308569.R01.S.doc Version 5.2 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a relevant complaints procedure and the staff has received abuse awareness training. EVIDENCE: The resident’s routines of daily living are tailored to their needs and choice and there is an activities organiser for 20 hrs per week to assist with in social activities. The activities organiser’s work is important and particularly well appreciated both by the residents and staff spoken to during the inspection. The organiser makes it her job to identify those who may require a visit in their rooms and help either with conversation or assistance with letters or other private matters. She has more recently been developing biographies of the residents so that the staff can relate to them on a more personal basis. Significant events in the resident’s life such as anniversaries, events, including deaths are important to be aware of as they can trigger responses, which may require sensitive intervention. Anley Hall Nursing Home DS0000027923.V308569.R01.S.doc Version 5.2 Page 14 Visitors can attend at any time they choose, day or night with drinks provided for them routinely and also meals when required. The residents were very complimentary about the quality of the food provided, and the staff spoken to also confirm that the meals were of consistently good quality. Entertainers are arranged on a regular basis and outings are also organised with the use of a mini–bus that is made available on request. Anley Hall Nursing Home DS0000027923.V308569.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 21, 22, 24 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The environment is clean and comfortable but requires some improvement in the general décor and improved equipment. EVIDENCE: The home is set in very pleasant grounds and these are kept in a good condition with easy access by wheelchair being provided. There are thirty-three single rooms, twenty-five of which have en-suite toilet facilities and four shared rooms also with en-suite facilities. The décor of the environment looks tired in places and in need of redecoration. Anley Hall Nursing Home DS0000027923.V308569.R01.S.doc Version 5.2 Page 16 The manager mentioned that the provider has in mind a significant improvement plan for the home to be unveiled in the near future. This would include endeavouring to provide more en-suite rooms and general upgrade of the facilities. Issues, which need to be addressed, include: • • The provision of an additional sluice room with another disinfector on the ground floor as there is at present only one provided on the first floor. Only one adjustable bed for nursing cases is at present provided. These are particularly needed for the bed-fast nursing cases of whom there are nine at present. Power assisted hoists in the bathrooms are required to replace the mechanical’ wind-up’ variety presently in use. One ‘island bath’, i.e. a bath that is located in the centre of the bathroom and permits access to three sides is required for the increasingly debilitated residents. An additional assisted shower is needed, as these are popular with the residents and easier to access than baths. The provision of power assisted mobile hoists. A ‘Stand aid’ to assist the transfer of residents from wheel chair-to-chair is needed. ‘Turntables’ are required to facilitate the easy transfer to different surfaces of the more ambulant resident. Attention is required to the cast iron conservatory, which although small and possibly not big enough for the resident’s to sit in, is a splendid feature, which at present looks rather dilapidated. • • • • • • • Anley Hall Nursing Home DS0000027923.V308569.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Satisfactory recruitment practices are followed. There is sufficient staff to provide personal care, however there should be an RMN qualified nurse employed as this could help improve the demented and mentally ill resident’s quality of life. EVIDENCE: The staff spoken to felt that they were able to provide a good level of personal care and that the residents confirmed this when spoken to. The numbers of care staff with NVQ qualifications is 80 , thereby exceeding the 50 minimum standard. Several have trained to NVQ Level 3 standard Two of the staff has a first –aid certificate. There is a key worker and named nurse system on place whereby there is identified staff allocated to particular residents and helps ensure the continuity of care. Anley Hall Nursing Home DS0000027923.V308569.R01.S.doc Version 5.2 Page 18 There is a dedicated activities person provided for 20 hrs per week. The care staff were able to confirm that mandatory training episodes in Health & Safety, Fire Safety, First aid, Basic food hygeine, Moving & Handling and Abuse awareness had taken place. This is arranged through ‘Tyro’ training organisation. Although the home is registered to receive residents suffering from dementia, and the mentally ill, eleven of the present population suffers from dementia, there are no specialist RMN trained nurses on the staff. This was discussed with the manager and she indicated that sourcing RMN nurses is difficult, however she would endeavour to recruit at least one in the near future. Anley Hall Nursing Home DS0000027923.V308569.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32, 33, 35 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The management of the home is focused on benefits to the residents and there is a caring ethos in the home. A development plan should be written for the home and shared with all the staff, residents and the CSCI. Anley Hall Nursing Home DS0000027923.V308569.R01.S.doc Version 5.2 Page 20 EVIDENCE: The manager has been in post for several years and it is clear that she enjoys the respect and support of the staff. She has obtained the NVQ level 4 in care management in addition to her first level nurse qualification and Diploma in care of older people and these qualifications help ensure the home is well managed. Regular meetings are held monthly with the staff to help keep them informed about the running of the home. The care staffs spoken to were unaware of an annual development plan for the home. An annual development plan should be provided for the home. Questionnaires are routinely distributed to elicit the views of the residents and relatives about the running of the home. The home are planning to use the quality assurance forms soon to issued by the CSCI when they are available later on this year. Regular servicing of gas boilers, lifts, hoists and other equipment takes place and the records of these are kept in an easily accessible ring folder. Anley Hall Nursing Home DS0000027923.V308569.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 3 2 2 3 2 3 2 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 2 X 3 X X 3 Anley Hall Nursing Home DS0000027923.V308569.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action Anley Hall Nursing Home DS0000027923.V308569.R01.S.doc Version 5.2 Page 23 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2 3 Refer to Standard OP8 OP21 OP22 Good Practice Recommendations All the care staff should be encouraged to record the care they give in the care plan documentation. An additional sluice-room and disinfector should be provided on the ground floor. Consideration should be given for the provision of power assisted hoisting equipment in the bathrooms. An additional assisted shower should be considered, as many of the residents prefer this. Additional power assisted hoists are required to facilitate easier and safer means of transferring residents. ‘Stand-aids’ should be provided to facilitate the resident’s transfer from one surface to another. ‘Turn-tables’ should be provided to aid resident transfers. 4 5 6 OP24 OP27 OP33 Height adjustable profiling beds should be provided for the nursing cases. An RMN qualified nurse should be provided so that the residents suffering from dementia and mental can have all their needs identified and met. The provider should present an annual development plan for the home. Anley Hall Nursing Home DS0000027923.V308569.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Anley Hall Nursing Home DS0000027923.V308569.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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