CARE HOMES FOR OLDER PEOPLE
North Yorkshire County Council Ashfield Malton Old Malton Road Malton North Yorkshire YO17 7EY Lead Inspector
Pauline ORourke Unannounced 23 August 2005 _ 9:10- 15:30 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 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. North Yorkshire County Council Ashfield Malton Version 1.40 J53_J04_S34316_Ashfield_V241998_stage4_2408051.doc Page 3 SERVICE INFORMATION
Name of service North Yorkshire County Council Ashfield Malton Old Malton Road Malton North Yorkshire YO17 7EY 01653 692371 01653 699211 Address Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) North Yorkshire County Council Mrs Jennifer Ann Beard Care Home 34 Category(ies) of Old age, not falling within any other category registration, with number (34) of places North Yorkshire County Council Ashfield Malton Version 1.40 J53_J04_S34316_Ashfield_V241998_stage4_2408051.doc Page 4 SERVICE INFORMATION
Conditions of registration: None Date of last inspection 23rd February 2005. Brief Description of the Service: Ashfield is a care home providing personal care and accommodation. It is registered for 34 older people, however due to the number of double rooms being used as single rooms a maximum of 31 service users can be accommodated at anyone time. Four of the beds are used for short-term care. The home is owned by North Yorkshire County Council and it is managed by Jennifer Beard. It is located approximately half a mile from the centre of Malton and service users can access the shops, the post office and other amenities easily. The home is an adapted property and is set in its own grounds. The grounds are well maintained and accessible to the service users. There is also a passenger lift. North Yorkshire County Council Ashfield Malton Version 1.40 J53_J04_S34316_Ashfield_V241998_stage4_2408051.doc Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection including preparation time took place over 12 hours. A tour of the building was conducted. A number of the service users records, staff records and records about the management of the home were inspected. 12 of the 29 service users, and 3 members of staff were spoken with. A visiting professional and several relatives were also spoken with What the service does well: What has improved since the last inspection? What they could do better:
Whilst the management have improved the service provided in several areas there remains several issues they need to address. On the whole the home was found to be clean and odour free. However, several areas of the home were found to have an unpleasant odour and they need to develop a regular cleaning regime that tackles these areas. They also need to ensure the paperwork connected with the service users is up to date. The registered manager should also audit the training staff have received that enables them to carry out their job. North Yorkshire County Council Ashfield Malton Version 1.40 J53_J04_S34316_Ashfield_V241998_stage4_2408051.doc Page 6 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. North Yorkshire County Council Ashfield Malton J53_J04_S34316_Ashfield_V241998_stage4_2408051.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection North Yorkshire County Council Ashfield Malton J53_J04_S34316_Ashfield_V241998_stage4_2408051.doc Version 1.40 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 standard(s) 3 The service users can be assured that their care needs will be met. EVIDENCE: The service user files seen contained copies of an assessment by a care manager. The duty manager confirmed that they do visit all prospective service uses before their admission. A record of their assessment is kept in the service users file. Service users spoken with confirmed they had seen someone from the home prior to their admission North Yorkshire County Council Ashfield Malton J53_J04_S34316_Ashfield_V241998_stage4_2408051.doc Version 1.40 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 standard(s) 7, 8, and 9. The health and social care needs of the service users are met. EVIDENCE: All the service user files seen contained a basic care plan pertinent to their needs. The document seen was not in line with the documentation used by North Yorkshire Social Services. The service users spoken with said that staff discussed these plans with them on a regular basis. Evidence was available in the file that the plans are reviewed monthly. The service users confirmed that they are able to see their GP or the district nurse in private and on request. Evidence was available in the service users files that they access other specialist health services as required. The control, storage and administration of the medicines was seen to be satisfactory. Staff who handle the medicines have received training in the safe handling of medicines. North Yorkshire County Council Ashfield Malton J53_J04_S34316_Ashfield_V241998_stage4_2408051.doc Version 1.40 Page 10 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 standard(s) 12 and 13 The service users are able to keep their own routine within the home and join in with social activities. EVIDENCE: The service users spoken with said that they are able to follow their own routines, the only limitations on this are the routines of the home. A member of staff is given the responsibility to organise activities each day and service users spoken said that they enjoyed the activities arranged. There is a visitor’s policy in place and service users are given a copy of this on their admission. Visitors spoken with confirmed that they are welcome at any time and refreshments are available during their visit. North Yorkshire County Council Ashfield Malton J53_J04_S34316_Ashfield_V241998_stage4_2408051.doc Version 1.40 Page 11 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 standard(s) 16 and 18 Service users were confident that any complaints or concerns they had could be raised and acted upon. Service users are protected from possible abuse through staff training and employment policies. EVIDENCE: North Yorkshire Social Services has a detailed complaints policy. This policy is provided to all the service users and is displayed around the home. There have been no complaints made to the CSCI or the home in the last 12 months. Service users spoken with all said that if they had any problems there was someone within the home they would go to. There is an Adult Protection Policy in place. Staff spoken with had received some training in Adult Protection issues and they had a good understanding of their responsibilities if they believed any inappropriate behaviour was taking place. Policies are also in place regarding the management of service users money. North Yorkshire County Council Ashfield Malton J53_J04_S34316_Ashfield_V241998_stage4_2408051.doc Version 1.40 Page 12 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 standard(s) 19, 21, 24, 26 The service users live in a well-maintained environment that is suitable for its stated purpose. EVIDENCE: The home is located near to shops and is suitable for its stated purpose. The grounds are well maintained and accessible to the service users. The service users have access to a patio area to the rear of the building where seats are provided. Several service users were enjoyed being outside during the good weather. There are sufficient toilet and bathing facilities. Evidence was available to show that the cubicle style toilets are to be altered so that they provide a more privacy for the service user. North Yorkshire County Council Ashfield Malton J53_J04_S34316_Ashfield_V241998_stage4_2408051.doc Version 1.40 Page 13 Service users are encouraged to bring their own furniture in to the home. The home has a programme of renewal so that any furniture identified as worn, unsafe or unsightly is being replaced. During the inspection several areas of the home were seen and found to be clean and odour-free. The communal areas were comfortable and warm. However, several rooms were identified to the manager as needing attention to ensure they are kept odour free and provide a safe environment. The corridor carpets are also looking worn and require cleaning or replacing. North Yorkshire County Council Ashfield Malton J53_J04_S34316_Ashfield_V241998_stage4_2408051.doc Version 1.40 Page 14 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 The service users needs can be met by the level of staff provided. EVIDENCE: The rotas seen during the inspection showed that on average there are three members of staff on duty from 8am until 4pm with a cross over of staff in the afternoon providing 4 staff. Whilst this can seem stretched the registered manager is managing the dependency levels of the home through her own assessments. The care staff are supported by the domestic staff and together they provide an effective team. The service users spoken with said that staff could not do enough for them and are always friendly. North Yorkshire County Council Ashfield Malton J53_J04_S34316_Ashfield_V241998_stage4_2408051.doc Version 1.40 Page 15 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 35 and 38 Policies and procedures are in place to ensure the service users’ financial interests are safeguarded. The health and safety of the service users and staff is promoted. EVIDENCE: The service users’ financial interests are safeguarded. Staff handle the personal allowance for several service users and the appropriate records were accurate and up to date. The staff spoken with during the inspection said that they had received training in, back care, first aid, food hygiene, COSHH, and fire training. Evidence was not available to support this. The equipment used in the home is serviced at the prescribed intervals. Health and safety notices were displayed around the building.
North Yorkshire County Council Ashfield Malton J53_J04_S34316_Ashfield_V241998_stage4_2408051.doc Version 1.40 Page 16 Accidents are properly recorded and were appropriate reported to the CSCI. Accidents are properly recorded and where necessary reported to the Commission for Social Care Inspection. Information from the accident records is used in the care planning process. All staff can access Induction and Foundation training, this provides them with basic skills required to undertake the role of resource worker. North Yorkshire County Council Ashfield Malton J53_J04_S34316_Ashfield_V241998_stage4_2408051.doc Version 1.40 Page 17 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 x
COMPLAINTS AND PROTECTION 3 x 3 x x 3 x 1 STAFFING Standard No Score 27 3 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x x x 3 x x 3 North Yorkshire County Council Ashfield Malton J53_J04_S34316_Ashfield_V241998_stage4_2408051.doc Version 1.40 Page 18 Are there any outstanding requirements from the last inspection? 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. 1. Standard 26 Regulation 16(2)k 23(2)b Requirement The registered manager must ensure that all parts of the home are kept odour free at all times. All the carpets and equipment that was identifed to the registered manager must be kept in a good state of repair. Timescale for action with effect from 23.08.05 30.09.05 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. Refer to Standard 7 38 Good Practice Recommendations It is recommended that the manager brings the paperwork used for the service user care plans into line with North Yorkshire Social Services paperwork. The registered manager should carry out an audit of staff training and ensure everyone is up to date with the statutory training. North Yorkshire County Council Ashfield Malton J53_J04_S34316_Ashfield_V241998_stage4_2408051.doc Version 1.40 Page 19 Commission for Social Care Inspection 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
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