Inspection on 17/08/06 for Canadia

This inspection was carried out on 17th 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

Canadia 07/04/09

Canadia 30/05/08

Canadia 28/11/07

Canadia 31/05/07

Canadia 28/02/06

Similar services:

Abbey The

Snydale Care Home

Hawkhills

Larchfield Manor

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

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

CARE HOMES FOR OLDER PEOPLE Canadia 41 Pearson Park Hull East Yorkshire HU52TG Lead Inspector George Skinn Key Unannounced Inspection 17th August 2006 09:30 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 Canadia DS0000064770.V310046.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. Canadia DS0000064770.V310046.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Canadia Address 41 Pearson Park Hull East Yorkshire HU52TG 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) 01482 341434 Mrs Heather Feeney Mrs Nicola Jayne Owens Mrs Margaret Lilian Norris Care Home 16 Category(ies) of Old age, not falling within any other category registration, with number (16) of places Canadia DS0000064770.V310046.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. Staffing must meet the levels set by the residential forum. The outstanding requirements must be met within four months of registration. The care home may provide care for 1 named service user with a MD To include one service user under 65 years of age. Date of last inspection 28th February 2006 Brief Description of the Service: Canadia is a three story semi-detached building situated in Pearson Park close to the centre of Hull. It is a period property and the front of the house still gives that impression. The home is on a bus route to the city centre and a short walk from Newland Avenue shopping area. Service users can access a small area to the front garden in warmer months and there is parking space to the side of this for two cars. Service user care only is provided, to a maximum of sixteen service users and mostly in double rooms; 7 of the 9 rooms are double accommodation. Only one bedroom has en-suite facilities of a toilet and a shower. Two lounges offer a pleasant environment in each, while the dining room is extremely small, resulting in some service users having to eat at tables in the lounges and others finding it difficult to get into their places at table. The laundry is sited in a wooden garage at the side of the house. The home is providing a service of care not only to older people, but also to one person with a hearing impairment, one person whose primary need is mental health and one person under the age of 65. Canadia DS0000064770.V310046.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. As part of the inspection process surveys were sent to all the service users (14), their relatives (10), GPs (9), social services placement officers (7), and all members of staff (13). 4 were returned from service users, 4 were returned from relatives, 3 were returned from GPs, 2 were returned from social services placement officers and 3 were returned from staff. Overall there was a very poor response to the surveys and the validity of the information could be questioned due to the small percentage returned. Service users were interviewed as part of the site visit; staff were also interviewed. What the service does well: What has improved since the last inspection? What they could do better: The home records which are kept about the service users need to be improved. Activities must be provided of the service users choice. The food must be improved. The staff training needs to be better. Canadia DS0000064770.V310046.R01.S.doc Version 5.2 Page 6 The home must give the service user a say in how the home is run. The home must be redecorated. 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. Canadia DS0000064770.V310046.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 Canadia DS0000064770.V310046.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 Service users needs were not assessed prior to admission EVIDENCE: Three service user care plans were looked at, one did not have a community care assessment, however the home had undertaken their own assessment but there was no evidence that this had been updated as the service users needs changed. Information regarding service user plans had not been updated. Changes in specific instructions regarding safety of service users were not reflected in the individual care plans. There was no evidence that important information and risk assessments were being updated as the service uses needs changed. The assessment and admission process is not adequate to provide service users with the assurance that the home can meet their identified needs and does not provide staff with sufficient information to ensure that new service users needs are met. These shortfalls could place service users at risk. Canadia DS0000064770.V310046.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 & 10 Care plans do not set out the service users health needs. Medication is handled appropriately. Service users are treated with respect. EVIDENCE: Service users care plans do not contain the required information. There was no evidence to indicate that the care plans had updated and they did not reflect the current needs of the service users. The safety of one service user is maintained by the staff following specific instructions, however it would appear that an arbitrary decision had been taken to change practise, which could put the service user at risk. There was no evidence to suggest that any consultation had taken place with the placing authority or a case meeting held to ascertain the best course of action. One service user has severe mobility restrictions, the staff only move her with the use of a hoist, however her care plan indicated that she still walked with the support of staff and could mobilise with a walking aid. Again there was no Canadia DS0000064770.V310046.R01.S.doc Version 5.2 Page 10 evidence that the home had informed the placing authority of the deterioration of her needs or any consultation had taken place as to the appropriateness of the placement. There were no risk in the care plan as to staff practise and how this could have an impact on the service users safety. Staff documentation of the daily care provided lacks detail and does not clearly show the actual care given. Discussion with the staff indicate that they have an understanding of the needs of the service users but this is on an informal verbal basis and the care plan lacked the guidance required. Service users are at risk of not having their health care needs met if these informal systems of communication break down. The home has adequate storage for medication. Inspection of the medication system indicated that the records where accurate and up to date regarding medication received, administered and leaving the home. All service users said that they feel that staff treat them with respect and that their right to privacy is upheld. Canadia DS0000064770.V310046.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): Service users are not enabled to participate in meaningful activities. Service users do maintain contact with family and friends. Service users can exercise choice over their lives Service users do not receive a balanced wholesome diet. EVIDENCE: The home still do not provide activities for service users to participate in. observation made during the site visit indicated that the service users sit for long periods of time watching TV or sleeping. Service users commented on being bored and appeared un-stimulated. The service users records did not indicate any interests or whether they had hobbies. Those service users who could tend to their own needs relied on their own social networks to keep them occupied. The home does record actives but these indicated that the service users spent the majority of their time watching TV or listening to music, it was not indicated whether this was what they wanted to do or if any other activities had been offered as an alternative. Canadia DS0000064770.V310046.R01.S.doc Version 5.2 Page 12 Many of the service users and staff commented on the quality and choice of food provided at the home. The service users were not happy with quality of the food especially at the weekend. They commented on the food being poorly presented and of poor quality. Those service users who could make a choice were not happy with alternative given. One service user commented that they “did not want any thing fancy but it would be nice if it was of a good quality”. The staff were concerned at the lack of choice which they were able to offer the service users and felt embarrassed when they only had limited amounts of food to offer, and could not meet the needs of the service users. Some commented on having to go to the local shops or bring food in as the food soon ran out or was very limited. Observation made during the site visit indicated that the food stocks at the home was limited and indicated that choice was restricted. Canadia DS0000064770.V310046.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): Service users know who to complain to. Service user are protected from abuse. EVIDENCE: The home has a satisfactory complaints procedure and those service users spoken with knew whom to complaint to and were confident that their concerns would be taken seriously. Service user survey also indicated that people were clear about how to complain. Those staff surveyed and interviewed were clear about what action should be taken if they suspected or witnessed any forms of abuse at the home. Canadia DS0000064770.V310046.R01.S.doc Version 5.2 Page 14 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 & 26 Service users do not live in a well-maintained environment The service users live in a home which was clean EVIDENCE: There have been improvements to the decoration in the home since the last inspection. A number of carpets are worn and stained and require replacement. Some of the furniture in the bedrooms is looking worn and has broken handles and trims. Furnishings are not provided as required and none of the service users spoken to have been asked about what furnishings they want. The new owners continue to address these requirements it will take some time to achieve, as there is so much work required. Service users confirmed that they are able to bring their own belongings into the home and furnish their room with them. Canadia DS0000064770.V310046.R01.S.doc Version 5.2 Page 15 The home have purchased a new hoist but staff reported that due to the lay out of the home they find this difficult to manoeuvre in some areas. If the home cannot meet the moving and handling needs of people then they must review the appropriateness of the placement. The new owners have employed two domestic staff and this has resulted in the more thorough cleaning of the home. There were no malodours. Canadia DS0000064770.V310046.R01.S.doc Version 5.2 Page 16 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): Service users needs are met by the number of staff. Service users are protected by the home recruitment procedures Staff are not trained to meet the needs of the service users. EVIDENCE: The home must maintain the agreed staffing levels at all times, including weekends. Service users commented on how good the staff are. The home has an experienced and enthusiastic team of staff who work well together. The staff are motivated and keen to ensure that service users receive a good standard of care. Staff files were being kept and these indicated that the correct checks are now being undertaken prior to staff being employed at the home. The training of staff has improved since the last inspection but some mandatory training needs up dating. Staff now receive the correct amount of supervision and this is recorded. Canadia DS0000064770.V310046.R01.S.doc Version 5.2 Page 17 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): The home is owned/managed by someone who is registered with the CSCI as being fit. Service users have no opportunity to participate in the homes functioning. Service users interests are protected by the home financial procedures. Service users health and safety is promoted as far as is possible. EVIDENCE: The owner of the home continues to manage the home, however an application for the registration of a manger has been submitted to the CSCI. Some concern was expressed about the availability of management support and there was a great deal of confusion about the management ‘on call’ arrangements in that staff were unclear about who to contact in an emergency. Canadia DS0000064770.V310046.R01.S.doc Version 5.2 Page 18 Following a discussion with the owner a better, clearer system will be implemented. There was no evidence of a Quality Assurance system which meets the requirements of standard 33. The service users financial interests were safeguarded by the homes procedures and practice. Some of the policies and procedures pertaining to health and safety require updating or replacing. Canadia DS0000064770.V310046.R01.S.doc Version 5.2 Page 19 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 2 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 2 Canadia DS0000064770.V310046.R01.S.doc Version 5.2 Page 20 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 OP3 Regulation 14 Requirement The Provider must ensure they obtain a copy of the care management assessment and care plan and that service users needs are fully assessed and recorded. The home must complete the documentation it intends to use. Previous time scale not met (30/04/06) new time scale. 2. OP7 4 A service user plan of care must be produced for each service user, with their consultation. The registered person must ensure that risk assessments are completed. All individual plans and risk assessments must be reviewed monthly. Previous time scale not met (30/04/06) new time scale. 3. OP8 12, 13 The registered person must ensure that healthcare needs are met and assessed. DS0000064770.V310046.R01.S.doc Timescale for action 01/01/07 01/01/07 01/01/07 Canadia Version 5.2 Page 21 Previous time scale not met (30/04/06) new time scale. 4. OP12 12 The registered person consults service users about their social interests, and makes arrangements to enable them to engage in local, social and community activities. Previous time scale not met (21/04/06) new time scale. 5. OP15 16, 17, 18 The registered person must provide food which is of the service users liking and choice. 23 The registered person must ensure that a programme of routine maintenance and renewal is devised and implemented. Previous time scale not met (30/05/06) new time scale. 7. OP23 23 For those rooms with less than 16sq metres usable floor space (excluding en suite) the registered person must clearly demonstrate:1. What compensatory communal space arrangements there are in the home?2. How the bedrooms meet service user needs and lifestyles.3. That service users have been made aware of the required minimum double room size. 4. And that each service user has made a positive choice to share their room. 5. This requirement does not necessarily waive the requirement for double rooms to have at least 16sq metres of usable floor space but the information will be taken into DS0000064770.V310046.R01.S.doc 01/01/07 01/01/07 6. OP19 01/01/07 01/01/07 Canadia Version 5.2 Page 22 account when making a decision. Previous time scale not met (30/05/06) new time scale. 8. OP24 23 Provider must ensure the service users have equipment listed in standard 24.2, worn and broken furnishings must be replaced. Previous time scale not met (30/06/06) new time scale. 9. OP28 18, 19 The registered person must ensure that all staff are trained and competent to do their jobs. 50 of the care staff must be trained to NVQ level 2 Previous time scale not met (30/04/06) new time scale. 10. OP33 33 The registered person must ensure that the home has a satisfactory quality assurance process the results of which must be published and distributes to stakeholders and the CSCI. Previous time scale not met (30/06/06) new time scale. 11. OP38 18 The registered provider must ensure that all staff receive mandatory training. Environmental risk assessments must be completed and reviewed on a regular basis. Previous time scale not met (30/05/06) new time scale 01/01/07 01/01/07 01/01/07 01/01/07 Canadia DS0000064770.V310046.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. Refer to Standard OP38 Good Practice Recommendations It is recommended that a more effective system of management on call arrangements is implemented. Canadia DS0000064770.V310046.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Hessle Area Office First Floor 3 Hesslewood Country Office Park Ferriby Road Hessle HU13 0QF 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 Canadia DS0000064770.V310046.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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