CARE HOMES FOR OLDER PEOPLE
Carentan House Carentan House Brook Street Selby North Yorkshire YO8 4AU Lead Inspector
Pauline O`Rourke Unannounced Inspection 16th January 2006 11:00 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 Carentan House DS0000034630.V274562.R01.S.doc Version 5.1 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. Carentan House DS0000034630.V274562.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Carentan House Address Carentan House Brook Street Selby North Yorkshire YO8 4AU 01757 702 815 01757 706443 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) North Yorkshire County Council Care Home 29 Category(ies) of Old age, not falling within any other category registration, with number (29) of places Carentan House DS0000034630.V274562.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. All Service Users admitted for Intermediate Care (up to a maximum of 8) will be accommodated in the Homewards Rehabilitation Unit 26.05.05 Date of last inspection Brief Description of the Service: Carentan House is operated by North Yorkshire County Council and provides personal care for 21 older people aged 65 years and over who do not have any specialist requirements and 8 older people requiring intermediate care or who are working towards rehabilitation. The home was purpose built approximately 25 years ago. It is located within a short distance of Selby town centre. Accommodation is provided on 2 floors and the upper floor can be reached by vertical passenger lift. All bedrooms are designed for single occupancy. There are enclosed outdoor seating areas. Carentan House DS0000034630.V274562.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection, including preparation time, took place over 8 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. 10 of the service users, and 4 of the staff on duty were spoken with. What the service does well: What has improved since the last inspection?
There was no evidence of any improvements in the service since the last inspection, however several areas of the home have been recently refurbished. Carentan House DS0000034630.V274562.R01.S.doc Version 5.1 Page 6 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. Carentan House DS0000034630.V274562.R01.S.doc Version 5.1 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 Carentan House DS0000034630.V274562.R01.S.doc Version 5.1 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): 6 Service users receive appropriate support to help them maximise their independence so that they can return home. EVIDENCE: Dedicated lounge / dining, bathroom and bedroom facilities are available on the first floor of the building for up to 8 residents who are admitted for intermediate care. A separate staff team including support from physiotherapy and occupational therapy staff cares for this client group. Inspection of the unit’s facilities and records was made and were found to comply with required standards. The manager of this unit spoke enthusiastically about the unit and is clearly committed to successfully assisting people to return to their own homes. The service users in this part of the home spoke very highly of the service they have received Carentan House DS0000034630.V274562.R01.S.doc Version 5.1 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): 9 and 10. Service users are treated with respect and dignity at all times. EVIDENCE: There is a medication policy in place and all staff who administer the medication have received appropriate training. The storage, dispensing and documentation of the medication was in line with the policy and procedure of the home. Staff were observed treating the service users with respect at all times. The service users said that staff always treat them with respect and try to preserve their dignity at all times. Carentan House DS0000034630.V274562.R01.S.doc Version 5.1 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 the following standard(s): 13, 14 and 15 The service users are able to keep their own routine within the home and join in with social activities. The service users have a varied and balanced diet EVIDENCE: Visitors spoken with said that they are always made welcome and there are no restrictions as to when they visit. The service users confirmed this was the case. One visitor said that the managers were good at keeping them informed about events affecting their relative or generally what’s going on in the home. A visitors’ policy is in place and all visitors sign a visitors book on entering the home. The service users spoken with said that they are able to follow their own routines within the routines for the home. They are able to choose where they want to be in the home and can go back to their rooms at any time. The service users spoken with expressed satisfaction at the quality and quantity of the food provided. They confirmed that choices are available at each meal. The meal observed was relaxed and the staff assisted service users appropriately where necessary. The menu was examined and appeared to provide a balanced and nutritious diet. The cook explained that local fresh produce is used and they are able to vary the menu to include seasonal foods.
Carentan House DS0000034630.V274562.R01.S.doc Version 5.1 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 the following standard(s): 16 Service users are confident that the manager would deal with any concerns they had. EVIDENCE: North Yorkshire Social Services has a detailed complaints policy. This policy is provided to all the residents and is displayed around the home. There have been no complaints made to the CSCI in the last 12 months. Any complaints made to the home have been dealt with in line with their procedure and a clear record of outcomes is maintained. Service users spoken with all said that if they had any problems there was someone within the home they would go to. Carentan House DS0000034630.V274562.R01.S.doc Version 5.1 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 the following standard(s): 19 The service users live in a safe, comfortable and clean environment. EVIDENCE: Carentan House is a purpose built two-storey establishment situation in Selby. It has recently had a new lift fitted and the entrance hall has been refurbished. However, the area on the ground floor near to the new lift now looks tired and would benefit from the same standard of refurbishment. Carentan House DS0000034630.V274562.R01.S.doc Version 5.1 Page 13 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): 28 and 30. Staff that receive regular training supports the service users and are experienced carers. EVIDENCE: 72 of the care staff team have achieved their National Vocational qualification level 2 in care. This training is supplemented by several distance learning courses covering topics such as The Safe handling of Medicines, Manual Handling, First Aid, Promoting Independence and Outcome Care Planning. A sensory impairment specialist has also provided training to the staff so that staff have the skills to meet the needs of the service users. Several staff spoken with said that they enjoyed the training and were keen to apply for any further courses that might be offered in the future. The staff team is experienced in care and interactions observed with the service users were respectful, relaxed and friendly. The service users said that the ‘staff are very nice’ Carentan House DS0000034630.V274562.R01.S.doc Version 5.1 Page 14 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 and 33. There has been a lack of clear management of the home. However, a new manager has been appointed and requires time to implement the changes required at Carentan House. EVIDENCE: A new manager has been appointed at Carentan House and she has previous experience of managing a service, she also has completed a city and guilds 325/2 and 325/3 and is currently undertaking a degree course in Health and Social Care. During the inspection it was clear that she operates an open door policy and staff and service users approached her with ease. North Yorkshire Social Services has implemented a quality assurance programme. Currently a three monthly review of the service against the National Minimum Standards for older people should be carried out. This should identify areas that require improvement. However this programme has
Carentan House DS0000034630.V274562.R01.S.doc Version 5.1 Page 15 fallen behind due to the lack of a manager. The new manager is aware that she needs to ensure that the quality assurance programme is effectively implemented and developed. She also plans to develop questionnaires for the service users, staff, relatives and stakeholders. Carentan House DS0000034630.V274562.R01.S.doc Version 5.1 Page 16 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 X X X 3 HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X 2 X X X X X X X STAFFING Standard No Score 27 X 28 4 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 1 X 1 X X X X X Carentan House DS0000034630.V274562.R01.S.doc Version 5.1 Page 17 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. 1 2 Standard OP31 OP33 Regulation 8(2) 24 Requirement Timescale for action 31/03/06 The manager must make application to become registered. The manager must fully 30/04/06 implement the quality assurance programme and forward a copy of the results to the Commission. 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 OP19 Good Practice Recommendations The manager should look at refurbishing the corridor near to the new lift so that it is of the same quality as the entrance. Carentan House DS0000034630.V274562.R01.S.doc Version 5.1 Page 18 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
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