Inspection on 11/10/07 for Courtfield

This inspection was carried out on 11th October 2007.

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

Courtfield 19/10/06

Courtfield 06/02/06

Courtfield 23/11/05

Courtfield 11/01/05

Courtfield 12/07/04

Courtfield 11/03/04

Similar services:

Snydale Care Home

Abbey The

Larchfield Manor

Hawkhills

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 Courtfield 3 St James Drive Harrogate North Yorkshire HG2 8HT Lead Inspector Denise Rouse Unannounced Inspection 11th October 2007 10:45a 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 Courtfield DS0000007812.V349006.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. Courtfield DS0000007812.V349006.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Courtfield Address 3 St James Drive Harrogate North Yorkshire HG2 8HT 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) 01423 509277 01423 701559 RBS Care Homes Foundation Mrs Louise Wiggins Care Home 24 Category(ies) of Old age, not falling within any other category registration, with number (24) of places Courtfield DS0000007812.V349006.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 19/10/06 Brief Description of the Service: Courtfield is registered for personal care for 24 older people. The home is owned by RBS Care Homes Foundation, and run by a board of trustees. People living there have all either worked for the group, or are dependants of those who have or still do, work for the group. The home is a large detached house set in its own grounds. It is close to Harrogate town centre and provides good access to the towns services and amenities. Fees on the day of the site visit ranged from £387.00 to £445.00 based on a banding system relating to peoples needs. Additional charges are made for hairdressing, newspapers and private chiropody. A copy of the last inspection report is available to people. The service user guide is available at reception. This contains a summary of the services the home provides. Courtfield DS0000007812.V349006.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The accumulated evidence used in this report has included: • A review of the information held on the home’s file since its last key inspection. • Information submitted by the registered provider in the Annual Quality Assurance Assessment. • Surveys received from five people living at the home, three relatives, one general practitioner and three staff working at the home. • An unannounced visit to the home, which lasted four hours and thirty minutes. This included a full tour of the premises. • Evidence gained by direct observation during the site visit; which involved talking with people living at the home, one visitor, the manager and Responsible Individual, and staff. • Inspection of records, including care profiles, medication administration records, staff files and some of the home’s policies and procedures. What the service does well: Assessments of peoples needs are very thorough and include details of risks, which people wish to take to maintain their independence. A range of activities is provided, which meets the social needs of people living there. People said they receive care in a way that respects their privacy and dignity. “I am well satisfied with the care given”. A robust complaint’s procedure is in place to ensure that any concerns raised are investigated and dealt with thoroughly. Checks on how the home runs are carried out by management, to ensure the quality of the service is consistently high. One person living in the home said “Courtfield is wonderful, I don’t think you could go anywhere better, I thoroughly recommend it”. Courtfield DS0000007812.V349006.R01.S.doc Version 5.2 Page 6 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. The summary of this inspection report can be made available in other formats on request. Courtfield DS0000007812.V349006.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 Courtfield DS0000007812.V349006.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 3 (6 not applicable) People who use this service experience excellent quality outcomes in this area. People are fully assessed, to ensure that their needs could be met. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: The home provides accommodation specifically for people who work for the bank or their relatives. Pre admission assessments are detailed, all relevant information about peoples needs including history of falls, personal care, physical well being, medical history, mental state and social interests are recorded. Information from care managers and hospitals is also provided, to ensure peoples full needs are known and can be met. People considering living at Courtfield spend two weeks at the home, on a trial basis, before a decision is made about if the home can meet their individual needs and provide long-term care. They can attend the coffee mornings with Courtfield DS0000007812.V349006.R01.S.doc Version 5.2 Page 9 their representatives and can visit and look round at any time, a representative from the company can arrange to see people in their own home to speak about what the home can offer them. One person said “ My sister and I had been on several visits, and decided it was the right place to make a new home when the time was right”. One person said “ I received respite care it was perfect, I made up my mind to stay here, the ability to experience the service helped me to make the decision, I have stayed in other homes, but this was more homely. I got a whole pack of information, a brochure of the care home and other literature including a service user guide, and had plenty of time to read this at my leisure, and show it to my friends and family and discuss it” The home provides all the information about what services are on offer so that people can make an informed choice. Significant time and effort is spent making admission to the home personal and well managed. People are treated as individuals with dignity and respect for the life changing decision they are to make. There is a high value placed on responding to people’s individual and diverse needs at this time. An allocated Key worker builds a supportive relationship with new people, which help them to settle into the home. Intermediate care is not undertaken. Courtfield DS0000007812.V349006.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7 8 9 10 People who use this service experience good quality outcomes in this area. Peoples health care needs are met, however balances of medication for people who self-administer should be monitored more often. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: Information from the pre admission assessment is used to create individual detailed care plans and risk assessments, which enables each person to be as independent as possible, and gain support from staff where necessary. These are reviewed and signed by the individual or their chosen representative each month, or as the person’s needs change, to ensure the care being given is relevant. Key workers are allocated to each person so that a strong relationship can develop to ensure that the person feels well supported. Information is recorded about each person physical needs, including a falls risk assessment, likes and dislikes and social preferences. People have their personal “ Objectives” recorded to enable them to live as full a life as possible. Courtfield DS0000007812.V349006.R01.S.doc Version 5.2 Page 11 People are addressed by their preferred name and treated with dignity and respect. They follow their own chosen routines. Special equipment is available in the home they can see health care professionals at the surgery or have home visits. Opticians, dentists and chiropodists also visit the home. Referrals are made to health care professionals to ensure people’s full needs are met. Surveys indicate people living in the home have no concerns about the care; one person said “ I am well satisfied with the care given”. Another said,” Courtfield provides a good standard of care, and is successful in maintaining our aims and objectives”. Medication systems in operation protect people who are not self-medicating living in the home. People who wish to self medicate are assessed to ensure they are safe to do so. However further medication balance checks should be undertaken as necessary to ensure that people are taking medication as prescribed during the month before new stock is ordered and placed in the secured storage drawer in peoples bedrooms. Medication stock brought into the home and left with the individual person by health care professionals must be recorded as received in the home, so that stock balances can be checked, to ensure peoples health and safety is protected. A person said “Courtfield meet each individuals requirements in a professional manner”. Courtfield DS0000007812.V349006.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12 13 14 15 People who use this service experience good quality outcomes in this area. People’s social needs are met and they receive a nutritious diet. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: People can follow their chosen routine supported by the staff. They can go out and use the garden as they wish or socialise in the two lounges provided. One person said “ The homes staff look after residents in a caring, cheerful and unobtrusive way allowing them to live their own lives depending on their abilities and without any pressure to participate in a varied range of activities”. Clergy visit as required, and there is a monthly Holy Communion held in the home as well as people attending the local churches. Outings to Bolton Abbey, Solitaire and Otley are provided in summer. There is a good programme of celebrations arranged for the Christmas period, which includes a pantomime being performed in the home and an outing to The Old Swan for lunch. Open visiting occurs and people are made welcome by the staff at any time. One person said, “ My relatives can visit at any time”. Relatives can stay for a Courtfield DS0000007812.V349006.R01.S.doc Version 5.2 Page 13 meal, served on a separate table in the lounge to allow people to talk privately over their meal. People are asked for their suggestions for activities in the resident and relatives meetings. There are regular afternoons and evenings put aside for crosswords and a quiz. Board games, bingo, and chair keep fit is also provided. Library books are available in large and regular print as well as audio books. Entertainers visit the home regularly. People said they are happy with the activities available to them. A hairdresser attends the home weekly to allow people to have their hair done. There is an annual BBQ for people and their relatives, staff and trustees. And pensioner coffee mornings held every second Wednesday in the month. To encourage people to socialise. Birthdays are celebrated with cakes and cards from the Trustees and staff. A “ Pink Day” is being held where staff will dress in pink clothes and pink food provided, to raise money for charity. The kitchen is clean and tidy; all health and safety checks are carried out and recorded. The chef is aware of peoples special dietary needs. People place their order for lunch and tea at breakfast. There is a choice of meals available. People can dine in the dining room or in their own bedroom. Food served for lunch looked appetising and is served individually by staff on warmed plates. Vegetables are placed in tureens so people can help them selves, and portion sizes are requested to suit each individual. Special equipment is provided for people to help them eat independently. Meals are unhurried and staff assist people with patient, dignity and respect. One person said, “ The food is excellent”. A new four-week rotational menu is in place to reflect the new seasons fayre. Courtfield DS0000007812.V349006.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 16 18 People who use this service experience good quality outcomes in this area. People can be assured that complaints are dealt with and people are protected from abuse. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: The home has a complaints policy available in the service user guide which is robust. One complaint has been received since the last inspection, this has been investigated by management and dealt with thoroughly. Surveys indicated that people feel happy to talk about any concerns they may have with the manager or staff and feel that issues raised would be addressed. The policies and procedures at the home ensure that people are protected from abuse. Staff receive training about safeguarding adults and those questioned about what they would do if an allegation of abuse were to be reported knew what action to take. All necessary pre employment checks are carried out to ensure that people are protected from staff who may not be suitable to work within the care industry. Courtfield DS0000007812.V349006.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19 26 People who use this service experience good quality outcomes in this area. People live in a clean home, which is well maintained. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: The home is spacious and airy all areas are clean and well kept. Secure entry to the home ensures people protection from uninvited guests. Information is available in reception about advocacy services. A payphone is provided as well as a mailbox to allow people to keep in touch. A passenger lift is available to the first floor. Handrails are provided throughout the home to aid people’s mobility. The dining room is spacious, set with linen cloths and napkins. Fresh fruit is available and flowers are provided on the tables. Period features are evident in some areas of the home. Bedrooms are individualized and personalised and Courtfield DS0000007812.V349006.R01.S.doc Version 5.2 Page 16 laid out to help people use the space to increase their mobility and independence. Two lounges provide comfortable sitting accommodation. One lounge has a snooker table and dartboard available and direct access out onto a patio area with garden furniture and pots filled with seasonal flowers. This has been newly resurfaced so that it provides a non-slip surface for people who are not so stable on their feet. Garden furniture is available in the grounds; the home has achieved a “silver guilt award” in The Harrogate In Bloom Competition, for the well-presented gardens and floral arrangements, which people living in the home enjoy. Private phone lines are available in some bedrooms and can be provided in others upon request enabling people to keep in touch with family and friends. A programme of maintenance and improvements are undertaken to ensure that the environment remains pleasant for people living there. Communal bathrooms and toilets are fitted with adaptations to aid people’s independence and help staff to assist them without placing their health and safety at risk. Laundering systems prevent the risk of cross contamination. Hand washing facilities are available throughout the home to help reduce the risk of the spread of infection. One person said, “The environment is excellent, I can sit out in the sun or shade, the gardens are beautiful, the hanging baskets are a picture”. Courtfield DS0000007812.V349006.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27 28 29 30 People who use this service experience good quality outcomes in this area. People are cared for by staff who are well trained, effectively recruited and in sufficient numbers to meet individuals needs. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: Staff are recruited using thorough processes to ensure people are protected, from staff that may not be suitable to work in the care industry. Set interview questions ensure that equal opportunities are maintained, the responses to these questions are recorded. Staff receive information and sign policies relating to health & safety, advice on accepting gifts, senior’s duties lists, and the health care agreement policies in operation the home, which informs them of what is expected of them. Induction training is provided to all new staff and this is completed for all new staff by the home manager to ensure consistency. It includes information about safe moving and handling techniques and abuse awareness, to help maintain peoples safety. Regular updates are provided to all staff. Training records are kept and a training matrix helps to alert the manager when training is due, to ensure staff continue to practice safely. Courtfield DS0000007812.V349006.R01.S.doc Version 5.2 Page 18 The home has achieved a 50 ratio of care staff that hold the National Vocational Qualification In Care at Level 2 or 3. This ensures that staff have knowledge, which helps them provide good care to people living at the home. Training is provided in moving and handling, food hygiene, fire, health and safety and infection control to ensure staffs health and safety is protected. Even the handyman receives abuse awareness training. Handovers occur at the end of each shift to ensure staff are fully aware of how people are. Regular staff meetings are held. Staff supervision and a yearly appraisal is undertaken to ensure staff receive the support they need, as well as identify any training they require to help them carry out their work. Regular staff meetings are held so that the views of staff are listened to and acted upon Care staff no longer have to carry out domestic duties, cleaning is undertaken by staff specifically recruited and criminal checked. This ensures care staff can spend quality time with people who use the service. One person said “ All the staff are so kind and caring, real teamwork, nothing is too much trouble for them”. A new system for monitoring sickness and absence is in place, and has decreased sickness and has helped people to gain health advice to aid their return to work. Agency staff in use are supplied by agencies who check their staffs suitability. The same agency staff are requested where possible to aid continuity of care. Staff have access to confidential phone numbers and a Dignity at work policy, staff could contact the companies’ solicitor and Trustees to discuss issues or concerns. Company schemes are in place to reduce staff sickness and to increase staffing levels by asking staff if they have a friend or relative who would be suitable to work in the home. A bonus is paid if the introduction is successful over a six-month period. There is also a staff suggestions box in the staff room so that the staff can raise their views constructively. Staff are asked to complete an employment opinion survey, results are anonymous and sent to head office for processing. Results are then sent to the home and action is taken to address any issues raised. This ensures staff views are valued and acted upon. One carer said, “ Through time and training I feel confident in my knowledge”. One relative said, “Staff have a caring attitude, there are appropriate level of staff provided”. Courtfield DS0000007812.V349006.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31 33 35 38 People who use this service experience good quality outcomes in this area. People live in a home that is well managed and maintained to protect people’s health and safety. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: The manger is experienced and approachable. Staff said that she listened to what they had to say and acted upon it. The manager undertakes night visits to ensure that the quality of the services over a twenty-four hour period is maintained. One person said, “ There is a nice homely atmosphere, staff look after you, they are nice and reassuring. The manager comes to chat, if you speak with her things get done, and it gives me peace of mind”. Courtfield DS0000007812.V349006.R01.S.doc Version 5.2 Page 20 Quality assurance procedures are undertaken. The company’s representatives and trustees attend the home to undertake quality audits and support the manager. Any issues raise are dealt with to ensure the quality of the service is maintained. People at the home their relatives and health care professionals are also surveyed. The results of these are available to people and any shortfalls are acted upon. Management should listen to people’s views and where possible, continue to develop the service. Regular reports are provided by the home to the Commission for Social Care Inspection. This ensures that management are constantly checking the services provided are of the right standard. Detailed information is sent to the Commission for Social Care Inspection throughout the year about the business plan and outcomes of surveys, to ensure that we are kept fully informed. Personal allowance account balances were looked at and found to be correct and receipts are kept of all transactions, as a way of protecting people from financial abuse. Health and safety checks and general maintenance is carried out. Fire safety checks are undertaken weekly and staff are well trained in this area to ensure peoples health and safety is protected. Courtfield DS0000007812.V349006.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 4 3 3 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 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Courtfield DS0000007812.V349006.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. 1 Standard OP9 Regulation 13 (2) Requirement Medication balances must be recorded of all medications brought into the home. These balances must be checked to ensure people remain safe. Timescale for action 20/11/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Courtfield DS0000007812.V349006.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Courtfield DS0000007812.V349006.R01.S.doc Version 5.2 Page 24 - 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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