Inspection on 19/10/06 for Courtfield

This inspection was carried out on 19th October 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

Courtfield 11/10/07

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 19th October 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 Courtfield DS0000007812.V315771.R02.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.V315771.R02.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.V315771.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 23/11/05 Brief Description of the Service: Courtfield is registered to provide residential personal and social care for 24 older people. The home is owned by RBS Care Homes Foundation, and run by a board of trustees. Service users 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 £380.00 to £414.00 But could be extended to £456.00 per week, dependant on the service users consistent care needs. Courtfield DS0000007812.V315771.R02.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 homes file since its last inspection. • Information submitted by the registered provider in the pre inspection Questionnaire • Surveys received from two service users, two relatives, and one general practitioner. • An unannounced visit to the home, which lasted five hours and fifteen minutes. This included a full tour of the premises. Evidence gained by direct observation, talking with service users, management staff, and visitors. Inspection of records, including care profiles, medication administration records, staff files and the homes policies and procedures. What the service does well: What has improved since the last inspection? There were no requirements or recommendations made following the last inspection. Courtfield DS0000007812.V315771.R02.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Courtfield DS0000007812.V315771.R02.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.V315771.R02.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 Quality in this outcome area was good. Service users were fully assessed, to ensure that their needs could be met. This judgement has been made using available evidence including a visit to this service EVIDENCE: Potential service users completed a pre admission questionnaire prior to being admitted to the home for a two-week assessment period, where the staff were able to ensure that the full care needs of the new service user was fully understood. This process ensured that the service users needs were thoroughly met. Prospective service users would not be accepted by the home if their needs could not be fully met. Staffing levels were increased as necessary to ensure during the trial 2-week assessment period that staff had enough quality time to spend with the new service user. This ensured that service users settled well. Courtfield DS0000007812.V315771.R02.S.doc Version 5.2 Page 9 Respite care was provided prior to some service users being admitted to the home. This ensured that service users knew the home intimately prior to making a decision to stay permanently. Prospective service users all received a pack with relevant information included, so that they could make a fully informed choice about the service. Relatives and prospective service users were allowed to visit the home, to ensure that they were happy with the quality of the services provided prior to being admitted to the home. Two service users were case tracked both stated they had received enough information about the home and were both very happy to become service users at the home. One service user stated, “ We are exceptionally lucky to be here, it’s a fabulous place to stay”. One case tracked service user had read about the home in a banks magazine, then came to experience the respite care, and was quite happy to move to the home, on a permanent basis. Courtfield DS0000007812.V315771.R02.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 Quality in this outcome area was good. Service users were treated with dignity and respect, their health and personal care needs were well met. This judgement has been made using evidence including a visit to the home. EVIDENCE: Two service users plans were inspected, they were detailed including risk of falls, mobility, continence and mental assessments. Service users also had “Objectives” for example “ To keep as mobile as possible” “To attend all in house activities” This ensured that the service user was the key focus and the care profile was based on the desired outcome for each service user. Care documentation was reviewed monthly, with the service user, their key worker and the manager, all of whom signed the review documentation. This ensured that the service users needs were always met. One of the case tracked service users risk assessments had not been reviewed since 2005, the manager read this document and reviewed it at the time of the site visit with the inspector, the service users needs had not changed. Courtfield DS0000007812.V315771.R02.S.doc Version 5.2 Page 11 Staff seen to be on duty were respectful to service users and addressed them by their preferred name. All service users were seen to be treated with dignity and respect. Service users could follow their own chosen routines of daily living. Service users confirmed that they could see the general practitioner of their choice either at the home or surgery. Hospital appointments and opticians appointments could be easily attended, staff were available to escort service users as necessary. This ensured that service users medical needs were met. Medication systems were inspected for the case tracked service users, all areas were handled correctly. Staff had undertaken accredited courses upon medication administration before being allowed to dispense medications. This ensured that service users were protected by the homes policies and procedures relating to medications. A service user stated “ We can come and go as we wish, supported by the staff, who treat us with respect, but do not overprotect us”. Another comment received was “I can please myself, more or less what I would like to do for my daily routine, I just need a little help”. Also “The staff are polite, respectful and attentive”. Courtfield DS0000007812.V315771.R02.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 Quality in this outcome area was good. Service users followed their chosen routines and received a nutritious healthy diet, however there were some shortfalls relating to the recording of temperatures and cleaning undertaken in the kitchen. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service users within the home stated they were all very happy with the activities available to them, and that they met their preferred social needs, which were recorded in their individual care profile. There was no formal weekly schedule of activities displayed but there were regular afternoons and evenings put aside for quizzes, board games, bingo and chair keep fit. There was a library available with large print, regular and audio books. Concerts were held at least once a month within the home. Outings to Newby Hall and other local attractions were available. The chef also played snooker with the gentlemen when not working in the kitchen. Clergy visited as required and provided there a monthly Holy Communion service in the home. A harvest festival and Christmas Carol service was also Courtfield DS0000007812.V315771.R02.S.doc Version 5.2 Page 13 provided. And an annual BBQ for service users, relatives, staff and trustees was provided by the home for everyone to enjoy. Service users had taken part in requesting the activities provided within the home. A hairdresser also attended the home weekly, for service users to be able to get their hair done. The home operated an open visiting policy; this was confirmed by the service users and visitors spoken with at the home. Visitors spoken with upon the site visit were full of praise about the home. The kitchen was inspected, it was clean and tidy. The food served for lunch was seen to be nutritious and appetizing, Service users stated “ The food was good” “ the vegetables are lovely” vegetables were placed in tureens so service users could help them selves. Service users could have whatever sized portion for lunch that they wished. The chef knew the needs of the service users. Meals were unhurried and staff assisted service users as required. The chef had a four-week rotational menu in operation, which was being changed to reflect the new seasons fayre. The kitchen cleaning schedule, fridge, freezer temperatures and hot meat temperatures were not recorded daily. This was discussed with the home manager and the chef. The temperatures were recorded from the time of the day of the site visit. These will be checked by the manager and the area manager, to ensure that service users continue to be protected by keeping adequate temperature and cleaning records. Courtfield DS0000007812.V315771.R02.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): Standards 16 18 Quality in this outcome area was good. Service users were protected from abuse; they could be assured that any complaints would be dealt with thoroughly. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service users were fully protected by the homes policies relating to the protection of vulnerable adults. Staff were aware what action they should take if they ever received an allegation of abuse. All staff received training in this area at induction and during their employment at the home. A copy of “ No secrets” was available, and there was a video which staff routinely watched about abuse. All potential new recruits were asked at interview about abuse, and their understanding of this subject. There was a robust complaints procedure in operation in the home, there had been no complaints received since the last inspection. Service users stated “I have no reason to complain” and “ I would speak to the manager if I had any concerns”. All necessary pre employment checks were made to ensure that staff that were employed by the home, were suitable to work within the care industry. Courtfield DS0000007812.V315771.R02.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 Quality in this outcome area was good. Service users lived in a homely clean environment, which was very well maintained. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home had a lovely, warm and welcoming atmosphere. A tour of the home was undertaken; all areas were clean and free from malodour, there was a lovely homely atmosphere in the communal and dining areas. Care staff were undertaking cleaning duties when service users had received all their personal care required. This ensured that the needs of the service users were the main priority. The laundry was inspected and was found to be clean and tidy. Infection control systems were in place to ensure that service users were protected. Courtfield DS0000007812.V315771.R02.S.doc Version 5.2 Page 16 The home was well maintained and well presented. There were period features in some areas, which enhanced the ambiance of the home. The gardens were well kept and extensive. Garden furniture was available for the service users to use in the garden. Some bedrooms had patio doors and excellent views of the grounds. Handrails were available in the corridors to assist service users with their mobility. Moving & handling equipment was available for staff to assist service users. All health and safety checks had been made to protect the service users and staff within the home, however there were some small shortfalls relating to the kitchen, as described. Courtfield DS0000007812.V315771.R02.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 Quality in this outcome area was good. Service users lived in a homely clean environment, which was very well maintained. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Staff were well trained and there were adequate numbers of staff on duty on the day of the site visit. The home had achieved a 50 ratio of staff that had gained their National Qualification In Care at Level two or three. This ensured that staff had received the relevant underpinning knowledge to enhance the standard of care given to the service users. Staff received induction and mandatory training; Service users confirmed that they were happy with the staffing levels. The manager worked in the office and also cared for the service users; this ensured that she was well aware of the service users needs. Handovers occurred at the end of each shift to ensure that all staff were fully informed. Staff were given appraisals and supervision, although one of the two-care staff case tracked had not received supervision recently, this was due in April 2005, the home manager immediately addressed this. Courtfield DS0000007812.V315771.R02.S.doc Version 5.2 Page 18 Evidence on file was seen which indicated that Health & safety, advice on accepting gifts, senior’s duties lists, and health care agreement policies were on file as being read and signed by staff. Comments received from staff included “ It’s not like coming to work, it’s like coming home”. Service users commented “ We get lots of help and support from the manager and the company”. Service users stated “ Staff are always polite and helpful”. Courtfield DS0000007812.V315771.R02.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 36 38 Quality in this outcome area was good. Service users live in a home that is well managed, quality assurance systems were in place which were thorough. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home had a thorough quality assurance system in place. Which included surveying service users, relatives and visiting health care professionals. The outcomes of the surveys were shared with the service users, relatives, staff and the Commission for Social Care Inspection. Regular provider visits were conducted and a summery of these visits were provided to the Commission for Social Care Inspection. This information was very thorough and detailed. Courtfield DS0000007812.V315771.R02.S.doc Version 5.2 Page 20 Staff undertook an employment opinion survey, which staff filled in anonymously, these were sent to the head office, and then feedback was given to the home. There were company schemes in place to reduce staff sickness, and to increase staff to introduce new staff to the home. This helped to ensure that staff felt valued and that their views were important to the provider. It also helped to ensure that the staff turnover was decreased, some staff who had left the home had returned stating “ there’s no where out there as good as this”. Health and safety records relating to the building were inspected, all safety checks had been implemented to help maintain the health and safety of the service users and staff. There was also a dignity at work policy in operation at the home. Staff could contact the companies’ solicitor and Trustees if they so wished to speak with them or report issues if they did not feel they wished to speak with the home manager or area manager. This ensures service users and staff are protected. Service users personal allowance balances were checked and found to be correct, this ensured that they were protected by the homes policies and procedures relating to financial abuse. The manager was approachable, supportive and knowledgeable, of good character and experienced. Quotes received included “ the manager was good at her job, and supported service users independence” We are exceptionally lucky here, it a fabulous place”. Staff stated that the style of management was supportive; the manager was approachable and good at her job. Trustees also visited the home to gain service users comments. There was also a suggestion box for staff and service users; staff that made a good suggestion could receive £25.00. The manager undertook night visits, to ensure the quality of the service was maintained on nights and days. All these measures ensured that staff felt valued and supported by the home manager and the company. Courtfield DS0000007812.V315771.R02.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 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 2 X 3 Courtfield DS0000007812.V315771.R02.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 OP15 Regulation 13 (4) (b) Requirement Kitchen cleaning undertaken on a daily basis must be recorded. Fridge, freezer and hot meat temperatures must be recorded daily, and kept for inspection. Timescale for action 30/10/06 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 OP36 Good Practice Recommendations The one member of care staff should receive their supervision as discussed. Courtfield DS0000007812.V315771.R02.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.V315771.R02.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. 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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