CARE HOMES FOR OLDER PEOPLE
Cymar House 113 Pontefract Road Glasshoughton Castleford WF10 4BW Lead Inspector
Susan Vardaxi Unannounced 9 August 2005 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Cymar House J51J01_s6176_Cymar House_v230282_090805.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Cymar House Address 113 Pontefract Road Glasshoughton Castleford WF10 4BW Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Cymar Care Homes Ltd 01977 552018 01977 603038 Ms Jillian Gill Care Home 22 22 22 22 Category(ies) of Older people over 65 registration, with number Mental Disorder over 65 of places Dementia over 65 Cymar House J51J01_s6176_Cymar House_v230282_090805.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: Conditions of this registration are listed on the registration certificate displayed at the service. Date of last inspection 28th February 2005 Brief Description of the Service: Cymar House provides residential care for 22 older people over the age of 65 years, some whom may have dementia type illnesses or mental health disorders. The home is situated in a residential part of Glasshoughton on the outskirts of Castleford. It is on the main bus route and close to all amenities including shops, post office, supermarkets and public houses. Set back in its own grounds there is car parking to the front of the home and lawns to the front and rear of the building. the large hallway at the front entrance leads into the dining room and kitchen to the left, and a large lounge to the right of the hallway. a small quiet lounge is available for service users at the rear of the building. A shaft lift is available for service users and bedrooms are located on the upper and ground floor of the home. The main provision of bedrooms is for single occupancy, however there are two large bedrooms that are available for service users who wish to share. Cymar House J51J01_s6176_Cymar House_v230282_090805.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection completed on 9th August 2005 over 5 hours and involved discussions with service users, visitors, staff and looking at some records. The general atmosphere in the home was relaxed and friendly, some service users were chatting together, staff were busy going about their duties. The interaction between staff and service users was seen to be good. The inspector would like to thank the service users, manager and staff for their cooperation and hospitality throughout the visit. What the service does well:
The manager and staff work hard to provide a quality care service. Service users and relatives spoken with made some very positive comments about the care provided which included “ the girls are very good” “highly satisfied” “care is excellent” The admission and assessment arrangements are satisfactory ensuring that service users are appropriately placed. The home is well and cleaned to a good standard. Care plans are written to a good standard and are appropriate to needs identified at assessment. The manager ensures that service users’ health is monitored and when necessary GPs and other health care providers visits are requested and outpatients appointments arranged. The service users spoken with said that they have choices over meals, getting up, going to bed, going out etc. Advocacy arrangements are made when needed. The staffing levels at the home are satisfactory and training is provided on an ongoing basis. The home has a quality assurance programme, which includes service users’ questionnaires and the manager makes unannounced visits to the home. Cymar House J51J01_s6176_Cymar House_v230282_090805.doc Version 1.30 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. Cymar House J51J01_s6176_Cymar House_v230282_090805.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Cymar House J51J01_s6176_Cymar House_v230282_090805.doc Version 1.30 Page 8 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2,3,4, Pre admission arrangements are satisfactory. Service users and their representatives are provided with accurate information regarding the service provided and their rights under the homes terms and conditions. EVIDENCE: Pre admission assessments, contracts were seen on the service users’ records checked. Relatives spoken with said that they were given a copy of the home’s service user guide (brochure). Cymar House J51J01_s6176_Cymar House_v230282_090805.doc Version 1.30 Page 9 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7 8 9 10 The provision of health care is satisfactory and the standard of care planning ensures that service users needs are appropriately met. EVIDENCE: Care plans seen were appropriate to the service users’ assessed needs and had been reviewed monthly. Risk assessments had been completed for manual handling and falls. Records seen showed that GPs, district nurses, physiotherapist, continence adviser and other health professionals visit the home and hospital outpatients appointments made when needed. Nutritional assessments have been completed and weights checked regularly and records kept. The medication storage arrangements and records were not checked on this visit however staff were observed assisting and encouraging service users to take their medication. A member of staff stayed with the service user until they had taken the medication and signed the medication sheet, another member of staff was left in charge of the medication trolley for safety and security purposes.
Cymar House J51J01_s6176_Cymar House_v230282_090805.doc Version 1.30 Page 10 Visitors were seen in a small quiet lounge talking with their relative. They said the care at the home is excellent and staff are very good. No incidents that could have compromised the service users’ privacy or dignity were observed. Cymar House J51J01_s6176_Cymar House_v230282_090805.doc Version 1.30 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 standard(s) 12 13 14 15 The provision of social activities and meals are satisfactory. Service users are able to maintain contact with relatives and links with the community. The meals provided are satisfactory. EVIDENCE: The manager said that some activities take place. A local library is due to start reminiscence sessions at the home and the provision will depend on service users’ interest. The manager said that staff sit and chat with service users in the afternoons, a Summer Fayre is being arranged for August 2005 and the local clergy visit. The service users spoken with said that they were happy at the home, some go out with families, a service user goes to a local community centre weekly and they have visitors regularly. Relatives spoken with said that they are satisfied with the care and are able to visit at any time and made to feel welcome. Service users said they could go to bed and get up when they want to. The manager said that advocacy arrangements are in place.
Cymar House J51J01_s6176_Cymar House_v230282_090805.doc Version 1.30 Page 12 The cook said she does home baking ,scones and buns were seen and she is baking for the Summer Fayre. The cook said that some service users call at the kitchen door and thank her after their meal. A service user said that someone goes round daily to ask what they want to eat. Cymar House J51J01_s6176_Cymar House_v230282_090805.doc Version 1.30 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 standard(s) 16 17 18 Service users rights are protected. EVIDENCE: The manager said that no complaints had been made recently, the complaints book was seen and the last entry recorded was 2004. Relatives spoken with said that they would “feel confident to discuss concerns if they arose with the staff”. No complaints were raised at this visit. The manager said that all new staff are expected to complete Adult Protection training by September. The manager said that service users are able to vote if they choose to, only 8 used the postal vote at the last election. Cymar House J51J01_s6176_Cymar House_v230282_090805.doc Version 1.30 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 standard(s) 23 24 26 The home provides a safe well maintained environment for service users to live in. EVIDENCE: The overall environment was not checked on this visit The lounges and dining rooms and bedroom visited were clean and tidy. The laundry room located outside the main house was seen and was clean and tidy. The laundry assistant said that heavy rainfall had caused a leak on the guttering which was dripping onto on the boiler which had been switched off until the guttering had been repaired. No issues that could lead to cross infection were observed, a new clinical waste bin had been provided as required at the last inspection. Cymar House J51J01_s6176_Cymar House_v230282_090805.doc Version 1.30 Page 15 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 28 29 30 The staffing levels and training ensure that service users’ needs can be met appropriately. EVIDENCE: The staff rosters show that 3 care staff are on duty during the day, the home employs a laundry and domestic assistants. The manager said staffing levels are increased to demand for hairdresser, health professionals’ visits and outings.’ Staff files seen showed that all information and checks required prior to staff being recruited is obtained. The staff rosters showed that a new member of staff was supervised when POVA first checks have been completed and CRB checks have been requested. The Commission had been notified of this at the time. The training record book seen showed that mandatory training has been completed and included records of staff inductions. A 16 week Dementia training course has been provided and NVQ training is ongoing. Cymar House J51J01_s6176_Cymar House_v230282_090805.doc Version 1.30 Page 16 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32 37 38 The overall management of the home is satisfactory. EVIDENCE: Records seen showed that staff have induction training and receive copies of the General Social Care Council’s Code of Practice. The owners visit the home regularly and also complete unannounced monitoring visits to the home to support the manager and staff. Some questionnaires completed by the service users were seen and generally the comments made were positive. The manager said that she visits the home at various times of the day and night when she is off duty as part of the monitoring process and evidence of her visits was seen in the visitors signing in book. The home was awarded the Investors in People Award which was reassessed in June 2005 and the award extended for a further three years.
Cymar House J51J01_s6176_Cymar House_v230282_090805.doc Version 1.30 Page 17 Mandatory training is provided and the service users records seen showed that risk assessments are completed. It was recorded on one of the monthly reports received from the home that some staff have had Health and Safety training. The pre inspection questionnaire received by the Commission prior to the inspection shows that First Aid training is being planned. Cymar House J51J01_s6176_Cymar House_v230282_090805.doc Version 1.30 Page 18 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x 3 3 3 x x 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 x x x x 3 3 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 Standard No 16 17 18 Score 3 3 3 x 3 x x x x x 3 Cymar House J51J01_s6176_Cymar House_v230282_090805.doc Version 1.30 Page 19 NO 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 Regulation Requirement Timescale for action 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 Good Practice Recommendations Cymar House J51J01_s6176_Cymar House_v230282_090805.doc Version 1.30 Page 20 Commission for Social Care Inspection Park View House Woodvale Office Park Woodvale Road Brighouse HD6 4AB 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 Cymar House J51J01_s6176_Cymar House_v230282_090805.doc Version 1.30 Page 21 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
