CARE HOMES FOR OLDER PEOPLE
EMYVALE HOUSE 29 Brampton Road West Melton Rotherham S63 6AR Lead Inspector
Valerie Hoyle Unannounced 11 August 2005 09:00. 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. EMYVALE HOUSE J55-J07 S40187 Emyvale House V186444 110805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service Emyvale House Address 29 Brampton Road West Melton Rotherham South Yorkshire S63 6AR 01709 874910 None None Mr Stephen John Oldale 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) Mrs Julie Count PC Care Home only 16 Category(ies) of OP Old Age: 16 registration, with number of places EMYVALE HOUSE J55-J07 S40187 Emyvale House V186444 110805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: None Date of last inspection 18 January 2005 Brief Description of the Service: Emyvale House is situated in the village of West Melton on the northern outskirts of Rotherham. It is near the village facilities such as the shops, public houses, public transport and the Church. Located on the main road, it has the appearance of a large ordinary house and has been converted for this current use.A small car park and garden area are at the front of the building. A further small garden area leads off the conservatory at the side of the house, and this is level, and has seating for residents, bird tables and other decorative features.Emyvale House is registered to provide care for 16 elderly people with accommodation on three floors comprising of 14 single and 1 double room, all with en-suite facilities. There are two bathrooms, one with a special bath to aid people with disabilities. A lift gives access to the first floor in addition to a centrally located staircase. There is a lounge that overlooks the conservatory and a ramped passage leading to the conservatory. The conservatory is also the smoking area of the home. The dining room is nearby and provides adequate space and facilities, with a serving hatch from the kitchen. EMYVALE HOUSE J55-J07 S40187 Emyvale House V186444 110805 Stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection took place over 5.5 hours where a partial tour of the buildings was undertaken. The inspector examined four service users care plans and supporting documentation. Eight service users and six staff were spoken to during the visit. The inspector was able to speak to a number of relatives, and the hairdresser, to gain their views on how the home is run. What the service does well: What has improved since the last inspection?
The registered providers continue to improve the environment by replacing carpets and decorating bedrooms to the likes and tastes of service users. A ramp and handrail has been fitted to ensure service users have easy access to the well maintained gardens An activity co-ordinator has recently been employed at the home to ensure service users have the opportunity to take part in a variety of activities, she is enthusiastic about her new role and has introduced the making of crafts to see at a forthcoming summer fayre. EMYVALE HOUSE J55-J07 S40187 Emyvale House V186444 110805 Stage 4.doc Version 1.40 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. EMYVALE HOUSE J55-J07 S40187 Emyvale House V186444 110805 Stage 4.doc Version 1.40 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 EMYVALE HOUSE J55-J07 S40187 Emyvale House V186444 110805 Stage 4.doc Version 1.40 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) 3, 5. Service users are not admitted into the home without a full needs assessment undertaken by the registered manager, to ensure their needs are met. Service users can visit the home prior to their admission to assess if they want to live there. EVIDENCE: The placing authority provides information to the home prior to admission and the registered manager is able to make an initial judgement about the suitability of the service user, and assess if the staff are able to meet their care needs. Information is gained from relatives and health professionals to ensure their needs can be met at the home. Two assessment documents examined included sufficient information to ensure care needs can be met by the staff at the home. One service user was able to confirm that she/he was visited prior to admission, and said the staff were very good and were able to meet her/his needs. Another service users who is currently receiving respite at the home said that family had been to look round
EMYVALE HOUSE J55-J07 S40187 Emyvale House V186444 110805 Stage 4.doc Version 1.40 Page 9 the home prior to arriving and said that the home was very welcoming and the staff were helpful and kind. EMYVALE HOUSE J55-J07 S40187 Emyvale House V186444 110805 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9, 10. The care planning systems are sufficiently detailed to enable staff to deliver the care to service users who have specific identified needs. Arrangements for dealing with service users health issues are adequately met by staff at the home, with support from health professionals. Medication policies and procedures are well managed and almost all staff have the necessary skills to administer the medication to service users, ensuring their safety and protection. Staff have the necessary skills and knowledge to ensure service users are treated with respect and dignity. EVIDENCE: Four care plans examined and these were comprehensively written with clear methods of staff intervention. There is sufficient evidence to confirm staff on a regular basis reviews the care plans and comprehensive risk assessments ensure service users can maintain their independence while remaining in a safe environment. Risk assessments should be developed for those service users who choose to have their door left open and this must be with consultation of the fire officer. Annual care plan reviews should be established to ensure
EMYVALE HOUSE J55-J07 S40187 Emyvale House V186444 110805 Stage 4.doc Version 1.40 Page 11 service users and their relative is given the opportunity to review care needs and agree and sign the care plan. Staff are comfortable with their abilities to meet the needs of service users and they are well informed and trained to deliver the care. Records examined and discussion with the staff confirmed service users healthcare needs are met. District nurses give advice and support staff to ensures service users healthcare needs are met. Service users are escorted to medical appointments by staff or relatives and comprehensive records are completed ensuring information is shared with those who care for the individual. An audit of medication stocks and records was examined and were found to be correct ensuring the health and safety of service users. Most of the senior carers have undertaken accredited medication training to ensure they have the required skills and knowledge, although arrangements must be made to ensure the remaining staff who have not completed the course attend an accredited course as soon as possible. The registered manager said that a course should have taken place in July but due to college funding had to be cancelled. There were many examples of good practise by staff and on many occasions there were good interactions between staff and service users and the visiting relatives. Most service users were referred to by their first name and this was with the approval of users, and was also stated in their care plan. Staff were particularly kind and gentle with a service user who has sustained a fractured arm ensuring the least discomfort when moving him to his wheelchair. One visiting relative said that their observations of the staff at the home was genuine caring and efficient, although they did comment that staff appeared to be very busy all of the time. EMYVALE HOUSE J55-J07 S40187 Emyvale House V186444 110805 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 15. Social activities are arranged by the home and service users are able to participate if they wish, to enhance their lifestyle experience. Mealtimes are well managed and the facilities promote a calm environment with a pleasant dining area to accommodate all service users. The home has clear visiting policies and procedures to ensure service users can maintain contact with their family and friends. EVIDENCE: There is a lively atmosphere at the home and service users choose where and with whom they want to spend their time. A new activity co-ordinator is now in post and she appears to be enabling service users to become involved in craft activities including making cards and trinkets for a forthcoming summer fayre. She said that she is able to obtain craft items to generate money, which is used to provide entertainment for the residents. ‘Lost Chord’ still attends providing musical entertainment and is popular with most of the service users. The conservatory is an area used by service users who enjoy a quieter area to entertain their visitors. One service user said it was a lovely area and liked to be able to go into the garden with help from staff. The visiting hairdresser said
EMYVALE HOUSE J55-J07 S40187 Emyvale House V186444 110805 Stage 4.doc Version 1.40 Page 13 that she enjoyed visiting the ladies at Emyvale and said the staff were always willing to help. Visiting relatives said they were always made to feel welcome and staff were very caring. One relative visiting the home from abroad gave very positive observations about the home. The staff at the home encourages relatives to play an active part in the home and they are invited to social events and outings. The menus are well balanced with a good choice for each meal. Mealtimes were observed and the food looked good quality and was well presented. Staff were available throughout the meal and were able to give assistance where needed, they appeared to be unhurried and had time to chat to service users. Service users said the meals were very nice with a good variety and a number of service users said the cook was excellent and spent time chatting to them about the food and how she liked to do fancy cakes and sweets. EMYVALE HOUSE J55-J07 S40187 Emyvale House V186444 110805 Stage 4.doc Version 1.40 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16, 18 Service users and their relatives are provided information to enable them the raise concerns about the home and their care. Adult protection Policies, procedures and training of staff ensures the protection of service users from abuse. EVIDENCE: There is a complaints procedure that is available to service users and visitors. The procedure is also referred to in the service users guide, identifying the stages to follow; this includes the time scales to respond to complaints. The address and telephone number of the Commission for Social Care Inspection is included in the procedure. There is a comprehensive Adult Abuse and Whistleblowing and staff follow the procedures to those standards. The registered manager would investigate fully any allegations of abuse and would follow the necessary procedures if any were substantiated. The registered manager holds discussions with staff to talk over issues and how to recognise different forms of abuse. EMYVALE HOUSE J55-J07 S40187 Emyvale House V186444 110805 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 26 The registered provider continues to improve the décor and furnishings at the home creating comfortable and safe environments for service users. The home is clean and free from odours and there is sufficient domestic staff to maintain good hygiene standards. EVIDENCE: The registered providers continues to make improvement to the decoration and a number of bedrooms have been fitted with new carpets, the registered manager said the rolling programme is to continue and a number of other carpets have been identified to be replaced. Two additional bedrooms have been created on the second floor of the home and access is via the passenger lift. The rooms meet the spatial requirements and have been furbished to a good standard. There are gardens at the home and these are well maintained and service users are able to enjoy the area in the summer when garden furniture is available. A new concrete ramp with handrails has made access to the garden easier for service users. EMYVALE HOUSE J55-J07 S40187 Emyvale House V186444 110805 Stage 4.doc Version 1.40 Page 16 The home was clean and free from offensive odours and service users and visitors confirmed that the home was always that way. The domestic staff are commended for their efforts in maintaining the cleanliness of the home. EMYVALE HOUSE J55-J07 S40187 Emyvale House V186444 110805 Stage 4.doc Version 1.40 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 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) 7, 28, 29, 30 Staff have the skills and knowledge to fulfil their roles within the home, and a stable staff group ensures continuity of care by staff that knows the service users. Recruitment policies are generally followed although CRB checks are not always obtained prior to the commencement of employment. EVIDENCE: Staff rotas examined showed that two staff are employed to work throughout the day, although this sometimes includes the registered manager. The registered provider is currently trying to recruit night carers to ensure the required levels during the night can be maintained. The staffing levels should be reviewed using the residential forum to ensure appropriate levels are maintained. The staff at the home have achieved the required 50 NVQ level 2/3 and are commended for their efforts. The registered provider has demonstrated a continuing commitment to developing the workforce and the home has achieved ‘Investors in People’ award. Examination of training records show that some staff now requires refresher training in food hygiene and this must now be arranged by the registered manager. Two staff files examined showed that CRB’s had not been obtained prior to commencing employment. The registered manager must ensure that staff
EMYVALE HOUSE J55-J07 S40187 Emyvale House V186444 110805 Stage 4.doc Version 1.40 Page 18 without CRB check are supervised until they can be obtained to ensure the safety and protection of service users. EMYVALE HOUSE J55-J07 S40187 Emyvale House V186444 110805 Stage 4.doc Version 1.40 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 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) 31, 38. The registered manager is skilled and experienced to manage the home to ensure the safety and protection of the service users. Staff and service users follow health and safety procedures and records provide evidence of servicing of essential equipment EVIDENCE: The registered manager has a wealth of experience and knowledge and is able to demonstrate her ability to manage the home. She holds the required management and care qualifications and operates an open door policy to ensure she is accessible to staff and service users. The registered manager also undertakes care duties and covers for the cook on her days off. This impacts on his ability to complete the roles and responsibilities of a registered manager. The registered provider should undertake a review of the roles and responsibilities of the registered manager.
EMYVALE HOUSE J55-J07 S40187 Emyvale House V186444 110805 Stage 4.doc Version 1.40 Page 20 Service users spoke highly of the manager and said she was very caring. Staff and group meetings ensure that staff are informed about training opportunities and the day to day running of the home, they are also encouraged to be involved in decision making. Accident reports are analysed by the manager to ensure risk assessments are developed where required. Maintenance and service records examined were up to date and current to the services provided. The manager has the required Health and Safety policies and procedures and displays the relevant notices. Fire safety procedures are in place and service records were examined and were current, a tour of the building found the two bedroom doors to be wedged open, which puts service users at serious risk of harm and must be removed. This was discussed with the manger who must undertake risk assessments and consult with the fire officer regarding closure units for bedroom doors. EMYVALE HOUSE J55-J07 S40187 Emyvale House V186444 110805 Stage 4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x 3 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 4 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 4 14 x 15 3
COMPLAINTS AND PROTECTION 3 x x x x x x 4 STAFFING Standard No Score 27 2 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 x x x x x x 2 EMYVALE HOUSE J55-J07 S40187 Emyvale House V186444 110805 Stage 4.doc Version 1.40 Page 22 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 OP7 Regulation 15 Requirement The registered manager must develop risk assessments for those service users who choose to have their bedroom doors open, the fire safety officer should be contacted for advice The registered manager must ensure that all staff who administer medication attends an accredited medication course The registered providers must ensure that the residential forum is used to calculate staffing ratios to ensure that needs of the service users can be met The registered manager must ensure that CRB clearence is gained prior to commencement of employment The registered provider must ensure that all staff who have responsibility for handling of food receives refresher training in food hygeine The registered manager must ensure that bedroom doors are not wedged open Timescale for action 1 Oct 2005 2. OP9 13 1 Dec 2005 3. OP27 1 Oct 2005 4. OP29 1 Oct 2005 5. OP30 1 Dec 2005 6. OP38 13 1 Sept 2005 EMYVALE HOUSE J55-J07 S40187 Emyvale House V186444 110805 Stage 4.doc Version 1.40 Page 23 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard OP22 OP7 OP31 Good Practice Recommendations The home must ensure that a moving and handling assessment takes place with regard to equipment The registered manager should ensure that an annual care plan review takes place on all service users wher relatives have the opportunity to discuss and agree the care plan The registered provider should undertake a review of the roles and responsibilities of the registered manager as it was noted that on a number of occasions she provided cover for care assistants and cook. EMYVALE HOUSE J55-J07 S40187 Emyvale House V186444 110805 Stage 4.doc Version 1.40 Page 24 Commission for Social Care Inspection First Floor, Barclay Court Heavens Walk Doncaster DN4 5HZ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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