Inspection on 27/04/08 for Esk Hall Residential Home For The Elderly

This inspection was carried out on 27th April 2008.

CSCI found this care home to be providing an Adequate service.

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

Similar services:

Abbey The

Snydale Care Home

Hawkhills

Larchfield Manor

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 27/09/2008.

CARE HOMES FOR OLDER PEOPLE Esk Hall Residential Home For The Elderly Sleights Whitby North Yorkshire YO22 5EG Lead Inspector Ray Burton Unannounced Inspection 25th April 2008 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Esk Hall Residential Home For The Elderly DS0000070748.V364100.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. Esk Hall Residential Home For The Elderly DS0000070748.V364100.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Esk Hall Residential Home For The Elderly Address Sleights Whitby North Yorkshire YO22 5EG 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) 01947 810482 01947 810482 Esk Hall Ltd Mrs Tracy Elizabeth Byrne Care Home 17 Category(ies) of Old age, not falling within any other category registration, with number (17) of places Esk Hall Residential Home For The Elderly DS0000070748.V364100.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care Home only - Code PC To service users of the following gender: Either Whose primary care needs on admission to the home are within the following category: Old Age, not falling within any other category, Code OP - maximum number of places 17 The maximum number of places who can be accommodated is: 17 2. Date of last inspection 2nd May 2007 Brief Description of the Service: Esk Hall is a Grade II listed Georgian country house set in grounds of approximately five acres running down to the river Esk. The house, which is situated in the village of Sleights, has panoramic views across the Esk valley. Accommodation is provided for up to seventeen older people. The home was recently bought by the Fisher Partnership trading as Esk Hall Ltd. The previous owner, Mrs T Bryne has continued as the registered manager. The new owners have recently embarked upon a building development programme that when completed (hopefully by September this year) will see the existing building completely refurbished and a new wing added to provide further accommodation. Current weekly charges range from £320 to £500. Esk Hall Residential Home For The Elderly DS0000070748.V364100.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate outcomes. This report gives the findings of an unannounced key inspection that commenced on 25/04/08 and was completed on 29/04/08. During the inspection a tour of the building was conducted, records examined and the inspector spoke to residents, members of staff, the registered manager and a visiting community nurse. In addition completed surveys were received from four residents and two relatives. What the service does well: What has improved since the last inspection? What they could do better: Care plans need further development to include more comprehensive information and risk assessments must be more detailed and include strategies to eliminate or minimise identified risk. Esk Hall Residential Home For The Elderly DS0000070748.V364100.R01.S.doc Version 5.2 Page 6 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. Esk Hall Residential Home For The Elderly DS0000070748.V364100.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 Esk Hall Residential Home For The Elderly DS0000070748.V364100.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): 1, 3 & 5. People who use this service experience good quality outcomes in this area. Prospective residents were given information prior to admission to enable them to make an informed decision about the suitability of the home and its ability to meet their needs. The homes assessment procedure ensured no one would be admitted unless his or her needs could be met. We have made this judgement using a range of evidence, including a visit to the service. EVIDENCE: The home had a statement of purpose setting out the aims, objectives and philosophy of care. Resident’s records and conversation with the registered manager showed that, prior to admission, prospective residents and their relatives were invited to visit to look around the home and meet members of staff and the people already living there. The manager said that sometimes two or three visits were made and that during this time assessments were conducted to assess need Esk Hall Residential Home For The Elderly DS0000070748.V364100.R01.S.doc Version 5.2 Page 9 and to decide whether or not the placement was suitable. Where possible the manager visited prospective residents in their own homes or in hospital. Following admission there was a trial period during which time new residents were able to decide if they wished to continue to live at Esk Hall. The home does not offer intermediate care therefore standard six does not apply. Esk Hall Residential Home For The Elderly DS0000070748.V364100.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): 7, 8, 9, & 10. People who use this service experience adequate quality outcomes in this area. Personal care was conducted in a sensitive manner that upheld the dignity and privacy of residents. Systems were in place to ensure the safe handling of medication. Care plans need to be further developed especially with regard to the assessment and management of risk. We have made this judgement using a range of evidence, including a visit to the service. EVIDENCE: Monitoring of health was undertaken and healthcare needs addressed by community based healthcare professionals e.g. G.P’s, District Nursing Service, Chiropodist etc. The manager and members of staff had good knowledge of residents and their needs and were able to demonstrate how those needs would be met however, that knowledge had not always been fully recorded in care plans. Esk Hall Residential Home For The Elderly DS0000070748.V364100.R01.S.doc Version 5.2 Page 11 Examination of three plans revealed further development was required to ensure each care plan contained all available relevant information that would provide a more comprehensive picture of the resident, and help staff to deliver support to the residents in the way that was wished. Each plan contained a basic information sheet with details of next of kin, G.P., medical consultant, likes and dislikes etc. There was good medical information i.e. general health of the individual and details of any specific medical conditions or ailments; however there was little background information about the person and his/her life that would help staff to identify preferences, interests etc so that support could be delivered in the way that the individual wished. Risk assessments had been conducted however they were not always sufficiently detailed and did not fully explore identified risk to enable suitable risk management strategies to be put in place. The home had appropriate policies and procedures for the receipt, recording, storage, handling, administration and disposal of medicines. Medication was stored securely and administered by staff who had received training in the administration and safe handling of medicines. Residents who had been assessed as being able to administer their medication were asked if they wished to keep their own medicines. It was observed during the inspection that residents were treated with respect and addressed courteously and appropriately. In conversation residents said they were satisfied with the way in which support was given and felt staff were respectful towards them and delivered care in a way that ensured dignity and privacy was preserved. The questionnaire returned by a relative of one of the residents contained the following comments: “I have every faith in the care staff. There is a good range of experience and everybody is kind, respectful and considerate. Individual preferences and interests are taken into account.” Esk Hall Residential Home For The Elderly DS0000070748.V364100.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): 12,13,14 & 15. People who use this service experience good quality outcomes in this area Residents were able to exercise choice and make decisions about their lives. Routines were flexible and able to accommodate individual preferences and expectations. Residents were encouraged to maintain links with family, friends and the local community. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Esk Hall provides care in an informal, friendly and relaxed atmosphere with residents being able to exercise choice about everyday things such as when to rise and retire to bed. Members of staff said residents were encouraged to make decisions about their own lives and to be as independent as possible. The home had an activities co-ordinator who visited the home on two afternoons each week and an activities programme encompassing things to do both in the house and outside: board games, weekly quiz, indoor quoits, DVD’s, visits to the library bus when it visited the village, walks and drives in the car etc. Seasonal and special events were organised such as Christmas parties and birthday celebrations to which relatives and friends were invited. Esk Hall Residential Home For The Elderly DS0000070748.V364100.R01.S.doc Version 5.2 Page 13 Once a month the local Vicar visited to conduct a Communion service in the home; and the manager stated, in the AQAA, that different denomination services could be arranged if requested. Although residents were encouraged to take part in organised activities the staff team understood the importance of allowing people to choose whether or not they wished to participate; and respected their decision should they decide not to. Meals were generally served in the dining room at set times although there was a high degree of flexibility to accommodate individual wishes - meals could be served in resident’s rooms if they wished. Menus showed a varied and balanced diet was served with alternatives being available should a resident not wish to have the dish of the day. The manager said that all meals were prepared from fresh local produce. Residents made many favourable comments about the quality and variety of the meals. On one of the days of the inspection the inspector shared a meal with the residents – it was nicely presented and well cooked. It was observed that members of staff were available to encourage and assist those residents in need of help with their meal. A relative said: “ There is always an atmosphere of warmth and caring – almost like a family. Relatives/visitors are always welcome and an informal, friendly atmosphere prevails.” Esk Hall Residential Home For The Elderly DS0000070748.V364100.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): 16 & 18. People who use this service experience good quality outcomes in this area. The home had appropriate policies and procedures in place in relation to the protection of vulnerable adults and for dealing with complaints. This judgement has been made using available evidence including a visit to this service. We have made this judgement using a range of evidence, including a visit to the service. EVIDENCE: The home had a suitable complaints procedure, stating how complaints could be made, who would deal with them, the time scale for the process and what to do if not satisfied with the way in which the matter had been handled. There had been no complaints received since the last inspection. The inspector spoke to several residents, all of who expressed satisfaction with the general running of the home and the care and attention shown by the manager and staff. They said that they did not have any complaints, but if they were unhappy about anything they knew who to approach to have the matter dealt with. One resident said: “I am very satisfied and comfortable – the staff are very good and thoughtful and will do anything for you.” Esk Hall Residential Home For The Elderly DS0000070748.V364100.R01.S.doc Version 5.2 Page 15 In a completed questionnaire the relative of a resident stated she had been informed of the complaints procedure when her mother first arrived at the home. Policies and procedures were in place to ensure the safety and protection of residents and to respond to any suspicion or allegation of abuse. The manager said that staff training in the Protection of Vulnerable Adults (POVA) was due to take place later this year; it is important that this training takes place as soon as possible as it was originally planned for last year. Esk Hall Residential Home For The Elderly DS0000070748.V364100.R01.S.doc Version 5.2 Page 16 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): 19, 20,25 & 26. People who use this service experience good quality outcomes in this area. Careful planning and good risk management has ensured that, in spite of the extensive building work being carried out, residents live in an environment that is comfortable and homely. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is currently undergoing extensive building work to completely refurbish and upgrade all communal areas and bedrooms. A lift is to be installed to service all three floors of the building, disabled bathing facilities, hairdressing room, visitors room and a new conservatory are to be provided; in addition an extension is under construction to increase the number of people who can be accommodated. The manager said that once the building work has been completed the grounds immediately around the house are to be Esk Hall Residential Home For The Elderly DS0000070748.V364100.R01.S.doc Version 5.2 Page 17 landscaped and seating provided. It is anticipated that all work will be completed by September this year. The inspector attended a daily site meeting between the manager and site foreman during which the days work was discussed and risk assessments completed. It was apparent that great attention was paid to health and safety matters and of ensuring work was carefully planned so that disruption was kept to a minimum and that the safety and comfort of residents was maintained at all times. A walk round the building revealed all completed work to have been carried out to a high standard and that the new facilities when completed will greatly enhance the lives of the people living in the home. It is to the credit of the staff team and to the builders that, in spite of the unavoidable mess caused by such major building work, the home was maintained in a clean and hygienic manner and all areas of the home were maintained in a safe condition. Residents said they were kept informed about what was happening and did not feel disturbed by the alterations that were taking place. A relative said: “With the building work in progress it is difficult at the moment for all concerned however I think when the improvements are completed the conditions for residents should be very satisfactory.” Records showed regular checks and servicing of equipment was undertaken. Esk Hall Residential Home For The Elderly DS0000070748.V364100.R01.S.doc Version 5.2 Page 18 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): 27,28,29 & 30. People who use this service experience good quality outcomes in this area. Staff were employed in sufficient numbers, and with suitable skills and training to meet the needs of residents. The home operated an appropriate recruitment procedure. We have made this judgement using a range of evidence, including a visit to the service. EVIDENCE: On the days of the inspection there were sufficient numbers of staff on duty to meet the needs of the people living in the home. Examination of staffing rosters revealed that appropriate staffing levels were maintained at all times. Eight personnel files were examined, each contained evidence that all necessary checks, including Criminal Records Bureau (CRB), were carried out and satisfactory references obtained prior to commencement of employment. All new members of staff received induction training and there was ongoing mandatory training for all members of staff. Esk Hall Residential Home For The Elderly DS0000070748.V364100.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): 31, 33, 35, 36 & 38. People who use this service experience good quality outcomes in this area. This is a well manage home with systems in place to protect residents and safeguard their health, safety and welfare. We have made this judgement using a range of evidence, including a visit to the service. EVIDENCE: The registered manager has the required qualification and experience to run the home. The manager and staff were aware of their responsibilities under Health & Safety legislation. Regular checks of the building and equipment were conducted and maintenance and servicing undertaken to maintain a safe Esk Hall Residential Home For The Elderly DS0000070748.V364100.R01.S.doc Version 5.2 Page 20 environment. Particular attention was accorded to any risks emanating from the building work currently being carried out. Records were maintained in a satisfactory manner and were stored appropriately. Policies and procedures were in place covering all aspects of the management of the home and the health, safety and welfare of residents and staff. A designated representative, generally a family member, dealt with the financial affairs of residents and only small amounts of cash were handled by staff at the home. Appropriate records were kept of all financial transactions. The home had systems, both formal and informal, to measure success in meeting its aims and objectives and statement of purpose and to ensure residents rights and best interests were safeguarded: Regular meetings with residents and their relatives; staff meetings; regular case reviews; regular formal supervision for all members of staff; feedback from visiting professionals e.g. social workers, district nurses etc.; informal daily contact with residents. Esk Hall Residential Home For The Elderly DS0000070748.V364100.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 3 X 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 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 3 X X X X 3 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 3 X 3 Esk Hall Residential Home For The Elderly DS0000070748.V364100.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 OP7 Regulation 15 Requirement Each care plan must be developed to include all relevant information that would provide a more comprehensive picture of the resident, and help staff to deliver support in the way that the individual wished. Risk assessments in care plans must be more detailed and include strategies to eliminate or minimise identified risk Timescale for action 25/07/08 13 (4) (b) (c) 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 Esk Hall Residential Home For The Elderly DS0000070748.V364100.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB 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 Esk Hall Residential Home For The Elderly DS0000070748.V364100.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. 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!