Inspection on 23/12/08 for Grove House - City of York Council

This inspection was carried out on 23rd December 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

Grove House - City of York... 21/11/07

Grove House - City of York... 30/11/06

Grove House - City of York... 21/03/06

Grove House - City of York... 18/10/05

Grove House - City of York... 09/03/05

Grove House - City of York... 09/06/04

Extracts from inspection reports are licensed from CQC, this page was updated on 27/02/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Grove House - City of York Council Grove House 40-48 Penleys Grove Street York North Yorkshire YO31 7PN     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Denise Rouse     Date: 2 3 1 2 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Grove House - City of York Council 40-48 Penleys Grove Street Grove House York North Yorkshire YO31 7PN 01904628250 Telephone number: Fax number: Email address: Provider web address: ephgrovehouse@york.gov.uk Name of registered provider(s): Name of registered manager (if applicable) Mrs Ann Morton Type of registration: Number of places registered: City of York Council care home 33 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: All Service Users for Intermediate Care (up to a maximum of 11) will be accommodated within Intermediate Care Unit and be in the category OP. Date of last inspection Brief description of the care home Grove House is a care home run by City of York Council and is registered to provide a service for 22 older people of either gender aged over 65 years who do not have any specialist requirements. There are an additional 11 places for people aged 65 years and above who require high dependency care. Grove House was purpose-built approximately 40 years ago and is located within a short walk of local facilities in Monkgate. The centre of York is within 1 mile. The accommodation is provided in single rooms on two floors. The upper floors are accessible via passenger lift. There is an enclosed rear garden. Fees charged to each person may vary, all have a financial assessment undertaken, benefits and pensions are taken into account. The fee charged Care Homes for Older People Page 4 of 27 Over 65 33 0 Brief description of the care home per week on the day of the site visit was four hundred and fifty seven pounds and seventy four pence. Additional charges are made for hairdressing, chiropody services and individual items like toiletries. The service provides an information booklet about the home to prospective residents. The statement of purpose and service user guide is available to people as well as the last inspection report. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 1 star. This means people who use this service experience adequate quality outcomes. This evidence used in this report has include: A review of the information held on the homes file since its last inspection. Information provided in the Annual Quality assurance Assessment (AQAA). Surveys received from five people living at the home, five staff and one health care professional. Care Homes for Older People Page 6 of 27 An unannounced visit to the home which lasted six hours, undertaken by one inspector. Evidence gained by direct observation during the site visit. And from talking with people living at the home, with senior care staff, the care leader and manager. Inspection of records, including care profiles, medication administration records, staff files and some of the homes policies and procedures. We have reviewed our practise when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations. But only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will take place. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. Care Homes for Older People Page 8 of 27 The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 27 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are assessed so their needs are known and can be met. Evidence: People are assessed before they are offered a place in the home. The assessment is undertaken by the manager who is experienced and competant in assessing peoples needs. Information is gained from care management, discharging hospitals and the persons relative or representative to make sure all necessary information is known. Prospective residents are invited to spend some time at the home before making a decission about if the home is the right place for them. Information is provided in the statement of purpose and homes brochure to help people understand what the home has to offer them. A place is only offered to people if the home assesses that staff can meet the persons needs. A six week trial period is then offered and the placement is reviewed after this Care Homes for Older People Page 11 of 27 Evidence: to make sure people are happy with the care and services they are receiving. Emergency admissions are not taken without the care managers assesment being sent to the home. The manager and staff look at this information and then decide if they can meet the persons needs. Emergency admissions are not received if it is felt the home cannot meet their needs. Care Homes for Older People Page 12 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have their needs met, however risk assessments are not reviewed regularly, and daily care given is not always recorded, which may not protect peoples wellbeing. People are better protected by the medication systems now in place. Evidence: People spoken with said they were treated with dignity and respect by the staff. They said staff listened to them and acted upon what they said. Staff were seen to be attentive and patient with people who required some help and assistance. Three peoples care documentation was inspected. Care plans were in place and there was information about risks to peoples health and wellbeing. However risk assessments had not been reviewed timely for some people and this may place people at risk of harm. Staff should make sure that risk assessments are reviewed in line with the City of York Councils policy to make sure that people continue to have their needs met. Care Homes for Older People Page 13 of 27 Evidence: Daily entrys were not always recorded for people living in the home. The manager said that she expected staff to record an entry of everyone living in the home, on a daily basis. This should be undertaken to provide a record of how each person has spent their day and how they have been assisted by staff. To make sure there is evidence that peoples needs are being met. Medication procedures have improved since the last inspection and staff have received training to help them give medication safely using the systems they have in place. Medications received are recorded and stock is carried forward as necessary. There were no gaps on the medication administration records, which were filed in order with dividers between each persons medication record. This helps to make sure that people are receiving the medication they are prescribed. However the medication fridge temperature was not recorded daily. The manager agreed to commence this on the day of the site visit. One person who had an item of medication recorded in the controlled medication register had been given their medication, but staff had not recorded the dose correctly in the register. This was discussed with the manager and rectified at the time of the site visit. Staff must make sure that the dose of medication is correctly recorded in the controlled medication register, to ensure accurate records are being kept. Care Homes for Older People Page 14 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have their social needs met, However there are shortfalls in the recording of information in the kitchen which may place people at risk. Evidence: People spoken with said they could join in with activities if they wished. There is a separate day area where people can go to if its not to busy and join in with bingo.On the day of the visit a carer was reading to a group of people. In the afternoon an arts and crafts session was being undertaken in the main dining room this was well attended and occurs once a week. Open visiting occurs and people can go out when they wish. There is no activities organiser provided for the home and no budget is given to help provide activities. The manager and chef currently plan activities with the help of care staff who take people out on a one to one basis for shopping. Staff also raise money by undertaking raffles and other events to be able to give people living at the home birthday and Christmas presents. There have been trips arranged for people to go out for lunch, visit the reindeer at Care Homes for Older People Page 15 of 27 Evidence: Wigginton and go Christmas shopping. Carol singers have also attended the home. There is a hairdresser that visits the home to provide a service to all. Local clergy also visit the home and people can go out to churchs and to the Salvation Army when they wish. Holy communion is provided at the home every Sunday, to make sure that peoples religious needs are met. The kitchen was inspected. Food being prepared for lunch looked appetising and the chef knew who required special diets. Home made mince pies had been baked. The cleaning undertaken in the kitchen is not recorded. The hot meat temperatures are also not recorded daily and the hot trolley temperature and fridge temperatures were recorded for the last 2 days only the chef could not find the inspector any evidence for the rest of December. This documentation should be completed as these shortfalls place people who live at the home of risk of harm. This issue had been found during the homes environmental health inspection. Care Homes for Older People Page 16 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are protected from abuse. People know how to raise complaints and feel issues raised would be addressed. Evidence: People spoken with and those who completed surveys said that they knew how to raise issues they may have to the staff or manager. They said they felt any issue raised would be investigated and dealt with appropriately. The City of York Council complaints leaflet is available in the home. There have been no complaints received since the last Inspection. Staff receive training about how to safeguard people from abuse during their indication training and at regular intervals whilst they are working in the home. Staff spoken with knew what to do if an allegation of abuse occurred. This helps to protect people. Care Homes for Older People Page 17 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a home that is maintained, however there were some small shortfalls to be addressed, to protect peoples health and wellbeing. Evidence: The home has a secure door entry system to make sure unauthorised people cannot gain entry to the home, this helps keep people safe. There are a variety of living rooms and dining areas provided on both floors of the home. A passenger lift is available to help people gain access to all areas of the home. There is a smokers lounge on the ground floor. General maintenance is undertaken. There have been some improvements made to the decor of the building and some new carpets have been laid to make sure that the home is pleasant for people who live there. There is a larger refurbishment of some communal areas planned for 2009, including erecting a conservatory for people to enjoy. There is a garden with a patio area this is accessible by people who use wheelchairs and those who may not be steady on their feet. Garden furniture is available for people to use.There are some raised beds for plants the staff attend to the garden and plant pots so that it looks nice for people in summer. Care Homes for Older People Page 18 of 27 Evidence: The laundry was inspected. Infection control measures are in place for handling soiled linen. Hand wash facilities are available for staff throughout the home to help maintain infection control. In two bathrooms some repair work was required. In an upstairs bathroom the lino had come un stuck round the edges of the wall and there was an area of lino missing behind the bathroom door which requires replacing. In the second bathroom on the ground floor there was a tile missing at the tap end of the bath. and there was a build up of dust on the floor at the tap end of the bath. These issues should be addressed to make sure that thorough cleaning can take place to maintain adequate infection control. Care Homes for Older People Page 19 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are looked after by well trained staff, however some do not receive regular supervision which can help staff develop their skills, this should be addressed. Evidence: Staff are professional and friendly towards people living in the home. This produces a homely environment which people enjoy. Staffing levels have been increased since the last inspection and there may be a deputy managers post created at the home to help support the manager and staff team. The home has taken high dependency clients and due to this the staffing levels are being constantly reviewed to make sure that people can get the care they need when they want it. The manager and some staff spoken to said they would still like to have more staff at times, this will continue to be reviewed. Staff are recruited using thorough recruitment methods which ensure equal opportunities and anti discriminatory recruitment takes place. All staff have police checks undertaken before they commence work at the home to make sure new staff are suitable to work in the care industry. New staff complete induction training which helps them gain the skills they need to be able to give good care. Regular refresher training is provided for staff in safeguarding adults, moving and handling, infection control and other subjects that enhance the Care Homes for Older People Page 20 of 27 Evidence: care that staff can give to people living in the home. A number of staff have undertaken their National Vocational Qualification in Care. Some staff have received some supervision, however this was poorly recorded and not evident for two out of three care staff who were case tracked. Although other staff spoken with said they had received supervision. The manager should make sure that staff receive regular supervision, so that staff can have the chance to discuss their practise formally and highlight any training they may need, this should be recorded. One person spoken with by the inspector said We are all looked after quite well, the girls are alright, I am happy here , there are no problems. Staff spoken with said they received enough training and said they were supported by the care leaders and manager. Care Homes for Older People Page 21 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed, however there are some shortfalls relating to health and safety which may place people at risk. Evidence: The manager is experienced and has a team of care leaders at the home to help support her. Staff spoken with said that they could speak to her or their care leader at any time. The manager is supported by senior managers from the City of York Council who visit the home on a regular basis to make sure that the home is running as it should be. Questionnaires are sent to people living in the home and their relatives on a yearly basis to gain their views. This was being undertaken at the time of the site visit. There are new quality audits being introduced in January 2009 to make sure that all the departments in the home are assessed each month to make sure they are delivering a good standard of service to people who live there. The manager currently undertakes a Care Homes for Older People Page 22 of 27 Evidence: spot check of the controlled medication register and medications and records this. She has carries out spot checks on the kitchen but these checks are not recorded. Care plan audits are undertaken and the manager currently samples these. Personal allowance accounts are available for people who live at the home. Receipts for all deposits and transactions are kept. Four peoples personal allowance balances were checked. One person had a five pence deficit which was to be rectified by the manager. At the last Inspection a recommendation was made that the amount of money kept in the home should be in line with the amount which is insured. This has not been undertaken, this should be addressed. Some health and safety checks undertaken at the home were looked at. The City of York Council provide ongoing repairs and maintenance to make sure the home is pleasant for people to live in. A fire risk assessment has been undertaken and issues highlighted in this report are being addressed. Weekly fire alarm checks are undertaken, to help protect people. The hot water temperatures for peoples bedrooms and communal areas have not been taken or recorded since the end of March 2008. This does not help to protect peoples safety and these checks should recommence. The shortfalls found on the Environmental Health Inspection, in relation to recording the temperature of food which is cooked or delivered to the home, and the recording of fridge temperatures should be undertaken and recorded. To make sure that peoples health and wellbeing is protected, this shortfall should be addressed. Care Homes for Older People Page 23 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 7 Risk assessments should be reviewed in line with the City of York Councils policy to make sure peoples known and staff can still meet peoples needs. Daily entries should be recorded for each person living in the home to record how staff have met peoples needs, and how people have spent their time. 2 9 Staff should make sure that the dose of medication given is recorded correctly in the controlled medication register. To help protect peoples health and well being. The temperature of the medication fridge should be recorded daily.To make sure that items that require to be stored in a fridge are stored at the correct temperature to ensure they are effective. 3 15 The shortfalls identified in the Environmental Health Inspection should be addressed to make sure food being prepared and stored is safe to eat. The bathroom on the first floor should have the lino stuck down round the edges of the floor and the missing lino should be replaced. The ground floor bathroom should have the missing tile replaced and the bathroom should be thoroughly cleaned to make sure infection control measures are in place. Page 25 of 27 4 26 Care Homes for Older People 5 33 The new quality audits created by the City of York Council should be commenced in the home, to help the manager thoroughly review the services that are being provided in the home. Any shortfalls found should be addressed. Personal allowance balances should be checked to make sure all balances are correct. The manager should make sure that the amount of money held on the premises does not exceed the amount that is insured, and the storage facility for the safe storage of peoples personal money should be replaced. The manager should make sure that hot water temperature checks are undertaken to help protect peoples health and safety. The shortfalls relating to food preparation records should be monitored by the manager and action should be taken to make sure make sure peoples health is protected. 6 35 7 38 Care Homes for Older People Page 26 of 27 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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