Inspection on 30/11/06 for Grove House - City of York Council

This inspection was carried out on 30th November 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Grove House - City of York... 23/12/08

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

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 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Grove House - City of York Council Grove House 40-48 Penleys Grove Street York North Yorkshire YO31 7PN Lead Inspector Jo Bell Key Unannounced Inspection 30th November 2006 11:00 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 Grove House - City of York Council DS0000034935.V322144.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. Grove House - City of York Council DS0000034935.V322144.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Grove House - City of York Council Address Grove House 40-48 Penleys Grove Street York North Yorkshire YO31 7PN 01904 628250 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) City of York Council Mrs Ann Morton Care Home 33 Category(ies) of Old age, not falling within any other category registration, with number (33) of places Grove House - City of York Council DS0000034935.V322144.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 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. 21st March 2006 Date of last inspection Brief Description of the Service: 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. Grove House - City of York Council DS0000034935.V322144.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. A key inspection of this service took place on Thursday 30th November 2006. Prior to the visit a pre-inspection questionnaire was completed, four relative comment cards, two care manager cards and five service user surveys were also returned to the CSCI. One inspector spent five hours at the home, the manager was available to assist throughout the visit. During the day service users, a relative, a district nurse and a range of staff were spoken with. Observations of care practices, care plans, documentation relating to three service users and staffing issues were all discussed. The new high dependency unit was discussed along with health and safety and aspects pertaining to service users. The home offers a good standard of care in a pleasant environment. The manager has the best interests of service users at heart and there are a range of activities to participate in and enjoy. The home needs to ensure that all staff are consistent in their approach to medication and nutrition in order for outcomes for service users to be improved. What the service does well: What has improved since the last inspection? Many aspects of the home are sustained, no major improvements have been made since the last inspection. Though this will be reviewed when the high dependency unit is fully occupied and completed. Grove House - City of York Council DS0000034935.V322144.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Grove House - City of York Council DS0000034935.V322144.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 Grove House - City of York Council DS0000034935.V322144.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): 3 (Standard 6 is not applicable) Quality in this outcome area is good. Service users have their needs assessed prior to admission to ensure needs can be met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service users needs are assessed via the care manager prior to admission to the home. The format used is standard throughout the City of York Council Homes. Three assessments were checked and these contained details of personal and social care needs. All areas were completed appropriately. The manager of the home also carries out her own assessment by visiting the service user either in hospital or at home. This needs to be consistently documented. The home no longer offer intermediate care and therefore this Standard was not assessed. Grove House - City of York Council DS0000034935.V322144.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 & 10 Quality in this outcome area is adequate. Whilst the quality of care is good, aspects of nutrition need to be improved on, and service users are put at risk because the medication system is poor. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service users receive a good standard of care, one person said ‘the home is lovely, I have no complaints’. Positive comments were received through the surveys and comment cards. One person said ‘Grove house is a nice home’. Service users spoken with all confirmed the care they receive was good. Observations showed service users looking happy, and well cared for. Three care plans were checked. These detail how individuals needs are to be met, care plans are in place and generally all information was completed. Risk assessments for moving and handling, prevention of pressure sores and falls were in place. Monthly reviews and evaluations of the care plans take place which was consistently documented. The manager stated audits of a random selection of care plans takes place on a regular basis. Currently there is a high Grove House - City of York Council DS0000034935.V322144.R01.S.doc Version 5.2 Page 10 dependency unit in the home this will cater for up to eleven service users who have greater dependency levels than those in the rest of the home. The manager is in the process of reviewing the staffing levels to meet the needs of these individuals. One lady spoken with stated how good the staff are at meeting her needs. She is settled and enjoys living at the home. Regarding nutrition, service users likes and dislikes were recorded though the home currently does not have any sit on scales to weigh service users, this would be beneficial. The manager is aware that an overall assessment regarding nutrition is needed to ensure staff are aware of how to care for service users who are under or over weight. A discussion took place with a district nurse who regularly visits the home. She confirmed that if a nutritional need is identified the community nurses would carry out their own nutritional assessment based on the ‘MUST’ tool. It would be useful if the home could implement the same type of tool. Four comment cards were received from GPs, no issues were raised. The home has good links with healthcare professionals and are aware of how to refer to the community psychiatric nurse, continence advisor, district nurse and the local hospital which is close by. The home complete Regulation 37 notifications which detail issues affecting the well-being of service users. A discussion took place regarding composite records, each incident form should be kept in individual service users files. The medication system was inspected and discussed with the manager. Medication charts were correctly completed, stock balances take place and service users are aware of how and when medication is administered. On arrival at the home the medication room which is located near the main entrance was wide open, the drugs trolley was not secured to the wall, a pot of medicines was left on top (three different tablets) and a range of medication was left on view. This included blister packs, ready coming into the home and standing next to the medication room. The care leader responsible was asked after ten minutes if she would come and lock the room and secure the trolley. Later in the morning when the manager was available the room was left wide open again. The manager addressed this issue. A discussion took place with the care leader and it was evident that she was not aware of the potential risk of leaving the room open, she said ‘the room is often left open all day’. Her attitude was extremely poor, this was also evident at the start of the site visit and in further discussions regarding training. A serious concern letter was given to the manager regarding the medication system. Privacy and dignity in the home was observed, staff were treating service users in a pleasant and friendly manner, a good rapport was established between staff, relatives and service users. Room doors were kept closed and vacant/engaged signs were available for the bathroom/toilet areas. Grove House - City of York Council DS0000034935.V322144.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 & 15 Quality in this outcome area is good. An excellent range of activities are provided, autonomy and choice is encouraged, and mealtimes are enjoyed by service users. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home provides a range of stimulating activities, the day after the site visit a trip was planned to Ripley Castle, service users have been to Bridlington, had high tea at Dean Court Hotel in York, three service users go to the Salvation Army each week, there is bingo, arts and crafts and afternoon and evening entertainment. This was confirmed in the surveys completed, through discussions with a relative, district nurse and many service users. Visitors to the home are encouraged, there is a visitors book available that is signed when someone enters and leaves the home. Generally staff are welcoming and service users are encouraged to be autonomous. Four service users in the lounge were spoken with and they all confirmed they could get up and go to bed when they want, and they can decide which activities to participate in. Grove House - City of York Council DS0000034935.V322144.R01.S.doc Version 5.2 Page 12 Mealtimes were discussed with the care staff and cook. Currently some of the meals are provided through the hospital, and others are home made by the part time cook. At lunchtime sausages, Yorkshire pudding, gravy and vegetables were offered. Service users were observed enjoying the food in a pleasant environment. Staff ask each service user what food they would prefer prior to it being served. The kitchen was examined and found to be clean and tidy the cook had a good understanding of meeting individual needs and was aware of how to cater for service users who are under or over weight.. Grove House - City of York Council DS0000034935.V322144.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. Service users are aware of how to complain, and they are treated in a respectful manner with staff understanding adult protection issues. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service users in the home discussed how they would make a complaint, they said the manager would listen to any concerns they had. The home have a complaints procedure in place. No complaints have been received by the CSCI. Service users said they felt safe in the home and feel that they are treated in a respectful manner. One adult protection referral has been made since the last inspection, this has been dealt with, and the manager is now fully aware of the procedure to follow, how to make a referral and what the protection of vulnerable adults list is. Care staff generally were aware of the different types of abuse and what action to take if an incident is observed. One care leader said she was not aware of the procedure and had not seen the multi-agency vulnerable adults procedure. This was highlighted to the manager. Grove House - City of York Council DS0000034935.V322144.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is adequate. Service users live in a pleasant environment, which is clean and fresh smelling. Security of the laundry and sluice needs to improve to ensure service users aren’t put at undue risk. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service users spoken with enjoyed living in this environment. City of York Council are responsible for maintaining the building and carrying out any refurbishments. All areas observed smelt clean and fresh, general assistants are available for standards of hygiene in the home and the laundress is responsible for washing and ironing service users clothes. Infection control training takes place which was confirmed by staff and training records. Protective clothing is worn though staff do not wear uniforms. It was evident that the laundry and sluice rooms did not have locks on them and both Grove House - City of York Council DS0000034935.V322144.R01.S.doc Version 5.2 Page 15 contained very hot water and detergents were on view. Currently the sluice room on the high dependency unit is not being used and therefore a range of equipment is stored here. This will need to be addressed when it is fully operational. Grove House - City of York Council DS0000034935.V322144.R01.S.doc Version 5.2 Page 16 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 Quality in this outcome area is good. Service users are cared for by staff in adequate numbers who receive training which means service users needs can be met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Currently staffing levels are good in the home, there are four carers who work with a care leader and general assistants during the day. The manager is supernumerary. The home can have thirty three service users in the home, at present there are four service users in the high dependency unit out of a maximum of eleven. The manager is reviewing the staffing levels to ensure both areas of the home are adequately staffed. A decision needs to be made as to whether the high dependency unit should be separately staffed as the needs of these service users are different from other service users in the home. Many care staff have completed an NVQ Level 2 or above in care, this ensures that staff use a consistent approach and their standards of care remain constant. Recruitment practices in the home were examined. Three staff files were checked, these all contained two written references, CRB and protection of vulnerable adult checks. Human resources are responsible for holding the files, though the manager asks for copies of this information to keep at the Grove House - City of York Council DS0000034935.V322144.R01.S.doc Version 5.2 Page 17 home. The manager is aware of how old staff need to be before they can give personal care, and she had a good understanding of the procedures to follow when employing a new person. Induction training takes place (Skills for Care guidance used). Files confirmed staff have completed care practice and mandatory training in order to be effective in their role. This is well documented, this system has recently been introduced in City of York Council. Grove House - City of York Council DS0000034935.V322144.R01.S.doc Version 5.2 Page 18 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 & 38 Quality in this outcome area is good. The home is run in the best interests of the service user, health and safety is observed and service users finances are dealt with appropriately. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager of the home has many years experience working with older people, she is registered with the CSCI and has the best interests of the service user at heart. She has an extremely pleasant disposition and understands the needs of the service users well. Quality assurance in the home has been implemented well, this will help when the new annual quality assurance assessments come into force in 2007. Service users views and opinions are informally sought, audits take place on a regular basis and Grove House - City of York Council DS0000034935.V322144.R01.S.doc Version 5.2 Page 19 meetings for staff and residents are occurring. Service user finances were checked, three records confirmed that money is stored correctly and recorded. This was also confirmed by three service users. Pocket money allowances are in place for a limited amount of money. Health and safety in the home was discussed. Fire training, moving and handling, first aid, infection control and health and safety take place on a regular basis. New certificates had been received at the site visit which confirmed these courses had been attended. Staff also in discussion confirmed the training they have attended. Fire risk assessments have previously taken place and the manager is aware of the guidance from the fire officers which was amended in October 2006. Whilst touring the premises emergency lighting was evident, water temperatures were checked and were within expected parameters, fire zones were suitable and no undue risks from health and safety were identified. All service users spoken with said they felt safe in the home. Dates of certificates for equipment, legionnella testing, and electrical wiring were evident in the pre-inspection questionnaire. Grove House - City of York Council DS0000034935.V322144.R01.S.doc Version 5.2 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x 2 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 1 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 x x x x x x 1 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 x x 3 Grove House - City of York Council DS0000034935.V322144.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? N/A 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. 2. Standard OP26 OP9 Regulation 13 13 Requirement The laundry and sluice room must have a lock fitted to ensure the safety of service users The medication room must be kept locked when not in use The drugs trolley must be secured to the wall in the medication room when not in use Pots of medication must not be left on top of the drugs trolley, they must be disposed of correctly The medication room must be thoroughly cleaned, any unwanted items must be removed or destroyed Staff must understand the potential risk that is poised when this room is left open and unattended. Immediate requirement issued. Timescale for action 30/12/06 05/12/06 Grove House - City of York Council DS0000034935.V322144.R01.S.doc Version 5.2 Page 22 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. Refer to Standard OP3 OP8 Good Practice Recommendations Any assessment information received should be documented. A nutritional assessment should be carried out on all service users. Grove House - City of York Council DS0000034935.V322144.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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