Inspection on 25/03/09 for Hylands The

This inspection was carried out on 25th March 2009.

CSCI found this care home to be providing an Poor 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

Hylands The 29/01/07

Hylands The 09/02/06

Hylands The 21/09/05

Hylands The 08/12/04

Hylands The 08/07/04

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 27/06/2009.

CARE HOMES FOR OLDER PEOPLE Hylands The The Crescent Filey North Yorkshire YO14 9JR Lead Inspector Pauline O`Rourke Key Unannounced Inspection 25th March 2009 03:52 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 Hylands The DS0000007742.V374468.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. Hylands The DS0000007742.V374468.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hylands The Address The Crescent Filey North Yorkshire YO14 9JR 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) 01723 515213 01723 516279 info@hylands.co.uk Mr Anthony Rhoden Mrs Diane-Marie Rhoden Mrs Diane-Marie Rhoden Care Home 46 Category(ies) of Old age, not falling within any other category registration, with number (46) of places Hylands The DS0000007742.V374468.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 categories: Old age, not falling within any other category - Code OP. The maximum number of service users who can be accommodated is: 46. 4th April 2008 2. Date of last inspection Brief Description of the Service: The Hylands is a large former hotel occupying a prominent and elevated position overlooking the seafront of the town. It has been adapted to provide accommodation and care for a maximum of 46 older people. The home provides single and shared accommodation, many rooms having ensuite facilities. There is a passenger lift to each floor. Staffing cover is provided 24 hours a day. Leisure and recreational facilities are offered in the home, and people can also make use of the facilities in Filey itself. The Hylands is owned by Mr and Mrs Rhoden and managed by Mrs Rhoden. Hylands The DS0000007742.V374468.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 0 star. This means the people who use this service experience poor quality outcomes The Commission for Social Care Inspection inspects homes at a frequency determined by how the home has been risk assessed. The inspection process has now become a cycle of activity rather than a series of one-off events. Information is gathered from a variety of sources, one being a site visit. More information about the inspection process can be found on our website www.csci.org.uk We have reviewed our practice 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 be taken. The key inspection has used information from different sources to provide evidence for this report. These sources include: · · · Reviewing information that has been received about the home since the last inspection. Comment cards returned from a health care professional. A visit to the home by one inspector that lasted for six and a half hours. During the visit to the home twelve people who live there, four staff and one health professional were spoken with. Care records relating to four people, six staff members and the management activities of the home were inspected. Care practices were observed, where appropriate, and time was also spent watching the general activity within the home. This enabled the inspector to gain an insight of what life is like at The Hylands for the people living there. The Registered Manager was available for feedback at the close. What the service does well: Provides a very caring environment where people are allowed to choose what they wish to do. A number of people are independent; staff provide good care to people who live in the home that require some assistance. There are six lounge areas of the home for people to use whenever they wish. Hylands The DS0000007742.V374468.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Hylands The DS0000007742.V374468.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 Hylands The DS0000007742.V374468.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 does not apply. Quality in this outcome area is adequate. People who want to live at The Hylands have a basic assessment of the support they require. The information provided does not allow the staff to know what help and support is required on admission. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Four case files were seen and all of them contained a basic assessment of need carried out by the registered manager or by the funding authority. The assessment information included brief information about the help and support they would require. A member of staff said that the information provided before someone came in to the home was an initial guide and a fuller assessment was carried out when they had been in the home for a few weeks. An information guide was seen during this inspection and it contained some of the information necessary to allow people to gain an understanding of what Hylands The DS0000007742.V374468.R01.S.doc Version 5.2 Page 9 The Hylands had to offer. This document could be further improved by including an equality and diversity statement that outlines the different strands of the larger community whose needs could be met at The Hylands. Hylands The DS0000007742.V374468.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, and 10 Quality in this outcome area is adequate. Peoples health care needs and personal care needs are met. There are poor systems in place to ensure people who are self-medicating have the support they require to do this. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Four case files were seen and each of them contained a basic care plan. People spoken with were not always aware of these plans but they said that they received the help and support they required. A member of staff said that the plans are reviewed monthly. The daily records are comprehensively maintained and contain information that would better inform the care plan. The daily records are completed at least three times a day and more if someones needs change. The key worker system is in place although people spoken with were not sure who their key worker was. People spoken with said that they were registered with the local GP surgery Hylands The DS0000007742.V374468.R01.S.doc Version 5.2 Page 11 and were able to see the doctor on request. There was evidence in the daily records of when the doctor or district nurse had last visited. Evidence was also available to show that people had accessed, dental, chiropody, and optical services as necessary. A district nurse spoken with said that the staff always followed their advice and worked with them in the care of their patients. The staff are also very good and seeking advice if they are not sure. Medication is provided in monitored dosage boxes. The medication was found to be stored securely and staff that dispense the medication have received distance-learning training in the safe handling of medicines. There were no controlled drugs on the premises. The administration and recording of medicines was found to be accurate. Three people manage their own medication, and at the time of the inspection there were no lockable facilities in their rooms. This situation was reversed before the inspection had finished and lockable cupboards had been provided. There were no risk assessments in place to ensure people continue to manage their own medication safely. The storage of controlled drugs is not suitable. It is now a legal requirement for all care homes to store controlled drugs in a cupboard that meets the specific legal requirements. Advice can be found in the guidance provided by the Royal Pharmaceutical Society of Great Britain, The Safe Handling of Medicines in Social care Throughout the visit staff were observed treating the people in the home with respect, using their preferred names and talking to them discreetly about their personal care needs. The people in the home said ‘the staff here are wonderful’ and ‘they work very hard but will do anything for you’. The interactions were relaxed and friendly and it was clear that all staff respected them. Hylands The DS0000007742.V374468.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 and 15 Quality in this outcome area is good. People are encouraged to make decisions about their daily life and staff provide appropriate support and encouragement for them to remain independent This judgement has been made using available evidence including a visit to this service. EVIDENCE: People in the home are able to follow their own routine and this was evident throughout the visit. Activities are organised by staff but people did not always want to join in. People spoken with said that the staff encourage them to continue with the social activities they had before moving in to the home. One person spoken with was going out with friends for lunch. On the morning of the inspection there was an exercise session with people in the home. Those spoken with afterwards enjoyed this session. People spoken with also said they could follow their own routine throughout the day and staff supported them to do this. There is a visitor’s policy in place, and they are welcomed anytime. People moving in to The Hylands can bring their own furniture and other personal possessions if they wish. Information is available about advocacy Hylands The DS0000007742.V374468.R01.S.doc Version 5.2 Page 13 Alliance and other external agencies that may provide extra support if they require it. The home works with a six-week menu offering a choice at the breakfast and tea meals and a set lunch meal. An alternative is offered at this meal rather than a direct choice. They also cater to likes and dislikes as one person enjoys fish and requests it everyday. Lunch is three courses and the meal observed was relaxed and it was not rushed. People spoken with thought the food was all right. Hylands The DS0000007742.V374468.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 and 18 Quality in this outcome area is poor. There are satisfactory complaints and abuse procedures in place. However people in the home are not protected from possible abuse, as the proper checks have not been carried out on staff. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is a complaints policy in place. People spoken with said that if they had any concerns or complaints they would tell a member of staff. The Commission has received one complaint in the last twelve months about The Hylands and resulted in a random inspection. The complaint was not upheld. There is an Adult Protection Policy in place and staff spoken with were aware of their responsibilities if they suspected anyone was abusing someone using the service. Staff should be thoroughly checked prior to them being deployed in the home to ensure they are suitable to work with vulnerable people. The staff records checked did not all contain up to date and current Criminal Records Bureau disclosure and/or a POVAFIRST check. Where people are put at risk due to a lack of staff then a new member of staff may start working at the home before a full Criminal Records Bureau disclosure has been returned, but only where a POVAFIRST check has been obtained and the member of staff must work under supervision. Guidance can be found at www.crb.gov.uk. Hylands The DS0000007742.V374468.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is good. The standard of the environment within the home is good, providing people with a homely place in which to live. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The majority of the home was clean, pleasant and hygienic. Several areas were highlighted to staff during the inspection as requiring attention. The home is reasonably decorated and people living in the home said they were pleased with their own bedroom accommodation. There is a CCTV system in place for use in the corridors to assist staff to keep people safe. The system does not operate in anyones bedroom. There are six different lounge areas that people can access. Some people prefer to use their own accommodation as a bed sitting room and spend the majority of the time in their rooms. There is a Hylands The DS0000007742.V374468.R01.S.doc Version 5.2 Page 16 paved area to the front of the home that faces directly onto the sea where people can sit when they wish. Hylands The DS0000007742.V374468.R01.S.doc Version 5.2 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 consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is poor. Staff that have not been thoroughly vetted prior to the commencement of their employment support people. They receive training and are in sufficient numbers to provide the support required by the people in the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is adequately staffed with three carers on duty from seven in the morning until ten at night, and then there are two night staff awake. A team of ancillary staff supports the care staff. Currently there are 7 of the staff team who have or are working towards the National Vocational Qualifications in Care level two. Staff receive the statutory required training. People spoken to said that the staff are very good and the lasses are pretty helpful and the staff are very helpful and nice Staff spoken with said that they had completed distance-learning courses in Equality and Diversity, Dementia Care, Infection Control and The Safe Handling of Medication. The staff files for six people were seen. Each file contained an application form; there was no evidence of written references although the Registered Manager did say they took up verbal references. Only two of the files seen had Hylands The DS0000007742.V374468.R01.S.doc Version 5.2 Page 18 a Criminal Records Bureau disclosure that had been completed by the Registered Manager. Other files contained Criminal Records Bureau disclosures completed at the last place of employment one of which is a standard check rather than an enhanced check and the person concerned is working a care assistant. There was no evidence that a Criminal Records Bureau and/or a POVAFIRST disclosure had been requested for a member of staff whose employment started in January 2009. Staff should not start working with vulnerable people until the Registered Manager has received a Criminal Records Bureau disclosure and/or a POVAFIRST check. Criminal Records Bureau disclosures must be applied for all staff who have not been checked to the proper level by the registered person at The Hylands. The files contained limited information about the level of training completed and there was no evidence of formal supervisions. Hylands The DS0000007742.V374468.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 and 38 Quality in this outcome area is poor. People live in a home that is poorly managed. There are some systems in place to protect their health and safety, but these systems do not cover all aspects of their safety. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Registered Manager is experienced and has a National Vocational Qualification level 4 in management. During the inspection it became clear that she has not been as involved in the day-to-day running of the home as she had previously. However, she is in daily contact with the home either through visits or on the phone. Four senior carers carry out the management function when the Registered Manager is not available. Whilst the day-to-day care and Hylands The DS0000007742.V374468.R01.S.doc Version 5.2 Page 20 support received by people has not changed the supporting paperwork has deteriorated and is lacking in some instances. It is a legal requirement to provide information in an Annual Quality Assessment Assurance form. This information was not forthcoming for this inspection. The certificate of registration was not displayed in the home. There was no evidence available on the day of the inspection that any quality assurance systems are in place. Again it is a legal requirement that this work is carried out. The purpose of the quality assurance system is to ensure the standards of care and associated paper work remain consistent and identify areas that can be improved by the service. It is also an opportunity for people living in the home to contribute to the development of the home in which they live. Where necessary people are supported with their personal monies. The records checked along with monies held were accurate and up to date. The health and safety records showed that proper attention is given to providing a safe and secure environment in which people can live. The accident records were seen and advice was given about replacing the current records with a book that meets current data protection needs. Hylands The DS0000007742.V374468.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 X X 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 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 1 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 2 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 1 X 1 X 3 X X 3 Hylands The DS0000007742.V374468.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 OP9 Regulation 13(2) Requirement Controlled drugs must be stored according to current guidance and safe custody regulations. This provides the extra security needed for this type of medicine and will help to prevent loss or diversion. Timescale for action 30/06/09 2 OP9 13(4) 2 OP18 OP29 19(2) Schedule 2 paragraph 1 to 7 15/05/09 A risk assessment must be undertaken for everyone who self medicates. This must identify that they know what they take, when to take them and the consequences of not taking them. It must also show that the person understands they must not leave medicines lying around where someone else may take them. The registered person must carry 15/05/09 out a Criminal Records Bureau disclosure on all staff currently employed at The Hylands who have not been properly checked. Any newly appointed staff employed at The Hylands must be properly checked and a Criminal Records Bureau and/or Hylands The DS0000007742.V374468.R01.S.doc Version 5.2 Page 23 POVAFIRST disclosure must be obtained as well as two written references before they are deployed in the home. 3 OP31 24 and 43 and Section 31(9) of the Care Standards Act 2000 24 The AQAA has not been returned to the Commission. It is an offence under the Care Standards Act not to provide the information requested in this document There must be a system of reviewing and improving the quality of the care provided at The Hylands. The registration certificate must be displayed in a conspicuous place within the home. 15/05/09 4 OP33 31/05/09 5 RQN Care Standards Act 2000 section 28 30/04/09 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP1 Good Practice Recommendations Information provided to people thinking about moving in to the home should include an equality and diversity statement that outlines the different strands of the larger community whose needs could be met at The Hylands. Information gathered during the initial assessment process should be detailed enough to develop a care plan and include all of the elements of Standard 3 of the National Minimum Standards for Older People. The care plans should be detailed enough so that the individual can be identified by the information provided. This will allow all staff a better understanding of the people they are caring for. All care staff should receive formal supervision at least six times a year. 2 OP3 3 OP7 4 OP36 Hylands The DS0000007742.V374468.R01.S.doc Version 5.2 Page 24 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 Hylands The DS0000007742.V374468.R01.S.doc Version 5.2 Page 25 - 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!