Inspection on 10/11/06 for Larchfield

This inspection was carried out on 10th November 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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

Larchfield 14/03/06

Larchfield 20/10/05

Larchfield 16/09/04

Larchfield 15/06/04

Similar services:

Snydale Care Home

Abbey The

Larchfield Manor

Hawkhills

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 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Larchfield Joseph Street Leeds West Yorkshire LS10 2AD Lead Inspector Hebrew Rawlins Key Unannounced Inspection 10th November 2006 08:45 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 Larchfield DS0000001473.V314965.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. Larchfield DS0000001473.V314965.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Larchfield Address Joseph Street Leeds West Yorkshire LS10 2AD 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) 0113 2772284 (0113) 2705280 Anchor Trust Mrs Caroline Rhodes Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (40), Physical disability (5) of places Larchfield DS0000001473.V314965.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The PD places are only for the use of specified service users Date of last inspection 14th March 2006 Brief Description of the Service: Larchfield is owned by Anchor Trust, a registered charity and managed on their behalf by Mrs Caroline Rhodes. The care home provides care and accommodation for up to forty older people, five of who may have a physical disability. Larchfield is purpose built and opened in 1990. The care home is situated in a quiet cul-de-sac; to one side are eight properties, which provide housing for single persons who are supported by a visiting warden. These houses have no connection with the care home, apart from the fact that they are owned by the same organisation. A short walk from the home is the main road, which is well served by public transport. There are also local shops, which are within easy reach if service users do not wish to travel far. There is a perimeter fence around the building for added security. The care home is on two floors, there is a passenger lift. All bedrooms are single, with en-suite facilities. There are two dining areas on each floor, one communal lounge on the ground floor and a quiet sitting room on the first floor. The large kitchen is fitted with commercial equipment and is not used by service users. Small appliances are provided in service users rooms for their own use and in the dining areas. All service users are subject to a risk assessment prior to them using any appliances. There is a staff room, which doubles up as a training room. There are two communal bathrooms on each floor; each is fitted with specialist equipment. There is also a shower available. All laundry is dealt with in house, consequently a large laundry area is provided. An emergency call system is fitted throughout the home, which can be used to summon assistance if required. Respite care is provided if there is a vacancy and the home can meet the needs of the service user wishing to stay. Staff are provided over twenty-four hours and there are good systems in place for contact with senior managers. Larchfield DS0000001473.V314965.R01.S.doc Version 5.2 Page 5 Information is available to residents about the home i.e. Statement of purpose and service user guide. The weekly fees range from £405.83 to £450.00. Additional charges are made for hairdressing, private chiropody and newspapers. This information was provided to the Commission for Social Care Inspection in October 2006. Larchfield DS0000001473.V314965.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. In April 2006 the Commission for Social Care Inspection (CSCI) made some changes to the way in which care services are inspected. Care services are now judged against outcome groups. The inspection report is divided into separate sections for each outcome group for example Choice of Home. An overall judgement is made for each outcome group based on the findings of the inspection. The judgements reflect how well the service delivers outcomes to the people using the service. The judgements categories are “excellent”, “good”, “adequate” and “poor”. The judgements are recorded within the main body of this report. More detailed information about these changes is available on our website – www.csci.org.uk This unannounced key inspection took place between 8.45am – 4.00pm on the 10th November 2006. The purpose of the visit was to monitor standards of care in the home and to look at progress in meeting the requirements and recommendations made at the last visit. The manager completed a preinspection questionnaire and the administrator provided additional information. The information provided has been used in the preparation of this report. The people who live in the home prefer the term ‘resident’ and this will be used throughout this report. Before the inspection I sent out survey cards to residents, relatives and health care professionals. Comments from the survey cards can be found throughout this report. During the inspection I spoke to residents, visitors and staff on duty, I looked at records and made a tour of the building. Feedback at the end of this inspection was given to the manager and the administrator. I would like to extend my thanks to everyone who contributed to the inspection and for the hospitality during the visit. What the service does well: There is a welcoming atmosphere throughout the home. Residents’ needs are met in a way that appears to respect their privacy and dignity and staff are kind and courteous to the residents as well as visitors The home makes arrangements for residents to see GPs, district nurses, chiropodists, opticians and dentists in the home, and people’s health care needs are well met. One GP surveyed said, “I have always been impressed Larchfield DS0000001473.V314965.R01.S.doc Version 5.2 Page 7 with the knowledge of patients’ needs and the care shown to them. It is a pleasure to visit.” The home was clean and fresh and there were no offensive odours. One visitor on the day said, “This is one of the better homes it is always clean.” Residents are pleased with the meals; comments made during this visit included, “The meals are very good, every day there is something different.” “The meals are lovely.” 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. Larchfield DS0000001473.V314965.R01.S.doc Version 5.2 Page 8 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 Larchfield DS0000001473.V314965.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4 and 5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the home. Prospective residents have the opportunity to visit the home, stay for a meal and speak to other residents before making any decisions about admission. The home carries out a pre-admission assessment to make sure that it can meet the person’s needs. EVIDENCE: There is plenty of written information about the home for people to read. Copies of the statement of purpose and service user guide were and copies of previous inspection reports are made available to all. The home has started to use new care documentation and the assessment format is comprehensive. If used properly the assessment information has the potential to form the basis of a good care plan. Larchfield DS0000001473.V314965.R01.S.doc Version 5.2 Page 10 It was clear that prospective residents are given the opportunity to visit the home as many times as they like. One person visited twice before deciding to move in. Another resident told me that she visited the home, stayed for a meal and spoke to other residents. She said that she liked it very much and this was the place for her. Larchfield DS0000001473.V314965.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. Residents’ health care needs are met, and the new paper work for care planning has the potential to provide good care records if used properly. However, new care plans are not in place as yet for all residents, so there is the opportunity for needs to be overlooked. Medication practices are good and the home always follows safe guidelines and return unused medication to the pharmacy. EVIDENCE: A number of care records were sampled in the new format. Four people’s records in the new format were seen Care plans are reviewed monthly, but these reviews are not robust and do not show what factors have been taken into consideration. For example, in most cases the record state ‘reviewed no change.’ Larchfield DS0000001473.V314965.R01.S.doc Version 5.2 Page 12 In all of the care records sampled there was evidence of health needs being met, by dental appointments, chiropody, visits, optical prescriptions and visits from GPs and district nurses. One survey card has been returned from GPs, it indicated that there is always a senior member of staff to confer with. During the inspection a visitor said that she is always kept informed about any changes in her relative’s condition. Another relative surveyed said that carers go out of their way to make sure health care needs are met. Medication records were sampled and found to be in order. The home makes sure that any unused medication that has been prescribed for a resident is returned to the pharmacy and is not put into stock as a homely remedy. Through observation on the days of the inspection, and by speaking to residents and staff it is clear that the privacy and dignity of residents is respected. Larchfield DS0000001473.V314965.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. A range of activities is provided in the home, however these are not recorded in resident files to identify who has taken part and who has not. Visitors are made welcome and information is available for people who may need to use advocacy services. EVIDENCE: Regular committee meetings are held covering much ground, raising and suggesting many ideas. Summer outings are planned and residents and staff birthdays are celebrated. Although there is a list of activities for residents each month they are not recorded in residents files. Discussion took place with several residents about the meals in the home. All resident said they were happy with the food, there was a choice for each meal and the food was well presented and well cooked. Staff and residents spoke about the choices that are available to people such as times for going to bed and getting up in the morning. Larchfield DS0000001473.V314965.R01.S.doc Version 5.2 Page 14 Visitors on the day inspection and in returned survey cards said that they are always made welcome. Larchfield DS0000001473.V314965.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Residents and relatives feel listened to and know how to make a complaint. Staff are clear about what constitutes abuse and how and where to report any suspicions or allegations of abuse. EVIDENCE: Information about how to complain can be seen as you enter the home and it is also in the statement of purpose and service user guide. Relatives and residents who returned survey cards said that they knew how to complain, one person said, “The manager and staff are always ready to listen to any small problems.” A resident said, “Staff listen to you, I would definitely complain if I needed to.” Care workers said that they would pass any complaint on to the manager. All staff were familiar with the different types of abuse and were clear that they would report any suspicions or allegations of abuse to the manager and/or social services and the Commission for Social Care Inspection. Larchfield DS0000001473.V314965.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23, 24, 25 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The home is safe and well maintained and offers comfortable facilities for its residents. EVIDENCE: All areas of the home were inspected at this visit. Communal areas are furnished and decorated to a good standard providing light and spacious accommodation. Externally there is a well-maintained accessible garden. Bedrooms seen were decorated and furnished to a good standard. Residents said that they were pleased with their rooms and were glad to have many of their own personal belongings with them. There are sufficient and suitable lavatories and washing facilities for residents and guests. Larchfield DS0000001473.V314965.R01.S.doc Version 5.2 Page 17 The domestic members of the staff told how they manages their workload to ensure the home is kept clean and tidy, which it was on the day of the inspection. The home has a varied range of adaptations and equipment that assist residents in a number of ways. There is call bell system and resident said they felt that they did not have to wait long when they used the call bell. Staff were seen to knock on doors before entering residents bedrooms. Larchfield DS0000001473.V314965.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The staffing levels and the amount of training on offer meets the needs and numbers of residents, the recruitment practices are safe and always tries to guarantee that people are suitable to work with older people in the home. EVIDENCE: The comments made by residents were very positive about the staff and they complimented their care and kindness in meeting their personal needs. Staff spoken to and observed during the inspection appeared relaxed and confident. They displayed a commitment to the service and an understanding of the residents in their care, which demonstrated efforts they had made in responding to residents as individuals. In discussion with staff two care workers confirmed they had training in medication, wound care, depression, health and safety, adult protection and back care training. The percentage of care staff with NVQ level two in care was 55 . The home has a rolling programme for NVQ training (National Vocational Qualification). The manager confirmed that CRB/POVA Criminal Record Bureau/Protection of Vulnerable Adults checks had taken place before each person started work. Larchfield DS0000001473.V314965.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 36, 37 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The registered manager is well qualified with many years management experience. She provides strong leadership and support to the staff team. She is highly respected and committed to providing a quality service for residents. EVIDENCE: The returned pre-inspection questionnaire showed that servicing of equipment takes place as required and a selection of service certificates were seen, along with the records of fire alarm tests which show a different actuation point is tested each time. Larchfield DS0000001473.V314965.R01.S.doc Version 5.2 Page 20 The home appears to provide practices that protect resident’s health and safety. Residents said they are encouraged to participate in all aspects of the home and there are good systems of communication in place. Health and safety of residents and staff is promoted and protected. Larchfield DS0000001473.V314965.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 3 3 3 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 3 3 3 3 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 3 3 x x 3 3 3 Larchfield DS0000001473.V314965.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 The new care documentation must be used for all residents. Timescale for action 01/04/07 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 OP12 Good Practice Recommendations Activities that each resident has taken part in should be recorded in their files. Larchfield DS0000001473.V314965.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Aire House Town Street Rodley Leeds LS13 1HP National Enquiry Line: 0845 015 0120 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 Larchfield DS0000001473.V314965.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. 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