Inspection on 20/10/05 for Larchfield

This inspection was carried out on 20th October 2005.

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 10/11/06

Larchfield 14/03/06

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 Karen Westhead Unannounced Inspection 20th October 2005 07:30 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.V255979.R01.S.doc Version 5.0 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.V255979.R01.S.doc Version 5.0 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 (39), Physical disability (3) of places Larchfield DS0000001473.V255979.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. The PD places are for the use only of the specified service users Date of last inspection 16 September 2004 Brief Description of the Service: Larchfield’s 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’s 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 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. 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.V255979.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection year runs from April to March and within that twelve-month period, the Commission for Social Care Inspection (CSCI) is required to undertake a minimum of two inspections of all care homes. This was the first inspection of this home for the 2005/2006 inspection year. The inspection, which was unannounced, was undertaken by one inspector. The visit started at 7.30am and finished at 3.45pm. The purpose of the inspection was to make sure the home was operating and being managed for the benefit and well being of the residents and in accordance with the law. The last inspection of this service was on 16th September 2004. At that time one recommendation was made. This referred to the manner in which accident and incident records were being kept. During the course of the visit, the inspector spent a large proportion of time speaking with residents, staff members, visiting professionals and the administrator. A number of documents were inspected during the visit; some areas of the home were seen, such as bedrooms and communal areas. All staff on duty were spoken to and observed carrying out their work. Individual and group discussions were held with residents. A number of CSCI comment cards and post-paid envelopes were left, to be distributed to residents and their relatives. After completion these are returned to the CSCI. In addition, information leaflets were given to residents with a brief description of the CSCI function and details of how to contact the inspector. What the service does well: Larchfield’s caters for residents who have a specific range of diverse needs. Some residents exhibit challenging behaviour and mental illnesses. Some residents are in need of specialist help and the staff team manage to provide this in a way, which does not judge or discriminate against people. They have excellent links with outside agencies and other professionals who offer first hand knowledge and advice and provide an excellent back up service. Many of the staff have worked at the home for a number of years and are the core of a committed and caring team. It was clear that there are good relationships between staff and residents. Staff were described as ‘kind’ and Larchfield DS0000001473.V255979.R01.S.doc Version 5.0 Page 6 ‘good people’, by the residents. Staff on duty displayed their understanding and skills whilst working with those who were experiencing difficulties. The day-to-day tasks involved in the delivery of care keep staff busy, however they know how important it is to give residents individual time and make sure this is provided. Larchfield has a relaxed and homely atmosphere. Residents said they were treated with respect and their privacy was upheld. Residents said they were happy with the food provided. 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.V255979.R01.S.doc Version 5.0 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 Larchfield DS0000001473.V255979.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 3, 4 and 5 All new residents have a signed and current statement of terms and conditions. There is a clear admissions procedure but some residents have been admitted without pre admission assessment under the block purchase contracts with Leeds City Council. There is a risk that residents needs will not be identified and met. EVIDENCE: The pre-admission procedure allows for any prospective resident to visit the home and gain an insight into the ethos and running of the home before they commit themselves to a trial stay. Introductory visits range from mealtime visits to weekend stays, depending on the circumstances. Some of the residents said they had been able to visit the home before making up their minds. However, it was clear during the inspection that the home had admitted two residents, who were not given this opportunity nor were they assessed by staff in the home. The residents were admitted through a blockpurchasing contract, with Leeds City Council. It became clear after a short period that the home was not suitable for the them and they were transferred to a more appropriate setting. This matter has now been addressed by the Larchfield DS0000001473.V255979.R01.S.doc Version 5.0 Page 9 manager, who wants to make sure all residents are offered a choice before coming to the home and that staff are able to carry out their own assessments. Some residents were able to recall their experiences of moving into Larchfield. This showed that it had been done in an organised way and they knew what to expect. Five residents have lived there for a significant number of years, one for 15 years. The manager has struggled in the past to provide signed contracts for residents. Now all new residents are provided with an up to date contract of terms and conditions. Some sign for themselves if appropriate, others are supported in this by a third party. Larchfield DS0000001473.V255979.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Plans of care (Lifestyle Agreements) are comprehensive and give clear information about the needs of each resident and how these will be met within the home. Plans of care are evaluated regularly and amended according to the outcome. Medication records, drug storage and reordering is well managed. Residents are treated with respect and their privacy is upheld. EVIDENCE: The Lifestyle Agreements seen gave precise and detailed information about how and when the care is to be delivered. Information relates to night and day time routines. The reader is informed about the individual’s preferences, an insight into their lives prior to admission and their current needs. In some instances residents had signed their own agreements. Some residents are totally reliant on staff to maintain their self-image. This is handled sensitively by staff. All residents met on the day of the visit were Larchfield DS0000001473.V255979.R01.S.doc Version 5.0 Page 11 appropriately dressed for the weather and attention had been given to their hair and grooming. Residents said staff were ‘kind’ and ‘good people’. District nurses visit the home on a daily basis and are willing to discuss any resident with the staff and advise on medical issues. The inspector took the opportunity to talk to the visiting nurse during the visit. Her comments were positive about the home she said care was ‘good’ and that Larchfield was the ‘one of the best homes’ in the area. All residents had been seen by the visiting optician and dentist. Chiropody treatments were being recorded and residents had access to services as required. None of the current residents had pressure sores. Staff were able to demonstrate their understanding of appropriate care in this area during discussion. Risk assessments are in place to account for all aspects of care. Medication was being stored correctly and staff were familiar with the correct procedures when giving prescribed medicines. None of the residents were selfmedicating. Staff have attended an ‘end of life’ course and were looking at ways to improve existing procedures. Interest has been generated in the home and staff were now working with residents to plan for this time in their lives, rather than avoiding the topic. Links with other agencies have also been created thus enhancing the knowledge base in the home. Staff have regular contact with the continence advisor for a number of residents. They work alongside the mental health team where there are associated problems. It was clear that staff have a good understanding of the complex needs of residents and are able to overcome difficulties by working at the pace of the resident involved, taking into account their wishes and welfare. Staff showed they had a good understanding of what the rights of residents were, how they were able to respect dignity and privacy. Staff were seen knocking on doors before entering. Residents said this was usual practice. Staff use preferred names when talking to residents. Residents later confirmed they had given staff permission to use their shortened names and that they liked the relaxed atmosphere. On admission residents are asked how they would like to be addressed and this is recorded. Mail is given to residents unopened. If assistance is required this is offered at the time. Residents have full use of the office telephone if required. Otherwise there is a payphone. Larchfield DS0000001473.V255979.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Residents can come and go as they wish. Arrangements are in place to encourage them to keep in touch with the local community. A number of residents attend local day services. Group activities are organised and one to one time (quality time) is promoted. Residents said they were satisfied with the meals. Residents said they were encouraged to maintain contact with family and friends. EVIDENCE: The home has encouraged involvement with local community support police officers. This has helped to establish a good rapport with residents and help some come to terms with their life styles. Work has taken place to minimise the effect local youths have had on security and this has had a positive impact for residents who like to use the grounds and local paths. Since the last inspection, one member of staff has been given the responsibility of overseeing leisure activities. Staff are sensitive to those residents who do not wish to join in large group or organised activities. One to one time is setaside for all residents. A record is kept of all activities and those taking part. Larchfield DS0000001473.V255979.R01.S.doc Version 5.0 Page 13 The staff are keen to introduce new ideas and use their imagination when thinking of age appropriate pastimes. A number of residents said they preferred time alone in their bedrooms. They said staff help them to do this and provided the resources for reading, watching television and listening to music. Residents talked about the food provided. They said helpings were good and that the food was full of flavour. Drinks and snacks are provided throughout the day and night. On the day of the visit fresh fruit was being offered to residents. The main meal of the day is provided in the evening. During the day a selection of sandwiches are served. The inspector was invited to sample a choice of sandwiches. These were well presented. A homemade cake was also served. Residents can chose to eat where they like and often have their lunchtime snack in the communal area. They use the smaller dining areas for their breakfast and evening meal. Some residents need assistance with eating. This was offered in a discreet way. It was clear that visitors could come at any time and made to feel welcome. Larchfield DS0000001473.V255979.R01.S.doc Version 5.0 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 The level of staff understanding around the homes complaints procedure and adult protection gives assurance that complaints will be taken seriously and residents will be protected from abuse. The manager takes complaints seriously. Information is handled appropriately and acted upon if necessary. EVIDENCE: The inspector spoke to a significant number of residents during the visit. Conversations were held in private and in communal areas. Residents said they would not hesitate if they had a complaint and would raise the matter with a member of staff. Staff were able to say what they would do if they received a complaint. The home has a complaints procedure. This is displayed and each resident has a copy available to them. The last recorded complaint was in March 2005, the one before this was in 2004. Both complaints had been dealt with in the home and a satisfactory outcome reached. During the visit a serious incident occurred. The staff and manager dealt with the situation calmly and appropriately. Other agencies were notified and the situation was quickly dealt with. The incident prompted a discussion with staff. It was clear that they had a good understanding of the protection of vulnerable adults and had received training on this. Larchfield DS0000001473.V255979.R01.S.doc Version 5.0 Page 15 Financial recording systems are in place to ensure any money held on behalf of residents is handled correctly and any transaction documented. Some residents have savings accounts and the procedures for handling these include safe guards. Senior members of staff from the organisation carry out audits of finances on their monthly visits. Larchfield DS0000001473.V255979.R01.S.doc Version 5.0 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, 24, 25 and 26 The home is generally clean and tidy and provides a comfortable and homely environment for residents. Steps must be taken to reduce the occurrence of offensive odours Fire safety is compromised by the badly fitting glass panel to the office door. EVIDENCE: The home was generally clean and tidy. There has been a high incidence of incontinence, with proper cleaning and management this can be overcome. But staff need to remain diligent in making sure that the cause and source of unpleasant odours are dealt with promptly. Planning permission has been sought to allow for a perimeter fence around the entire site. There will be two gates to allow access to the building. This is as a result of continued nuisance from local youths who ride bicycles and play in the grounds with no consideration for the residents. This means the external décor, which was due for renewal has now been deferred until next year. Larchfield DS0000001473.V255979.R01.S.doc Version 5.0 Page 17 The fire safety glass to the office door was badly fitted. It was loose and poorly sealed. Otherwise fire safety precautions were adequate. All staff had been involved in at least one fire drill and manual testing of alarms was being carried out weekly. Two members of staff have been certified competent to provide fire safety training to staff. The bedrooms seen were comfortable and some had been personalised. Resident’s seen in their own room’s said they were happy with the facilities. The large communal lounge is a popular area for most of the residents. The chairs have been arranged in small groups around small tables. Since the last inspection this area has been redecorated. Laundry is dealt with in house. A laundry assistant is employed. Larchfield DS0000001473.V255979.R01.S.doc Version 5.0 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 and 29 The numbers and skills mix of the staff were adequate to meet the needs of the resident group. Staff on duty had a good working knowledge of the resident group and there is an atmosphere of teamwork, where staff work together to provide a good standard of care. EVIDENCE: At the time of the visit the home had one vacancy, however there is a waiting list of people wishing to move into the home and the manager was in the process of considering referrals. The number of staff on each shift, during the day and night time is sufficient for the current needs of the residents living at the home. There is a vacancy of twenty-one hours for a care assistant. Existing staff are covering the shortfall and agency staff are not used. The home employs a team of domestics. Their start times are staggered to account for later working. They have all completed a food hygiene course and stand in for the cook when required. It was clear from the attitudes of staff that they saw their roles as overlapping. Everyone said they were happy to cover for colleagues and that ‘they all mucked in – even the manager’ to make sure the residents did not want for anything. They gave examples of when they had worked together to overcome illness amongst the residents or when Larchfield DS0000001473.V255979.R01.S.doc Version 5.0 Page 19 colleagues were off themselves and they were deployed into different roles to cover. Staff were proud of the care they provided. All staff have had police clearance. Any issues highlighted from this were dealt with by the organisations legal department and if necessary risk assessments were put in place. Larchfield DS0000001473.V255979.R01.S.doc Version 5.0 Page 20 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, 33, 35 and 38 The manager and staff team continue to make positive changes to make sure the quality of care is good. The manager is well respected by the staff team, who under her leadership run a home, which is resident led. The management approach lets residents become involved in the day-to-day running of the home. EVIDENCE: The manager is well respected by the staff team and residents. She was described in positive terms by everyone the inspector spoke to, including visiting professionals. Staff said that Larchfield was a nice place to work and that they got a lot of job satisfaction. The staff and residents clearly benefit from the stability of the manager and senior staff team. Visiting professionals talked of the kindness shown by staff and gave examples of good practice when staff were often met with situation, which needed sensitive handling. Larchfield DS0000001473.V255979.R01.S.doc Version 5.0 Page 21 Residents are able to manage and take control of their own money if assessed as able to do so. If resident’s money is to be held by home, the method of safekeeping is agreed with them and systems are in place to make sure that records are kept of all transactions. Larchfield DS0000001473.V255979.R01.S.doc Version 5.0 Page 22 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 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 3 X X X 3 3 2 STAFFING Standard No Score 27 3 28 3 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 3 X 3 X X 2 Larchfield DS0000001473.V255979.R01.S.doc Version 5.0 Page 23 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 OP38OP19 Regulation 23(4) Requirement The registered provider must make sure fire safety is not compromised and that all fire safety precautions are in place. The registered provider must ensure the home is kept clean and free from unpleasant odours. Timescale for action 20/12/05 2 OP26 16(2)(k) and23(2)( d) 17/12/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Larchfield DS0000001473.V255979.R01.S.doc Version 5.0 Page 24 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.V255979.R01.S.doc Version 5.0 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. 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