Inspection on 08/05/07 for Larchfield Manor

This inspection was carried out on 8th May 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 Manor 19/01/06

Larchfield Manor 12/01/05

Larchfield Manor 03/06/04

Similar services:

Snydale Care Home

Abbey The

Hawkhills

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

Braeburn House - North Yorkshire County Council

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Larchfield Manor Leadhall Lane Harrogate North Yorkshire HG2 9NW Lead Inspector Kate Shackleton Key Unannounced Inspection 8th May 2007 09:15 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 Manor DS0000007800.V334127.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 Manor DS0000007800.V334127.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Larchfield Manor Address Leadhall Lane Harrogate North Yorkshire HG2 9NW 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) 01423 871077 01423 810317 Loyalmace Limited Mrs Kathleen Brook Care Home 47 Category(ies) of Old age, not falling within any other category registration, with number (47) of places Larchfield Manor DS0000007800.V334127.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 19th January 2006 Brief Description of the Service: Larchfield Manor is run by Loyalmace Limited and is registered to provide a care service for 47 for older people age 65 years and over. The home is a large converted manor house standing in its own garden and situated close to shops and other community facilities. It is approximately one mile from Harrogate town centre. Accommodation is arranged over three floors and the upper floors are accessible by a vertical passenger lift. The home provides a comprehensive customer enquiry information file. Usually when prospective residents visit for a look around the manager or deputy manager goes through the file answering any questions about the service offered at Larchfield Manor. People are told how to access the Commission for Social Care inspection report on the internet and are able to read the copy kept in the home. At the time of this visit charges for a single room range from £475 to £800 per week. Charges for a double room range from £1000 to £1200 per week. Costs residents have to meet in addition to the fees include hairdressing, chiropody, incontinence pads, toiletries, papers, telephone, taxis, escorts and dry cleaning. Larchfield Manor DS0000007800.V334127.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The accumulated evidence used in this report has included: • A review of the information held on the homes file. • Information submitted by the registered manager in the Pre Inspection Questionnaire • Three residents were selected to case track. This involved looking in detail at their file and having a private conversation with them to gain their views about living at Larchfield Manor. • Surveys received from seven service users and six relatives. • A visit to the home. The visit included talking to the management and staff. A tour of the premises and a sample of records were examined. What the service does well: The service has a clear referral and assessment process. People who use the service or their representatives are given enough information about the home so that they know what to expect. A manager visits the prospective resident at home to find out what support they need and the best way for the service to provide the help needed. The person and or their representative are always offered the opportunity to visit the home before making any decision. This allows the management the opportunity to decide whether they have the staff and resources to meet the persons’ needs before offering accommodation in the home. It also allows time for everyone to have their questions answered and decide if they want to go ahead and make arrangements for admission. Residents live in a clean fresh comfortable home. The staff team provide support in a kind and helpful manner. Residents are actively encouraged to be involved in the running of the home. This promotes their right to have a say in the care delivered and stay in control. It also makes sure that all of their needs are considered. There are clear ways in which quality can be measured which include feedback from people who use the service. This ensures that the service continues to deliver care in their best interests. Larchfield Manor DS0000007800.V334127.R01.S.doc Version 5.2 Page 6 The safety and protection of people who use the service and staff is an important aspect of the service delivered. It is demonstrated through robust policies and procedures, proper risk assessments, staff training and the servicing of equipment. The staff are provided with comprehensive training to improve their knowledge and skills. This means that care is delivered from a well-informed staff team whose practice is up to date. Comments like “Nothing is too much trouble” and “The food is good and the staff are very nice” were heard. Care workers are well supervised and supported which enables them to do their job well. The home is managed in a manner that concentrates on the needs, wishes and views of the people who use the service. 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. Larchfield Manor DS0000007800.V334127.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 Larchfield Manor DS0000007800.V334127.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 to this home. People who use the service experience excellent quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Comprehensive assessments are done to be sure that the service can meet all of the needs of the person requesting admission. EVIDENCE: Three residents files were examined. They showed that a proper assessment had been done by one of the homes managers before the prospective resident was offered accommodation in the home. The manager or deputy visits the person at home or in hospital and undertakes a comprehensive assessment of all of their needs. Relatives are involved where possible to find out more information that the service user may not be able to provide. Larchfield Manor DS0000007800.V334127.R01.S.doc Version 5.2 Page 9 Everyone is offered the opportunity to visit the home prior to moving in. They and their relative are invited to stay for a meal. At this visit the manager or deputy gives them information that helps them to understand how the home is organised and run and the facilities and services available. Admission documents provided good information. The diverse needs of service users are identified. The information is available to staff to enable them to understand the social, personal and emotional needs of people who use the service. Staff spoken to confirmed that they are given enough information about new residents before they arrived to ensure that they could deliver the service that is needed. Staff were able to describe how they welcome new service users to the home and help them to settle in. They were sensitive to the difficulties that service users may experience when having to move into a care home. It was evident through discussions with residents that proper discussions had taken place with them and or their relatives about their needs and how the service could offer the appropriate support. This was done before admission arrangements were made. Feedback from surveys confirmed that people were given enough information about the home prior to admission including the opportunity to visit and stay for a meal. Larchfield Manor DS0000007800.V334127.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 People who use the service experience excellent quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Resident’s personal, social and health care needs are met. EVIDENCE: The home has a strong ethos for involving service users in all aspects of their lives. Files examined confirmed that care plans are comprehensive. Managers work with residents to develop their plan. The plan is a working document. It contains sufficient detail to ensure that care staff knows the support they have to provide to meet the diverse needs of residents in a manner that promotes independence and respects privacy and dignity. Each plan contains comprehensive risk assessments. Management of risks takes into account the needs of service users balanced with their aspirations Larchfield Manor DS0000007800.V334127.R01.S.doc Version 5.2 Page 11 for independence and choice. The plan is regularly reviewed and updated as changing needs dictate. On admission a key-worker is allocated to each resident. The key worker role is to take a special interest in the resident and help them feel comfortable in the home. Residents spoken to said that they received a very good service and are treated with respect. Comments like “This is ideal”, “Nothing is too much trouble” and “The food is good and the staff are very nice” were heard. Feedback from seven residents surveys showed that they always received the care and support that they needed. Four of the six relatives surveys received felt that the home always met the needs of the resident, one felt that it usually did and one said that it sometimes did. Staff were observed providing support in a kind and helpful manner. Staff promotes the rights of residents to access the health care professionals that they need. All residents are registered with a General Practitioner and community nurses visit as and when needed. The home arranges training on health care matters that relate to the health care needs of residents. Residents spoken to say they can see the doctor when they need to. Resident’s surveys confirmed that they receive the medical support that they need. Feedback from relative’s surveys show that they are satisfied with the overall care provided. Comments like “I would say that they treat all residents very well with great patience and good humour” and “This care home in my opinion is very special, providing great care to all the residents” There are medication procedures to guide staffs practice and training is provided on the safe storage, administration and disposal of medicines. Medication is stored and administered in a safe manner. Residents assessed as being able are encouraged and facilitated to keep and take their own medication. Medication records seen were well maintained and up to date. There are designated named staff that are allowed to administer medications. . Larchfield Manor DS0000007800.V334127.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 People who use the service experience excellent quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents are supported to make choices and remain in control of their lifestyle EVIDENCE: Residents spoken to say that they felt in control of their daily lives. They are able to make decisions for themselves as to how they spend their time and said that the routines of the home are very flexible. Routines can be changed to meet individuals changing needs and wishes. Examples given included rising and retiring times, what, when and where to eat and types of activities to be involved in. Staff training and the homes policies and procedures focus on residents being in control of their lives. Residents care plans detail the types of activities that residents enjoy. The views of residents are actively sought through surveys Larchfield Manor DS0000007800.V334127.R01.S.doc Version 5.2 Page 13 and residents meetings. A range of activities that interest residents are made available Residents surveys confirmed that there are always activities arranged by the home that they can take part in. Relative’s surveys showed that the service provided enables residents to live the life they choose. One relative felt that there aren’t enough activities that people who are partially sighted can get involved with. During this visit a group of residents were seen involved in an art group, whilst others were visiting the hair- dresser. The home has a piano and one resident explained that she is arranging to have some piano lessons to improve her playing. Visitors are actively encouraged and made welcome. A number of visitors were seen in the home at the time of this visit. An interdenominational church service is held in the home each month. Residents are supported to get out and about. Trips out are arranged and one service user spoke of having spent an enjoyable day out the previous day. Menus seen are varied and nutritionally balanced. The cook meets with residents when they are first admitted to find out about their dietary needs and food preferences. There is a choice of food at each mealtime and special diets are catered for. Service users mostly eat in the dining rooms but can have their meal in their bedroom if they prefer to eat alone. Dining room tables were set properly with tablecloths, flowers, napkins cutlery and condiments. Residents spoken to enjoyed the meals provided. Larchfield Manor DS0000007800.V334127.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 People who use the service experience excellent quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents are safeguarded from harm and their complaints are taken seriously. EVIDENCE: The home has a clear complaints procedure. The procedure is given to every resident. Residents’ are given information about local advocacy schemes that provide independent support for people. Records examined showed that complaints are dealt with speedily. A recent concern received by the Commission for Social Care Inspection relating to the charging for incontinence pads is being followed up by the manager. Residents spoken to know how to complain. They said it would be easy to talk to the management team without any fear of repercussions. Feedback from service user and relative’s surveys confirmed that they are aware of the complaints procedure and know who to talk to if they are not happy. Larchfield Manor DS0000007800.V334127.R01.S.doc Version 5.2 Page 15 There are policies and procedures relating to the protection of residents. Staff are provided with training and are aware of the need to report any allegations or suspicions of abuse to their manager. Staff know the importance of taking the views of residents seriously and responding to any issues raised. Management know the measures to take in relation to safeguarding residents if an allegation of abuse is made. Residents said they felt safe living at Larchfield Manor. Larchfield Manor DS0000007800.V334127.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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 People who use the service experience excellent quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents live in a clean, safe and comfortable home. EVIDENCE: The home is very clean and smelled fresh. Aids and adaptations are provided and regularly serviced. The home employs a handyman who is responsible for routine maintenance and the monitoring of some health and safety aspects of the premises. Sampling of some health and safety records showed that fire alarms are tested regularly and staff receive fire training. A record of hot water temperatures is kept to ensure the delivery of safe hot water and prevent the risk of scalding. Measures are in place to prevent the spread of Legionella. Larchfield Manor DS0000007800.V334127.R01.S.doc Version 5.2 Page 17 Since the home was last inspected other agencies have visited and made recommendations about the environment. The manager has acted on the majority of them. The ones outstanding are under review. Larchfield Manor DS0000007800.V334127.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. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30 People who use the service experience excellent quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents receive care from a competent, well trained staff team. This ensures that residents are provided with a service that meets their individual needs. EVIDENCE: The rota shows that there is enough staff employed on each shift and especially at times of peak activity. Staff was observed responding quickly and appropriately to requests from residents and spent time talking to them. Residents spoken to say that staff are always available to provide appropriate support and that they never have to wait long for help. Residents said that they felt in safe hands. 62 of care staff have achieved National Vocational Qualification level 2 or above. Resident surveys showed that staff are always available when needed. Relatives surveys included comments like “Efficient friendly and well trained staff” and “The manner of the staff to the residents is very caring and supportive” Staff files examined showed that in general a proper recruitment process takes place which endeavours to make sure that only suitable people are employed. A resident is involved in the recruitment process. Application forms are Larchfield Manor DS0000007800.V334127.R01.S.doc Version 5.2 Page 19 completed and an interview takes place. References are sought including a Criminal Records Bureau check. In one instance a member of staff had commenced employment approximately three weeks before her CRB was issued. This has the potential to place residents at risk. All staff are subject to a one-month probationary period. There is an induction programme that ensures new staff members are given the right information to be able to do their jobs well. Staff spoken to said that the on going training programme is good, providing them with the skills and knowledge to meet residents needs. The training programme includes all the mandatory training needed to meet resident’s basic needs such as lifting and handling, food hygiene, and health and safety. Specialist training provided includes dementia care, continence care, nutrition and infection control. Staff say that they are able to identify their training needs in supervision sessions with their manager. Larchfield Manor DS0000007800.V334127.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 and38 People who use the service experience excellent quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home is managed in a manner that promotes and encourages residents to be involved in the running of the home. EVIDENCE: The manager is qualified and has many years experience of managing care services for older people. Discussions with the manager and deputy manager showed that they have a clear sense of direction and understanding of best practice. They are committed to delivering a service that gives every resident the opportunity to live a fulfilling and meaningful life. The manager has good Larchfield Manor DS0000007800.V334127.R01.S.doc Version 5.2 Page 21 support from the owner of the company who visits regularly. There are clear lines of accountability. Residents spoken to say that the management team are very approachable and easy to talk to. Relative’s surveys included comments like “This home is a great success because of its good management and staff. All concerned are genuinely caring people” and “Two very good people at the top and the staff on the whole follow the example” The home has sound policies and procedures in line with current thinking and practice. Efficient systems are in place to monitor staff adherence to policies and procedures in their practice. Regular residents meetings, staff meetings and staff supervision promotes an open and transparent management style that operates in the best interests of residents. The minutes of residents meetings show that they actively participate in how the home is run. There is a residents panel who act as representatives for people who are not comfortable speaking in a large group. Residents are also surveyed about different aspects of the service in order to get their point of view. The findings are analysed and wherever possible improvements made. Service users are encouraged to manage their own financial affairs and spend their money as they wish. Management provide support for service users who require help in keeping their money safe. There is a robust procedure and secure arrangements are in place to protect service users from financial abuse. Management work in partnership with a range of other key people to ensure continuous improvement of the service. The home works to a clear health and safety policy and regular safety checks are carried out. Staff training programmes include Health and Safety training. Records are of a good standard and routinely completed. Larchfield Manor DS0000007800.V334127.R01.S.doc Version 5.2 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 X 4 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 4 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 4 17 X 18 4 4 X X X X X X 4 STAFFING Standard No Score 27 4 28 4 29 2 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 4 X 4 X X 4 Larchfield Manor DS0000007800.V334127.R01.S.doc Version 5.2 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 OP29 Regulation 17(2) Schedule 4 Requirement To ensure the safety of residents staff must not be employed until a CRB/Povafirst check has been issued. Timescale for action 09/05/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Larchfield Manor DS0000007800.V334127.R01.S.doc Version 5.2 Page 24 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 Text phone: 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 Larchfield Manor DS0000007800.V334127.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!