Inspection on 22/06/06 for Larpool Lane (1) - North Yorkshire County Council

This inspection was carried out on 22nd June 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

Larpool Lane (1) - North... 30/04/08

Larpool Lane (1) - North... 31/05/07

Larpool Lane (1) - North... 03/01/06

Larpool Lane (1) - North... 25/08/05

Larpool Lane (1) - North... 12/01/05

Larpool Lane (1) - North... 27/04/04

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

CARE HOMES FOR OLDER PEOPLE Larpool Lane (1) - North Yorkshire County Council 1 Larpool Lane Whitby North Yorkshire YO22 4JE Lead Inspector Brian Hallgate Key Unannounced Inspection 22nd June 2006 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 Larpool Lane (1) - North Yorkshire County Council DS0000034288.V300985.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. Larpool Lane (1) - North Yorkshire County Council DS0000034288.V300985.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Larpool Lane (1) - North Yorkshire County Council 1 Larpool Lane Whitby North Yorkshire YO22 4JE Address 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) 01947 603582 01947 602 806 North Yorkshire County Council Mrs Avril Elizabeth Paton Care Home 52 Category(ies) of Old age, not falling within any other category registration, with number (52) of places Larpool Lane (1) - North Yorkshire County Council DS0000034288.V300985.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 3rd January 2006 Brief Description of the Service: 1 Larpool Lane is a care home providing personal care and accommodation for up to 52 older people. It is owned by North Yorkshire County Council. The home is located on the outskirts of Whitby. There is a steep hill down towards the centre of the town. The home consists of a two-storey building with a passenger lift and stairs between floors. All the homes bedrooms are single rooms. There is access to the grounds where suitable garden furniture is provided for those service users who wish to sit outside. This home is suitable for people with mobility difficulties as there is level access from the car park to the ground floor level of the home. A passenger lift suitable for people with mobility difficulties provides access between the two floors of the home. A copy of the service users guide to the home is given to prospective service users and a visit is made to the home before a decision is made to move in for a trial period. A copy of the latest Commission for Social Care Inspection report is available for prospective service users and relatives to read. The fees payable on the date of the inspection are £368.90 per week. There are additional charges for hairdressing, chiropody and transport to non-ambulance hospital appointments. Larpool Lane (1) - North Yorkshire County Council DS0000034288.V300985.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The evidence used to inform this report was obtained from the information documented in previous inspection reports, a site visit and discussions with service users, relatives and staff. This unannounced inspection took place on the 22nd June 2006, over a period of five and a half hours, commencing at 9.15am. During this time the registered manager, staff, service users and relatives were spoken to and a number of records were inspected including service users’ assessments, care plans and health and safety information. A tour of the home was made. Survey forms were received prior to the site visit from 5 of the 9 service users who received survey forms, 6 of the 6 care managers who received forms, 4 of the 7 GP’s who received forms and a service users’ relative. Comments made were generally complimentary in respect of the care received by service users within the home. What the service does well: What has improved since the last inspection? Larpool Lane (1) - North Yorkshire County Council DS0000034288.V300985.R01.S.doc Version 5.2 Page 6 On the day of the inspection there were no offensive odours. Service users, relatives and staff stated that the home was kept clean and well cared for. The staff records have improved with the necessary employment checks being undertaken before new staff commence employment. A quality monitoring exercise has taken place and the results documented and a copy placed on the notice board for service users, relatives and other professionals to read. 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. Larpool Lane (1) - North Yorkshire County Council DS0000034288.V300985.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 Larpool Lane (1) - North Yorkshire County Council DS0000034288.V300985.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6 Quality in this outcome is good. This judgement has been made using available evidence including a visit to this service. The assessments prior to admission are comprehensive and provide informed decisions about moving into the home. EVIDENCE: All potential service users have a comprehensive written assessment completed by a care manager. Staff from the home visit the prospective service user in their own home or hospital before admission. Admissions are arranged on a trail basis. The admission is only confirmed as long term after a review involving the service user. A service user recently admitted confirmed that this had occurred in respect of his admission. Records of five service users selected at random all had a completed assessment prior to admission. Intermediate care is not provided at this home. Larpool Lane (1) - North Yorkshire County Council DS0000034288.V300985.R01.S.doc Version 5.2 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected 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 is adequate. This judgement has been made using available evidence including a visit to this service. The staff have a good understanding of the service users’ support needs. This is evidenced from the positive relationships that have been formed between the staff and service users. The cubicle style toilets do not provide the privacy and dignity that service users should expect. EVIDENCE: All service users files read contained a detailed promotion of independence plan. Service users spoken to were aware of this plan and stated that they had been involved in discussions about their plans. Of the five files examined at random only two had up to date reviews. Two had no reviews recorded and the other file was three months overdue for a review. Each service user has a keyworker and it is the keyworkers responsibility to review the care plan at least monthly. All service users are registered with a GP and specialist health services are accessed through referrals from GPs. District nurses visit daily and a number of nurses visited during the inspection. Appointments are made when Larpool Lane (1) - North Yorkshire County Council DS0000034288.V300985.R01.S.doc Version 5.2 Page 10 necessary for service users to either visit the GPs surgery or for a home visit. Visits to dentists and opticians are made when required. There was evidence in the files examined of the appropriate medical attention being obtained for service users when they required it. No service user self medicates. The records and medication checked were up to date and in order. All service users spoken to said that they were treated with respect at all times by the staff. Staff were observed to treat service users with respect during the inspection and observed to knock on bedroom doors and wait for a reply before entering the room. No work has yet commenced to provide toilets that give service users privacy and dignity. This work has been approved and it is hoped that it will commence and be completed this year. Larpool Lane (1) - North Yorkshire County Council DS0000034288.V300985.R01.S.doc Version 5.2 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected 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 is good. This judgement has been made using available evidence including a visit to this service. Visiting arrangements are flexible allowing service users to maintain good and regular contact with family and friends. The dietary needs of service users are well met with a varied menu of good food being offered that satisfy service users tastes and choices. EVIDENCE: Service users spoken to said that they were able to maintain their own routines in the home. A number of activities were arranged both within the home and in the community for those service users who wished to participate. A number of service users stated that they had no wish to take part in organised activities. One service user saying, “Activities are arranged that I can take part in if I wish, but I rarely choose to”. Another service user stated, “Activities are organised but I prefer to sit in my chair”. The activities and entertainment are well publicised on the notice boards throughout the home. All service users surveyed and spoken to considered that the food was good and there was always something that they could eat. One relative said “My mother loves the food, ten out of ten”. A service user stated that she was on a Larpool Lane (1) - North Yorkshire County Council DS0000034288.V300985.R01.S.doc Version 5.2 Page 12 special diet and the kitchen staff always supplied food that she was able to enjoy. Three ministers of religion visit service users in the home. A Roman Catholic Priest, an Anglican Minister and an Evangelical Minister visit service users who wish to be involved. The registered manager has asked service users if they wish to attend local churches but no service user has taken up this offer. Larpool Lane (1) - North Yorkshire County Council DS0000034288.V300985.R01.S.doc Version 5.2 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be 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 is good. This judgement has been made using available evidence including a visit to this service. There are satisfactory complaints and abuse policies and there was evidence that staff had responded to complaints made. EVIDENCE: No complaints had been made to the Commission for Social Care Inspection since the last inspection. Two complaints had been made to the home. These had both been investigated and responded to within the twenty-eight day timescale. There is a copy of the York and North Yorkshire Vulnerable Abuse Policy. All staff spoken to knew what action to take in the event of a suspected abuse situation occurring. Larpool Lane (1) - North Yorkshire County Council DS0000034288.V300985.R01.S.doc Version 5.2 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome is adequate. This judgement has been made using available evidence including a visit to this service. The overall standard of the environment is satisfactory. Work that is required to provide toilets that give service users privacy and dignity has still not commenced. EVIDENCE: Although requirements have been made on a number of occasions that toilets that give privacy and dignity to service users must be provided, no work has commenced to change any of the toilets in the home. Plans have now been approved to change six bedrooms into toilets and convert the present toilets to provide private facilities for service users. The home provides reasonable facilities for service users in all other respects. Service users commented that they were satisfied with their own private accommodation. Larpool Lane (1) - North Yorkshire County Council DS0000034288.V300985.R01.S.doc Version 5.2 Page 15 On the day of the inspection the home was clean, pleasant and hygienic. There were no unpleasant odours anywhere in the building. Service users, relatives and staff stating that the home was kept in a clean condition. Larpool Lane (1) - North Yorkshire County Council DS0000034288.V300985.R01.S.doc Version 5.2 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected 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 is adequate. This judgement has been made using available evidence including a visit to this service. Since the last inspection the standard of vetting and recruitment practices has improved. Service users receive a good standard of care when the home is fully staffed. Difficulties have arisen in providing cover for absent staff. EVIDENCE: Staff and service users commented throughout the inspection that there were times when there were insufficient staff on duty to meet the needs of the service users. There are sufficient staff on the master duty rota and difficulties only arise when a member of staff does not turn up for their shift because of sickness or another reason. The registered manager had appointed relief staff and had used an agency in an attempt to resolve this problem. There were occasions however when she was unable to obtain cover from both relief and agency staff. She was attempting to recruit extra relief staff and an interview was taking place during the inspection. The staffing records showed that staff had undertaken relevant training. It was pleasing to see that 68 of care staff have obtained an NVQ Level 2 in Care. The necessary employment checks had been undertaken before new staff commenced work. Larpool Lane (1) - North Yorkshire County Council DS0000034288.V300985.R01.S.doc Version 5.2 Page 17 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 Quality in this outcome is good. This judgement has been made using available evidence including a visit to this service. The home is managed in an open and inclusive manner by the present manager who enjoys the support of staff and service users’. EVIDENCE: The home is managed by a person who is qualified, experienced and fit to be in charge, is of good character and able to discharge her duties. All staff and service users spoken to considered that the home was well run for the benefit of the service users. A quality assurance exercise has been undertaken and the results formulated and put on the notice board for service users, relatives and staff to read. Larpool Lane (1) - North Yorkshire County Council DS0000034288.V300985.R01.S.doc Version 5.2 Page 18 A number of service users deposit money in the home for safekeeping. Income and expenditure records and receipts are kept. The records checked were up to date and in order. The necessary health and safety checks were in order with the exception of the electrical wiring safety certificate that expired on the 1st April 2006. The registered manger is arranging for the necessary action to be taken without further delay. Larpool Lane (1) - North Yorkshire County Council DS0000034288.V300985.R01.S.doc Version 5.2 Page 19 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 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 2 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 2 X X X X X X 3 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 2 Larpool Lane (1) - North Yorkshire County Council DS0000034288.V300985.R01.S.doc Version 5.2 Page 20 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 service user’s plan of care is reviewed by care staff at least once per month and updated to reflect changing needs and actioned. The registered person must ensure resident’s privacy and dignity are respected at all times with particular regards to using the toilet. (Previous timescale of 30/01/06 not met) The registered manager must ensure that at all times suitably qualified, competent and experienced persons are working at the home in such numbers as are appropriate for the health and welfare of service users. The registered manager must ensure that all parts of the home are so far as possible free from hazards. An up to date electrical safety certificate must be obtained from a qualified electrician. Timescale for action 31/07/06 2. OP10 OP19 12 31/12/06 3. OP27 18 31/07/06 4. OP38 13 30/06/07 Larpool Lane (1) - North Yorkshire County Council DS0000034288.V300985.R01.S.doc Version 5.2 Page 21 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 Larpool Lane (1) - North Yorkshire County Council DS0000034288.V300985.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ 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 Larpool Lane (1) - North Yorkshire County Council DS0000034288.V300985.R01.S.doc Version 5.2 Page 23 - 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!