Inspection on 31/05/07 for Larpool Lane (1) - North Yorkshire County Council

This inspection was carried out on 31st May 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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... 22/06/06

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

Similar services:

Snydale Care Home

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Hawkhills

Larchfield Manor

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 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 10.30 31st May 2007 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 DS0000034288.V334120.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. DS0000034288.V334120.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 Larpool.Lane@northyorks.gov.uk www.northyorks.gov.uk 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 DS0000034288.V334120.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 22nd June 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 of £4 to £18 for hairdressing and £25 for chiropody. DS0000034288.V334120.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 pre-inspection questionnaire completed by the registered manager, a site visit, discussion with 14 people who use the service, 2 relatives and 6 members of staff. Survey forms were sent to 10 people who use the service and 5 were returned, four GPs and 2 were returned and three care managers and none were returned. This unannounced inspection took place on the 31st May 2007 commencing at 10.30 a.m. During the site visit a number of records were inspected including peoples’ assessments, care plans, duty rotas and health and safety information. A tour of the home was also made. What the service does well: What has improved since the last inspection? What they could do better: The work to improve the privacy and dignity of people living in the home by improving the toilets has not commenced despite the plans being approved a year ago. Senior staff stated that the work is to commence on the 4th June 2007. The management of the home must ensure that when staff on the master rota are on holiday or off sick that other staff or agency staff are used to fill the vacancies. Despite this being a requirement at the last inspection only three resource workers were on duty at the time of the inspection instead of four. The rota showed that only three resource workers were on duty on the afternoon shift instead of four. This level of staff cover did not meet the needs of the people living in the home. All staff spoken to confirmed this. DS0000034288.V334120.R01.S.doc Version 5.2 Page 6 Newly appointed staff should receive appropriate induction/foundation training on appointment to ensure that they have the necessary information and skills to care for the people living in the home. Activities and outings should be increased to offer more leisure opportunities to the people living in the home. All the records required to be available in the home should be available for inspection at anytime. 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. DS0000034288.V334120.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 DS0000034288.V334120.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 and 6. People who use the service experience good quality outcomes in this area. The assessments prior to admission are comprehensive and people receive enough information to help them decide whether to live at the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A pre admission assessment is carried out prior to admission for all people that come to live at Larpool Lane. Information is gathered from different sources including the person who is receiving care, care managers, relatives and any other relevant source. This means that the person can be assured that their care needs will be met and the staff at the home are aware of these needs at an early point. DS0000034288.V334120.R01.S.doc Version 5.2 Page 9 Three of the four records looked at had a full assessment completed. The fourth record had comprehensive information about the person’s need that had been supplied by previous carers. Intermediate care is not provided. DS0000034288.V334120.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 adequate quality outcomes in this area. Care plans, in some instances, have insufficient information. Staff would be unaware of how to meet their needs and this could potentially put some people at risk. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The care records that were looked at had basic information about people’s social and healthcare needs and how they would like these to be met. Specific care needs and plans that would direct staff how to meet these were not recorded. This means that in some cases staff would be unaware of how to meet these needs and could potentially place people at risk. This is particularly important as the service has had to use agency staff in recent weeks and it is vital that all staff have access to clear plans as to how to meet people’s needs. DS0000034288.V334120.R01.S.doc Version 5.2 Page 11 Some people were aware that written information is held about them and stated that they had been able to contribute to this information. In some cases personal profiles were held in peoples bedrooms so that they could look at them if they wished. Some people’s care needs had been reviewed but this had not been carried out consistently and in some cases reviews had not been held for a number of months. This means that it is possible that the care needs recorded are not current and staff do not have up to date information about people’s needs. Each service user has a key worker and it is their responsibility to review the care plan at least monthly. The person in charge on the day stated that they hoped to address this in the near future so that all care needs are reviewed on a monthly basis. People are registered with a GP and specialist health services are accessed through referrals to the GPs. There was evidence in the files examined of the appropriate medical attention being obtained for people when they required it. Policies and procedures relating to medication are in place and assist staff to make sure that these are handled and administered to people in a safe way. People felt that they were treated with respect at all times by the staff. Staff were observed to knock on bedroom doors and wait for a reply before entering the room. Some people did, however, say that if they rang their bell for attention or assistance they had to wait for a long time. This was observed at the inspection when a person had to wait for ten minutes after ringing their call bell. Call bells can be cancelled remotely but are activated again after approximately eight minutes if they are not cancelled at the point at which they were activated. This means that staff may not always have to immediately respond in person to calls for assistance and this results in delays in response times. DS0000034288.V334120.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 good quality outcomes in this area. The meals in the home are good, offering variety and catering for special diets. Social activities are limited and could be improved to enrich the social needs of people living in the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People living in the home spoken to said that they were able to maintain their own routines in the home. Some activities are arranged both within the home and in the community for those people who wish to participate. There were however no signs of any activities taking place during the inspection. Staff spoken to stated that they only had time to undertake the basic caring tasks. They had no time to spend with individuals or be involved in any activities. One person using the service stated, “I enjoy dominoes or whist or even simple handicrafts – but these are not done very often recently. Possibly because staff have to look after more elderly or disabled people”. A relative of a person living in the home stated, “Is there a residents/relatives and management/staff committee or group? Would this be useful to represent DS0000034288.V334120.R01.S.doc Version 5.2 Page 13 residents/relatives views/ideas and give support to the staff or is this not necessary” Senior staff stated that the resource workers found difficulty in keeping the care records up to date and completing the monthly reviews due to the needs of many people living in the home. Some people stated that they did not want to take part in activities and preferred to be in their own bedroom during the day. One person said “I prefer to stay in my room and do not wish to be involved in any arranged activities”. All people spoken to stated that the meals were good and that they could have an alternative meal if they did not like the dish of the day. There is a rotating menu with vegetarian options and diets being catered for. A relative said “My aunt always enjoys her meals”. Three ministers of religion visit the home and conduct services for those people who wish to attend. People living in the home have been asked if they wish to attend a local church not nobody has taken up this offer. Relatives spoken to said that their relatives received care on a daily basis from the staff. Staff spoken to considered that when there was not a full team of staff on duty on a shift they were unable to meet the needs of the people living in the home. DS0000034288.V334120.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 adequate quality outcomes in this area. Complaints policy and safeguarding adults policy are appropriate. The lack of knowledge of the safeguarding of adults procedures could potentially put people living in the home at risk. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Four complaints have been received since the last inspection. One of these complaints had not been dealt with in the time scale stated in the policy. Policies and procedures are in place to ensure that people are protected. Care staff spoken with were clear that they would immediately report any allegation to their manager. The person in charge however was not clear about the procedure to follow. There is an on-call duty system that is available to give advice to staff in these circumstances. Staff have received training in Adult Protection procedures. DS0000034288.V334120.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26. People who use the service experience adequate quality outcomes in this area. The standard of the decorations are reasonable. The toilets are inappropriate for the privacy and dignity of the people living in the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Although requirements have been made on a number of occasions that the toilets should give privacy and dignity to people in the home, no work had commenced to adapt any of the toilets. Senior staff stated that the work is to commence on the 4th June 2007. The corridors and some of the bedrooms had been redecorated and other bedrooms were to be decorated. The home provides reasonable facilities for people living in the home in all other respects with a choice of lounges throughout the home. People living in the home considered that their own accommodation was suitable. One person living in DS0000034288.V334120.R01.S.doc Version 5.2 Page 16 the home stated that “The home is excellent – both the furnishings of the home and also bedding etc. It cannot be faulted. It is home from home. I love my bedroom”. Call bells can be cancelled remotely for a period of time. This means that staff do not have to answer calls for assistance to cancel the bells and this leads to people having to wait for longer periods of time than is acceptable. DS0000034288.V334120.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. People who use the service experience adequate quality outcomes in this area. Progress has not been made in addressing staffing shortages and as a result people living in the home do not always receive consistent care. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Staff commented throughout the inspection that there were times when there were insufficient staff on duty to meet the needs of the people living in the home. There are sufficient numbers of staff shown on the duty rota but difficulties arise when a member of staff is on leave or off duty sick. This has been an on-going problem and a requirement was made at the last inspection for the registered manager to ensure that there were sufficient staff on duty to meet the needs of the people living in the home. On the day of the inspection there were only three resource workers on the morning shift instead of four and the rota showed only three on duty on the afternoon shift instead of four. Three resource workers for 42 people is insufficient in this home to provide the necessary care for the dependency needs of the people living in the home. The home has a number of relief staff and also uses three agencies to replace staff on leave or off duty sick. However the two resource workers absent on the day of the inspection had not been replaced. DS0000034288.V334120.R01.S.doc Version 5.2 Page 18 Staff had undertaken some training and 84 of resource workers have obtained an NVQ Level 2 award in care. One member of staff spoken to stated that she had only received one day induction training with another member of staff on her first day of employment. Although she had been employed for over eight weeks she had not received any formal induction/foundation training. Staff files were unavailable on the day of the inspection as the senior staff could not find them. The registered manager must ensure that the necessary records are available for inspection. A member of the administrative staff of the Council with some Human Resource aspects to her work was able to obtain copies of application forms, CRB checks and starting dates of employment. DS0000034288.V334120.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38. People who use the service experience adequate quality outcomes in this area. The management of the home is not satisfactory overall with clear communication problems evident in the senior staff team. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is managed by a person who is qualified and experienced in the care of older people. With the exception of the staffing levels staff considered that the home was well run. A quality assurance exercise had been undertaken in 2006 and the result published on the notice board. Managers from another home were said to be visiting shortly to undertake a quality check against the National Minimum Standards. DS0000034288.V334120.R01.S.doc Version 5.2 Page 20 A number of people deposit money in the home for safekeeping. Income and expenditure records and receipts are kept. The records checked were up to date. The health and safety checks made were up to date and in order. It was not possible for senior staff on duty to produce some of the records required for this inspection. DS0000034288.V334120.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X 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 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 2 2 X X X X X X 3 STAFFING Standard No Score 27 1 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 X X 3 DS0000034288.V334120.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 A written plan of care as to how the needs of each person living in the home are to be met in respect to their health and welfare must be developed for each person. These plans must be reviewed by care staff at least once per month and updated to reflect changing needs and actioned. (Previous time scale of 31/07/06 not met). 2. OP10 12 The registered person must ensure the privacy and dignity of people living in the home with particular regards to people using the toilets. (Previous time scales of 30/01/06 and 31/12/06 not met). The registered person must make arrangements to enable people living in the home to engage in local, social and community activities to enrich their lives. 30/08/07 Timescale for action 30/06/07 3. OP12 16 30/06/07 DS0000034288.V334120.R01.S.doc Version 5.2 Page 23 4. OP16 22 The registered person must within 28 days of any complaints inform the person making the complaint of the action taken to ensure that they are aware of the outcome of the complaint. The registered person must ensure that staff are trained in safeguarding adults procedures to provide and make proper provision for the health and welfare for the people living in the home. The call bell system in the home must be reviewed to ensure that calls cannot be cancelled without a member of staff visiting the person requiring assistance to ensure that their needs are met. The registered person 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 the people living in the home. 30/06/07 5. OP18 12 30/06/07 6. OP19 23 30/06/07 7. OP27 18 30/06/07 8. OP30 18 All staff working in the home 30/06/07 must receive the appropriate induction training to enable them to undertake the tasks required of them in providing appropriate care to people living in the home. DS0000034288.V334120.R01.S.doc Version 5.2 Page 24 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 OP31 Good Practice Recommendations That communication between the registered manager and senior staff is improved to ensure that information and records are accessible when the registered manager is not on duty. DS0000034288.V334120.R01.S.doc Version 5.2 Page 25 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 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI DS0000034288.V334120.R01.S.doc Version 5.2 Page 26 - 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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