Inspection on 08/03/07 for Neville House Residential Care Home

This inspection was carried out on 8th March 2007.

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

Neville House Residential Care... 12/01/09

Neville House Residential Care... 16/01/08

Neville House Residential Care... 08/08/07

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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 Neville House Residential Care Home 12 Montreal Avenue Chapel Allerton Leeds West Yorkshire LS7 4LF Lead Inspector Hebrew Rawlins Key Unannounced Inspection 08:45 8th March 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 Neville House Residential Care Home DS0000067959.V325557.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. Neville House Residential Care Home DS0000067959.V325557.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Neville House Residential Care Home Address 12 Montreal Avenue Chapel Allerton Leeds West Yorkshire LS7 4LF 0113 2629764 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) SK Care Homes Ltd Care Home 22 Category(ies) of Old age, not falling within any other category registration, with number (22) of places Neville House Residential Care Home DS0000067959.V325557.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection First inspection Brief Description of the Service: Neville House is a small care home for the elderly, owned by SK Care Homes Ltd. The home is ideally situated in Chapel Allerton, North Leeds and provides ample car parking and is near local shops. The Post Office, Doctors surgery and Dental Surgeries are all within a very short walk. Churches of most denominations are also close by. There is a choice of single and twin-bedded rooms, which are all pleasantly decorated and carpeted. Service users may bring items of their own furniture if they wish. All meals are prepared and cooked on the premises. A flexible menu is planned and served each day and the cook is able to cater for any individual specialised meals or dietary requirements. Neville House aims to provide a family atmosphere where service users can participate in the activities and events as much or little as they wish. The current fees range from £395.00 to 439.00 per week with additional charges for hairdressing, chiropody, newspapers and toiletries. This information was provided by the home as part of the pre-inspection questionnaire completed before this inspection. Neville House Residential Care Home DS0000067959.V325557.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. In April 2006 the Commission for Social Care Inspection (CSCI) made some changes to the way in which care services are inspected. Care services are now judged against outcome groups. The inspection report is divided into separate sections for each outcome group for example Choice of Home. An overall judgement is made for each outcome group based on the findings of the inspection. The judgements reflect how well the service delivers outcomes to the people using the service. The judgements categories are “excellent”, “good”, “adequate” and “poor”. The judgements are recorded within the main body of this report. Another significant change to the way in which inspections are conducted is that pre-inspection questionnaires are sent out to Homes on an ad-hoc basis and has no bearing on the timing of the inspection visit. More detailed information about these changes is available on our website – www.csci.org.uk This is the first inspection of the home since the new owner took charge in October 2006. This unannounced key inspection took place at 8.45am on 8th March 2007. The purpose of the visit was to monitor standards of care in the home. The home completed a pre-inspection questionnaire before the visit to the home. The information provided in that has been used in the preparation of this report. The people who live in the home prefer the term ‘resident’ and this will be used throughout this report. Following the inspection visit a number of comment cards were received from relatives/visitors and also from residents. The majority of the residents’ comment cards had been completed with the help of a member of staff; the responses were positive about care and life at the home. Comment cards received from relatives/visitors indicated an overall satisfaction with the care at the home. Comments from the survey cards can be found throughout this report. During the inspection residents, staff on duty as well as relatives were spoken with. Records were examined and a tour made of the building. Feedback at the end of this inspection was given to the senior carer. What the service does well: Residents said they were happy living at Neville House. It is evident that great effort has been made to ensure the physical surroundings within the building are well decorated. Finishing touches are in place, such as cushions and lamps and this contributes to a homely feel. Neville House Residential Care Home DS0000067959.V325557.R01.S.doc Version 5.2 Page 6 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. Neville House Residential Care Home DS0000067959.V325557.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 Neville House Residential Care Home DS0000067959.V325557.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): 1, 2, 3 and 5. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Prospective residents and others have access to information to help them make an informed choice about the home. EVIDENCE: A sample of residents’ files were examined and included the files of the four new residents who have relocated to Neville House since the new owners have taken over. Written contracts were between the Department of Social Services and the home. There was evidence of residents having been assessed prior to moving into the home, however the information held could be developed and the pre-assessment report should be signed and dated. There was no written evidence to show that prospective residents have the opportunity to visit and assess the quality, facilities and suitability of the home. Residents spoken with said they were placed there by Social Services without visiting the home. However during the inspection a family came to the home Neville House Residential Care Home DS0000067959.V325557.R01.S.doc Version 5.2 Page 9 making enquires about a place. The senior carer showed them around the home and was able to give them all the information they required. Neville House Residential Care Home DS0000067959.V325557.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. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Residents can not be sure their needs will be met at all times as care planning is poor. The principles of respect, dignity and privacy are put into practice. EVIDENCE: The care files showed that a physical and social assessment is undertaken routinely at the time of admission. Some of these were unsigned and undated and some of the writing throughout was difficult to read. There were no care plans to show the ways in which spiritual needs were to be met. There was no documented evidence to show that residents have been involved in the care planning and reviews have not always taken place. Residents have a choice about sitting in one of the lounges or remaining in their rooms, where they were surrounded by personal possessions. Care staff were observed explaining what they were doing when assisting residents and trying to encourage their cooperation. Neville House Residential Care Home DS0000067959.V325557.R01.S.doc Version 5.2 Page 11 Residents spoken with said they were treated with dignity and respect by staff however one person felt that a certain member of staff lacked understanding of the elderly. Accident records were checked. One injury seen had only been recorded in the daily notes and there was no evidence that the cause had been fully investigated. Four residents completed the Commission for Social Care Inspection (CSCI) questionnaires about service standards at Neville House. All but one made positive comments about staff and the care they receive. That person commented that the standard of personal care received was not as good as it used to be. Medication administering sheets were not always completed for each resident. The records should show when residents refuse their medication and why. If this persists the GP should be informed. There was no photograph of residents on their medication record so as to ensure residents receive the correctly prescribed medication. Neville House Residential Care Home DS0000067959.V325557.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. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The residents are provided with a nutritious and balanced diet in pleasant surroundings. However they are limited in social and leisure activities. EVIDENCE: The recordings of social interests and needs were not detailed. There was no evidence of a commitment to making sure residents could exercise choice in how they spend their day. Residents said they do not have anything to do and sit for a long period of time doing nothing. There are no trips/outings from the home. Staff spoken with said there was a person employed to help the residents with their movement/exercise, however he no longer attends because he has not been paid. The lunchtime meal was observed and seemed to be well managed with residents being enabled to eat at their own pace. The food looked and smelt appetising. There were mixed views about the food. Some residents were satisfied; some said that the food tasted the same. Neville House Residential Care Home DS0000067959.V325557.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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Overall residents are not fully protected by the home from abuse. Staff are not confident regarding the Local Authority adult protection policy. EVIDENCE: During discussions with residents they all said they know the procedures to follow in order to initiate a complaint, however they expressed the view that they were unsure whether the new owners would take any complaints seriously. This was also confirmed in the survey for service users returned. Nobody had any complaints, but one resident did have a concern about a member of staff. It was felt that staff were leaving because of this member of staff. However in discussion with staff they stated this resident was upset because his main carer left and it was not because of any disagreement with any other staff member, although he seems to think so. Since the new owners have taken over in October 2006 there has been one complaint to the Commission for Social Care Inspection (CSCI). The provider has been asked to investigate the complaint and respond to the CSCI in writing within a specified timescale. The training records show staff have not had adult protection training to ensure that residents are not at risk. Neville House Residential Care Home DS0000067959.V325557.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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 23, 24, 25 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home offers a safe, well-maintained environment for the service users and they can easily access the garden areas if they so choose. Communal areas and service users’ bedrooms are decorated and furnished to a good standard offering safety and comfort. EVIDENCE: All areas of the home were inspected. The home is decorated and furnished to a good standard throughout and the communal rooms offer a safe and comfortable space for the service users. All areas of the home were clean and tidy and nothing was seen during the inspection that could cause a hazard to service users. Service users have access to a well-maintained garden, at the rear of the building. Neville House Residential Care Home DS0000067959.V325557.R01.S.doc Version 5.2 Page 15 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 and 30. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The home management does not support staff. This could create a situation where residents as well as staff members are put at risk. EVIDENCE: A senior carer, two carers and the cook were on duty at the time of the inspection. The home has been running without a manager since the 2nd week in November 2006. The current deputy manager, who was employed by the previous owners has been in charge since November 2006, however she has been on sick leave for the past six weeks. In discussion with staff, it was clear that staff morale is low. Staff reported they have to cover each other’s workload and shifts and without a manager they said there is a real lack of guidance. Those spoken with stated they do not feel supported by the owner and the following account was provided in order to back this perception by staff. Staff recounted that two members of staff who are experiencing difficulty in working together to the point where the police have become involved although not on the premises of the home, have been informed by the owner, as I understand from staff that their disagreement is a personal matter for them to sort out. This situation has not yet been resolved. It has been reported that one of the staff involved is on sick leave and it is said by staff spoken with that their understanding is when she returns to work she is not allowed in the kitchen whilst the other member of staff is there. This Neville House Residential Care Home DS0000067959.V325557.R01.S.doc Version 5.2 Page 16 creates a difficult and potentially tense atmosphere within the home for both staff members to efficiently complete their jobs as well as for residents whilst the situation continues. Staff said they do not feel the owner makes himself readily available in the absence of a manager in the home. The senior carer said the home had a programme of National Vocational Qualification (NVQ) training. However it has not yet reached the target figure of 50 of care staff with NVQ level 2. Neville House Residential Care Home DS0000067959.V325557.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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 36, 37 and 38. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Residents are not safeguarded because of the lack of supporting management structures. EVIDENCE: As already stated in the staffing section the home does not have a manager. The senior carer reported that the owner has recently appointed to this post and is waiting for the Criminal Record Bureau (CRB) checks before a start date can be arranged. Without a manager staff supervision has not taken place. There was no written evidence of meetings between the owner and staff and residents. There was also no evidence to indicate the home undertakes a quality-monitoring audit of Neville House Residential Care Home DS0000067959.V325557.R01.S.doc Version 5.2 Page 18 services that includes the opinions of residents, relatives, staff and external professionals that visit the home. The home has a procedure for managing the small number of residents’ personal allowance monies held at the home. Residents have access to their personal allowance whenever they require it. Fire records were checked and these were not kept up to date. Staff reported they were trained in health and safety, including moving and handling and food hygiene. Neville House Residential Care Home DS0000067959.V325557.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 2 3 2 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 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 3 17 X 18 2 3 3 X X 3 4 3 3 STAFFING Standard No Score 27 3 28 2 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 1 1 2 X X 1 2 3 Neville House Residential Care Home DS0000067959.V325557.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(1) Requirement All residents must have an up to date, detailed care plan and this must be reviewed regularly. This will ensure they receive the support that meets their needs When medication is administered to residents it must be clearly recorded. This will ensure residents receive the correct levels of medication. Staff must have adult protection training to ensure that residents are not at risk. The home must achieve the target figure of 50 of care staff with NVQ level 2 qualifications. The home must undertake a quality-monitoring audit of services that include the opinions of residents, relatives, staff and external professionals that visit the home. Timescale for action 01/07/07 2 OP9 13(2) 01/05/07 3 3 5 OP18 OP28 OP33 13(5) 18 24 01/07/07 01/12/07 01/12/07 Neville House Residential Care Home DS0000067959.V325557.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. 1 2 Refer to Standard OP36 OP12 Good Practice Recommendations When the manager arrives he/she should ensure all staff receive supervision at least six times a year. The home needs to improve its social and leisure activities. This will help to ensure residents are not bored. Neville House Residential Care Home DS0000067959.V325557.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Aire House Town Street Rodley Leeds LS13 1HP 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 Neville House Residential Care Home DS0000067959.V325557.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. 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