Inspection on 19/05/09 for Northgate House

This inspection was carried out on 19th May 2009.

CQC found this care home to be providing an Good service.

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

Northgate House 16/06/08

Northgate House 19/06/07

Northgate House 13/06/06

Northgate House 06/03/06

Northgate House 09/12/04

Northgate House 26/08/04

Northgate House 27/02/04

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Extracts from inspection reports are licensed from CQC, this page was updated on 10/07/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Northgate House 92 York Road Market Weighton York East Yorkshire YO43 3EF     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Jo Bell     Date: 1 9 0 5 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 24 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 24 Information about the care home Name of care home: Address: Northgate House 92 York Road Market Weighton York East Yorkshire YO43 3EF 01430873398 01430871706 northgatehouse@supanet.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mr John Keith Chambers,Mrs Jean Chambers,Miss Elizabeth Joy Chambers care home 25 Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 25 25 dementia old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home 0 0 Northgate House is registered to provide residential, personal, and social care for 25 people over the age of 65 years, including people with dementia. The home is a large house that has been extended to meet the demand of a growing local population. There is a well-tended garden and patio area located at the rear of the premises that provides a safe and secure area for the residents walk around, sit, or enjoy activities. There is a car park for staff and visitors. All areas of the building are accessible to service users via the use of ramps and a stair lift. The home is located close to the centre of Market Weighton and provides good access to the town?s services and amenities. The home was first registered in 1984 and was acquired by the present owners in Care Homes for Older People Page 4 of 24 Brief description of the care home September 1998. The registered providers are Mr and Mrs Chambers and their daughter Miss Joy Chambers. The home has an information pack and service user guide to inform prospective residents about the home. The fees for the home ranged from £365-£500 per week. This information was correct at 19th May 2009. Extra charges are made for chiropody and hairdressing. The manager discusses the service user guide with prospective people, which includes the range of services available and the terms and conditions of stay. Care Homes for Older People Page 5 of 24 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations, but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. We went to the home without telling them that we were going to visit. This report follows the visit that took place on Tuesday 19th May 2009. The visit lasted from 10:00 until 14:30. The purpose of the visit was to make sure that the home was operating and being Care Homes for Older People Page 6 of 24 managed in the best interests of people living there. Information has been used from different sources for this report. These sources include- Reviewing information that has been received about the home since the last inspection. The annual quality assurance assessment. This is information which details what has happened during the past 12 months (including an improvement plan). Ten surveys were received from people using the service, three healthcare professional surveys and five staff surveys. Notifications (Regulation 37) relating to incidents in the home affecting people using the service. Details of complaints and allegations raised by people connected to the service. Progress of the previous requirements and recommendations made at the last site visit. At the site visit one inspector spent 4.5 hours at the home. During this time observations of care practices took place. People using the service were spoken with along with some visitors. Discussions with the manager and team manager regarding meeting needs, mealtimes, protecting people and the environment took place. The lunchtime meal was observed and time was spent inspecting care plans, looking at individual rooms and reviewing a selection of health and safety information. Staffing and management issues were discussed and feedback was given to the manager and two owners at the end of the inspection. All requirements and recommendations were met. However following this visit two issues were rasied regarding healht and personal care, these willbe dealt with via an additional visit to the home. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 24 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 24 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have their needs assessed, which helps staff determine if the individual can be offered a place at the home. Evidence: Since the last inspection a pre-admission assessment has been developed and implemented. The three pre-admission assessments looked at confirmed that a senior person completes an assessment before an individual moves to the home. This is to check what type of care and support the person needs and whether the staff have the skills and knowledge to provide that care if the individual chooses to move there. The process also reassures the individual and their family that they will receive the right support. All surveys completed confirmed that people receive enough information about the home before they move in. Assessments are completed if the person has a care manager or is privately funded. Care Homes for Older People Page 10 of 24 Evidence: These detail health, personal, nursing, social and mental health needs. This means people can make an informed choice about whether to move there or not. Whilst the pre-admission assessments have clearly improved, there does need to be a more consistent approach to completing them. The mental health aspects on all three assessments were left blank even though on two occasions short term memory loss had been recorded. The home are registered to care for people with dementia and it is important for staff to recognise the difference between people who need a residential home and those who need a nursing home. Care Homes for Older People Page 11 of 24 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have their health and personal care needs met in a dignified manner. Evidence: People were observed looking clean and well cared for. Three care plans were inspected and these contained risk assessments, reviews, evaluations and daily records of individuals. Mental capacity is assessed and reviewed in consultation and cooperation with the GP. Information relating to nutrition, pressure area care, risk of falls and aspects of moving and handling were in place and clearly recorded. Staff in the home understand the plans which are developed from the pre-admission assessments. The Annual Quality Assurance Assessment confirms that people have access to dental, optical and chiropody services when needed. The home have close links with Doctors and District Nurses. This was evident when speaking with one healthcare professional who spoke positively about the home and staff they communicate well with me, I visit weekly were some of the comments. The medication system was discussed with senior staff. Training had been given in this Care Homes for Older People Page 12 of 24 Evidence: area and staff had a good understanding of how to safely administer, record and dispose of medication effectively. A 6 monthly review by GPs takes place and the Manager carries out weekly drug audits. This helps to ensure peoples well being is maintained. Privacy and dignity in the home has improved in the past 12 months, with staff interacting positively with people using the service. One person said the staff look after my relative really well. Staff were observed knocking on doors and discussing issues in a respectful manner. The team was well lead by the assistant manager and this contributed to the relaxed and welcoming atmosphere. Following this visit two issues were raised regarding record communication and record keeping, this will be dealt with by an additional visit to the home. Care Homes for Older People Page 13 of 24 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live interesting and varied lives and receive a nutritious diet. Evidence: The home employ two Care Managers who are responsible for facilitating activities. The Annual Quality Assurance Assessment confirms people using the service are consulted to ensure activities are appropriate and what people want. Birthdays are celebrated, with visitors been encouraged to join in. Events including Bonfire Night, Christmas, Valentines Day, Wimbledon, Ascot Ladies Day, and Yorkshire Day are all celebrated and enjoyed. People can visit local shops and cafes, and craft afternoons are frequently organised. A monthly newsletter is produced which highlights birthdays and forthcoming events. This months letter discusses how Easter was celebrated at Northgate House and a reminder that the hairdresser and chiropody is available. The home encoruages visitors into the home and an advocacy service is available. One person spoke about their daily routine I can get up and go to bed when I want was one comment. Another person said I have my own routine. Care Homes for Older People Page 14 of 24 Evidence: The lunchtime meal was observed, home cooked sausage pie and vegetables was served in one of two dining areas. The tables were laid with glasses, napkins, suitable crockery and cutlery and table cloths. The dining experience was calm and pleasant with staff interacting positively with people. A choice of drinks was offered, one person had blackcurrant whilst another had water or orange. Assistance was given where necessary and plate guards were in place for a small number of people. The food looked appetising and the portions sizes varied. One surveys stated the home has good home cooked food. Staff explained that they ask people the day before what food and drink they would like the following day. For those people with dementia it may be more appropriate to ask them on the morning after breakfast, or when the food is about to be served. There is a large menu available on a board in the entrance area. People spoken with could not remember what the lunchtime meal was. A menu in the dining room or a menu on the dining table may be useful. This was discussed with the manager. Care Homes for Older People Page 15 of 24 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples concerns are taken seriously and staff are alert to signs of abuse. Evidence: The home have a complaints procedure in place. Three people spoken with all confirmed they would go to a member of staff if they were concerned about anything. No formal complaints have been made in the past 12 months. The atmosphere in the home is relaxed and people using the service have confidence that any issues will be dealt with. The home have a safeguarding procedure in place. Staff have received training in the different types of abuse which people may be subjected to. Two staff discussed how they would deal with an incident of physical or verbal abuse. The home have links with social services and were aware of the role of the police, The Commission and staff in the home when an allegation has been made. Since the last inspection the home has made the system for completing protection of vulnerable adults checks more robust. This helps protect people from harm. People were observed looking safe and comfortable in their environment. Care Homes for Older People Page 16 of 24 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a clean and warm environment, though aspects of the communal areas could be updated. This would enhance the home for people living there. Evidence: People live in a clean home which has a welcoming and homely feel. The Annual Quality Assurance Assessment states that the laundry area has been refurbished, a new boiler has been installed into one section of the house and there is a greater provision for emergency heating. The home has a range of communal areas and a secure garden is available for people to use. The corridor area near the entrance area needs updating, the carpet is very discolored (which was only replaced three years ago). This was discussed with the manager who is aware that aspects need improving. One person said my room is lovely, I have all my things around me. Another person said my room is always clean. There are enough domestic staff at the home and staff have completed infection control training. Staff were observed using protective clothing and using hand washing techniques. People using the service were observed wearing clean and well ironed clothes. Care Homes for Older People Page 17 of 24 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples needs are well met by a staff group who are recruited, trained and supported properly. Evidence: The home currently has nineteen people using the service, these are older people some of whom have dementia care needs. There is a manager, assistant manager and care manager and carers on duty, they are supported by domestic, maintenance and catering staff. Senior staff on duty have completed an NVQ Level 3 in care and all other care staff either have an NVQ Level 2 or are working towards this. A robust induction programme is now in place (exceeds Skills for Care) and staff confirmed they have worked through this and received training to ensure they are competent in their role. Staff receive supervision and each person has a personal development file. The recruitment system at the home has improved, two written references, a police check and protection of vulnerable adults checks take place prior to a person starting work. This all helps to protect people from harm. Staff are able to meet individual needs due to increased training in equality and diversity, dementia care training and mandatory training. Care Homes for Older People Page 18 of 24 Care Homes for Older People Page 19 of 24 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed and run in the interests of the people living there. Evidence: The home has a Registered manager, who is also the owner who has many years experience of working in the care sector. A manager has day to day charge of the home. This person is an enrolled nurse and is hoping to complete a Leadership or NVQ Level 4 training course in management. The home has made significant improvements in the past 12 months, requirements and recommendations have been acted upon and staff have a greater understanding of how individual needs can be met. A quality assurance system has been fully implemented with questionnaires been sent out to people and audits regarding health and safety, care plans and medication systems completed. The annual quality assurance system shows that robust systems are in place to ensure the security, accountability and safe-keeping of all residents valuables and money. Meetings take place with people using the service to seek their views and opinions. Results of audits are analysed and feedback incorporated into the Business Care Homes for Older People Page 20 of 24 Evidence: plan and other policies and procedures. People are looked after in a safe environment, a training matrix demonstrates that training in fire safety, infection control, moving and handling, food hygiene and abuse awareness all take place within their designated timescales. The home carry out regular fire alarm testing, and a risk assessment is in place and regularly reviewed. An electrical wiring certificate was available from 2004 and this test was been carried out at the inspection along with portable appliance testing. Two staff spoke about he action they would take in the event of a fire or an emergency situation where medical help is needed. Policies and procedures are updated and staff are alert to signs of hazards in the home with clear risk assessments routinely completed. Care Homes for Older People Page 21 of 24 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 22 of 24 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 2 3 15 The pre-admission assessment could be more detailed. Specifically regarding the mental health aspect. Consideration should be given to having a more accessible menu so people know what food and drink is on offer, staff should ensure they ask people at an appropriate time what their food choice is (relates to people with dementia). Consideration should be given to updating aspects of the environment, including the corridor near the entrance area. 3 19 Care Homes for Older People Page 23 of 24 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 24 of 24 - 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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