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Inspection on 21/06/06 for Nydsley Residential Home

Also see our care home review for Nydsley Residential Home for more information

This inspection was carried out on 21st 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The residents live in a very clean, comfortable home. Staff are kind and helpful and make an effort to provide the service the residents` want. Residents are able to make choices in some areas of their lives. Examples included rising and retiring times, clothes, and food. This ensures that they maintain some control. The residents are able to access the primary health care team and other professionals ensuring that their health care needs are met. A good choice of fresh well prepared food, and drinks are available. This ensures that they receive a varied and nutritious diet. The owner/manager gets the views of the residents about the service provided so as to make changes that improve the residents` quality of life.

What has improved since the last inspection?

Staff training is on going and ensures that the staff are up to date with care practices that benefit the residents. Some redecoration has taken place, which ensures that the home is kept at a good standard.

What the care home could do better:

The recruitment procedure needs to be improved, and all safety checks made to ensure the safety and protection of the residents. Food temperatures must be taken of all the food cooked in the home to ensure the safety of the residents.

CARE HOMES FOR OLDER PEOPLE Nydsley Residential Home Mill Lane Pately Bridge North Yorkshire HG3 5BA Lead Inspector Terry Downey Key Unannounced Inspection 21st June 2006 09:00 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 Nydsley Residential Home DS0000007797.V301925.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. Nydsley Residential Home DS0000007797.V301925.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Nydsley Residential Home Address Mill Lane Pately Bridge North Yorkshire HG3 5BA Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01423 712060 Mr Frank Leonard Hall Mrs Elizabeth Anne Hall Mrs Elizabeth Anne Hall Care Home 14 Category(ies) of Old age, not falling within any other category registration, with number (14) of places Nydsley Residential Home DS0000007797.V301925.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 24th January 2006 Brief Description of the Service: Nydsley is registered to provide residential social and personal care for 14 older people. The home is a detached house set in its own grounds. All areas of the building are accessible to service users via the use of a stair lift. There is a well-tended garden and a conservatory providing views of the local countryside. The home has a car park for staff and visitors and is located close to local services and amenities. The home was first registered to Mr & Mrs F Hall in 1989. The registered manager is Mrs E Hall. The home has an information pack and service user guide to inform prospective residents about the home. On 21st June 2006 the fees for the home ranged from £280 to £320. Nydsley Residential Home DS0000007797.V301925.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection consisted of a review of the information held on the homes file since the previous inspection, information submitted by the home in the Pre Inspection Questionnaire, and a 5 hour unannounced site visit to the home on 21st June 2006. At the time of the site visit the manager, Mrs Hall was available to assist with the inspection and was very helpful despite being very busy as she was temporary short staffed. The site visit included observation of care practices, discussion with 10 residents, 4 members of staff, and a visiting community nurse. Survey forms had also been completed by 3 residents and another community nurse. The visit also included a check on the requirements from the previous inspection, a tour of the premises and a check on the records kept by the home. The inspection showed that the residents were well cared for in a very clean, well maintained, comfortable home. There is a well established staff team and the manager works with them providing constant supervision. Staff training has improved, however the recruitment procedure could put residents at risk. What the service does well: What has improved since the last inspection? Staff training is on going and ensures that the staff are up to date with care practices that benefit the residents. Nydsley Residential Home DS0000007797.V301925.R01.S.doc Version 5.2 Page 6 Some redecoration has taken place, which ensures that the home is kept at a good standard. 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. Nydsley Residential Home DS0000007797.V301925.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 Nydsley Residential Home DS0000007797.V301925.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): 3,6. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. Prospective residents have their needs assessed but should have all the information needed to choose a home prior to admission EVIDENCE: Case tracking confirmed that the admission procedure is adaquate. The deputy manager carries out initial assessments prior to the residents moving in and makes a record of their care needs. The service users whose care was case tracked knew the home before deciding to move there, they are local people. The Service User Guide had not been issued and none of the recent residents were aware of a contract. The manager explained that these are not issued until the months trial period is over and both the home and the resident agree to make the move permanent. In two of the cases this had not happened. Two residents said that they liked the home and immediately felt comfortable with the residents and staff. Some of the residents admitted to the home have been for respite care prior to moving in. The home is not registered for intermediate care. Nydsley Residential Home DS0000007797.V301925.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): 7,8,9,10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The levels of care are very good and local health professionals visit regularly to ensure that the residents’ health needs are met. EVIDENCE: Care plans contain the information required to help the staff meet the needs of the individual resident but the information is not up to date, and monthly reviews are not carried out. Four residents were casetracked and they indicated that their personal care needs were met approriately. There is no evidence that residents are part of the process or that they sign to agree the contents of the care plan. Staff had a good overall understanding of the needs of the residents and were seen to be patient and kind when interacting with them. All residents have frequent contact with the manager and care staff which ensures that appropriate care is provided. Care plans include health care requirements and service users felt that if they needed to see a doctor or attend an appointment this was arranged quickly. The GP and two Community Nurses were surveyed but only one reply was recieved, which considered that Nydsley Residential Home DS0000007797.V301925.R01.S.doc Version 5.2 Page 10 the care needs of the residents were met and that good communication exists between the health centre and the home. Another district nurse who visits the home regularly was spoken to during the visit and she was very happy that any instructions left with the home regarding the care of a resident would be carried out. She also considerd levels of care were good. The home’s medication policies are good and well implemented. Staff have had training in the administration of medication and the pharmacist visits the home to check the system. Nydsley Residential Home DS0000007797.V301925.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): 12,13,14,15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The residents eat a healthy varied diet, and the social and recreational activities meet their expectations. EVIDENCE: The evidence indicated that the level of social activities is appropriate for residents. All the residents said that they enjoy the entertainers when they come, they have individual activities such as reading and crosswords, some enjoy having their nails done, or a foot massage, some play dominoes, so they do not want more activities. All the residents were very clean, well dressed, and clearly well cared for. An ecumenical religious service is conducted in the home, and one resident goes out to a service. The food is good, and prepared daily using fresh local ingredients. The cook consults the residents regularly to find their preferences. The kitchen is well equiped and cleaning rotas ensure that cleanliness is maintained. The temperatures of the cooked food is taken by the cook but not at weekends or when someone else cooks and this needs to be addressed. There was a cat in the kitchen when the food was being prepared and served, the home has been told about this previously, and must take some action to prevent it. Nydsley Residential Home DS0000007797.V301925.R01.S.doc Version 5.2 Page 12 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): 16,18. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. Residents are protected from abuse because staff are trained and work closely together but the recruitment procedure is unsafe. EVIDENCE: A complaints procedure was available to all service users and this was included in the service user guide. Some service users remembered they had the guide and the procedure but others did not think they had seen it. They all felt safe, listened to, and able to speak to the staff and manager if they were not happy about anything to do with their care. The evidence indicated that residents are protected from abuse, the staff had done a training course in adult abuse and were aware of the procedure. The recruitment procedure is unsafe, because of a lack of references and Police checks, and this could put the residents at risk. Nydsley Residential Home DS0000007797.V301925.R01.S.doc Version 5.2 Page 13 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): 19,26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The home provides a safe,well maintained, and comfortable place for the residents to live. EVIDENCE: The home was spotlessly clean, well decorated and furnished. The residents were very pleased with the home. The cleaner has worked in the home for 5 years and she explained that she works 5 mornings per week and this provides sufficient time to keep the home clean. She also said that every Thursday she completely cleans one of the rooms which ensures that nothing is missed. The home is also well maintained and the furnishings and decorations are of a ggod standard. Individual residents liked their bedrooms, and all were happy with the facilities in the home. There is a pleasant dining room, comfortable lounge, and a large conservatory with good views of the surrounding countryside. There were sufficient toilets and bathrooms and equipment available to help the residents. There was also a well maintained stairlift to help the residents negotiate the stairs Nydsley Residential Home DS0000007797.V301925.R01.S.doc Version 5.2 Page 14 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): 27,28,29,30. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to the service. Staff are aware of their duties and meet the needs of the residents. The recruitment procedure could put residents at risk. EVIDENCE: On the day of the site visit the home was a member of staff short due to illness and holidays. The staff coped very well due to good management and some of the residents didnt notice. The home has a well established staff team of mainly local people who are trained to meet the needs of the residents. Observation and discussion with the residents indicated that the staff were very supportive. kind, and always respectful. Staff themselves considered that they had sufficient time to spend with the residents although this morning, it was a bit hurried. They often give foot massages, take the residents out for walks or play dominoes with them. The care staff were well supported by ancillary staff and on the day of the inspection there was a cleaner, a cook, a schoolgirl on work placement helping in the kitchen, and a handyman. The files of two of the more recently employed staff members were checked and these showed good induction programmes, which had not been checked, only one reference for one member of staff and none for the other. Neither had a CRB check. The manager said she had obtained verbal references but there was no record of this. This procedure could put the residents at risk. Nydsley Residential Home DS0000007797.V301925.R01.S.doc Version 5.2 Page 15 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): 31,33,35,36,38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The management arrangements in the home are appropriate for the home. EVIDENCE: The manager has made a start in developing a quality assurance system and some residents have completed questionnaires. She also speaks to them daily and implements any improvements they suggest. The content of the questionnaires provides good information from which to produce the home’s annual development plan which is the next step. Although staff complete an annual appraisal as yet they do not receive formal supervision meetings with their manager. The home is small and has a small and long standing staff team and the manager and deputy work alongside staff Nydsley Residential Home DS0000007797.V301925.R01.S.doc Version 5.2 Page 16 on shift and monitor and assess practice and staff appreciate this style of management, which is also appropriate for the size of the home. Health and safety records are well maintained. Equality and diversity is not discussed formally but there is no doubt that the residents are treated with respect and dignity. Nydsley Residential Home DS0000007797.V301925.R01.S.doc Version 5.2 Page 17 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 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 3 9 3 10 3 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 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 X 3 Nydsley Residential Home DS0000007797.V301925.R01.S.doc Version 5.2 Page 18 Are there any outstanding requirements from the last inspection? yes 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 17 (1)(a) Requirement Service user plans must be reviewed on a monthly basis (timescale of 31/03/06 not met) Food temperatures must be taken of all food cooked and served in the home. All staff must have two references and checks with the Criminal Records Bureau prior to working in the home. Timescale for action 14/08/06 2. 2. OP15 OP29 16 19 31/07/06 31/08/06 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 OP3 OP15 Good Practice Recommendations Residents should have all the information about the home and a contract prior to moving into the home The cat should not be allowed in the kitchen Nydsley Residential Home DS0000007797.V301925.R01.S.doc Version 5.2 Page 19 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 Nydsley Residential Home DS0000007797.V301925.R01.S.doc Version 5.2 Page 20 - 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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