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Inspection on 29/09/05 for Nydsley Residential Home

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

This inspection was carried out on 29th September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

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

Service users said they were very happy living at The Nydsley and that the staff were " fabulous". They said that staff were always available to help and assist and " nothing is too much trouble" The owners and staff have good relationships with the people that live in the home and there is a family atmosphere. The Home was spotlessly clean and the standard of decoration and quality of furnishings and fittings is good.

What has improved since the last inspection?

Links have been made with a local training agency. Since the last inspection staff have undertaken training which improves the quality of care provided to service users. Almost all of the outstanding requirements and recommendations have been met.

What the care home could do better:

Staff including the manager need specific training about dealing with adult abuse. Some minor amendments need to be made in the way medication is stored. Records that staff complete must be dated and signed.

CARE HOMES FOR OLDER PEOPLE Nydsley Residential Home Mill Lane Pately Bridge North Yorkshire HG3 5BA Lead Inspector Chris Taylor Unannounced Inspection 29th September 2005 10:00 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.V252182.R01.S.doc Version 5.0 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.V252182.R01.S.doc Version 5.0 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.V252182.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 25th January 2005 Brief Description of the Service: The 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 and close to local services and amenities. The registered providers are Mr & Mrs F Hall and the registered manager is Mrs E Hall Nydsley Residential Home DS0000007797.V252182.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took five hours including preparation time. A tour of the premises was made as well as checking records about how staff are recruited and trained. Records about service users were also checked. Time was spent talking to service users about their experience of living at The Nydsley. What the service does well: 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. Nydsley Residential Home DS0000007797.V252182.R01.S.doc Version 5.0 Page 6 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.V252182.R01.S.doc Version 5.0 Page 7 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. Service users care needs are properly assessed prior to a service user being admitted. EVIDENCE: The case records including a recent admission all had a pre-admission assessment that had been completed by a senior member of staff. This provided clear evidence where the home would be able to meet the service users’ needs and where other agencies would need to involved. A service user who had recently been admitted confirmed that staff had talked to her about what aspects of care and support she needed. Nydsley Residential Home DS0000007797.V252182.R01.S.doc Version 5.0 Page 8 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Service users’ health and personal care needs are met. EVIDENCE: Care plans contain information about all aspects of the service users’ lives, what support is needed and how that support is to be provided. Where there is a risk, for instance of falling, a risk assessment was present. In the main care plans are reviewed every month but there were one or two gaps. Strategies to help staff maintain monthly reviews were discussed. Not all service user plans and risk assessments were signed and dated and although this does not affect the care being provided to service users it is a legal requirement and good practice. Service users said that they talked to staff about what help they needed and said that staff are polite and always knock on bedroom doors before entering. They said that there were no problems in seeing a GP and the district nurse came to the home almost every day. Nydsley Residential Home DS0000007797.V252182.R01.S.doc Version 5.0 Page 9 Positive relationships were witnessed between staff and service users. As a requirement of the previous inspection staff have attended accredited medication training and training in nutrition. It was reported that both were very useful and changes have been made within the home to improve practice. Medication is stored safely in a locked cabinet and only senior staff administer. Medication is decanted into Redidose boxes which are marked clearly, however, the individual daily cassettes are not, and if detached from the box there is no indication of whose medication it belongs to. The manager agreed to rectify this by labelling each daily cassette clearly. The dispensing pharmacist visits regularly to carry out an inspection. Nydsley Residential Home DS0000007797.V252182.R01.S.doc Version 5.0 Page 10 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Service users are supported with their chosen lifestyle. EVIDENCE: Service users said that they had plenty of visitors to the home and were able to make and receive phone calls. They said staff organise activities and they particularly liked the visiting keyboard player. Local clergy hold an interfaith service every month. Trips out are arranged and staff said service users enjoy shopping trips for personal items and to have a coffee. There are 3 main meals per day. Special dietary needs such as low-sugar diets are catered for and special requests can generally be met. Service users spoke positively about the quality of meals provided. Menus were looked at and these were varied. Hot and cold drinks are available throughout the day and a hot drink and snack is provided prior to bed. As a requirement of the previous inspection the manager and senior staff have attended training with regard to nutrition and consequently nutritional screening is undertaken where necessary and the use of high calorie/nutritional foods and substitute “build up” foods are used if assessed as needed. Nydsley Residential Home DS0000007797.V252182.R01.S.doc Version 5.0 Page 11 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): Service users are confident that complaints would be dealt with in a proper manner. Service users would be further safeguarded from abuse if staff completed specific training. EVIDENCE: A complaints procedure is provided to service users and is included in the Statement of Purpose. Service users said that they felt able to talk to the owners of the home if they had complaints and that they would be dealt with properly. There have been no formal complaints made since the last inspection. The previous requirement to obtain a copy of North Yorkshire’s Social Services policy and procedure with regard to adult protection has been met. It is the owners’ intention to provide staff with a briefing on this. It is still, however a requirement that staff attend external training and that adult protection is included in staff induction. Nydsley Residential Home DS0000007797.V252182.R01.S.doc Version 5.0 Page 12 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Service users live in a home that is clean, comfortable and well maintained. EVIDENCE: A tour of the premises was made. Everywhere was spotlessly clean and decorated to a high standard. The quality of furniture and fittings was also good and in keeping with the house and the age and needs of service users. All bedrooms are single with the exception of two shared rooms. There are sufficient en suite and communal bathrooms and toilets. The home has suitably located grab rails and moving and handling equipment. There is a large lounge and conservatory adjacent to the dining room. Nydsley Residential Home DS0000007797.V252182.R01.S.doc Version 5.0 Page 13 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28 , 29 and 30. Service users receive care from staff who complete appropriate training. EVIDENCE: Major improvements have been made with regard to staff training and the benefits of this were clear throughout the inspection. Although the manager finds it difficult to motivate staff to complete NVQ training they have completed all statutory training and some additional training pertaining to care of the elderly. Records of this training were seen. There is a long-standing stable staff team with a low turnover. Most staff live in the village and surrounding areas. Records of those staff most recently recruited were checked; all and completed an application form, had CRB check and two written references. Staff complete induction and these records were seen. The manager works alongside staff and as such monitors their practice. At every shift change there is handover where specific issues relating to service users are discussed. Polices and procedures are discussed at monthly staff meetings. Staff complete an annual appraisal and it is the managers intention to extend this to more regular formal supervision sessions. Nydsley Residential Home DS0000007797.V252182.R01.S.doc Version 5.0 Page 14 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, and 38. This home operates with its service users best interest as its priority, however there is no formal system to obtain and act upon service users views about how the home is run. Staff take proper precautions to ensure the health and safety of service users. EVIDENCE: The manager has yet to formalise a quality assurance system. She has made a start with staff completing questionnaires about ideas for improving the services provided. This needs to be developed further seeking the views of service users and their representatives’ collimating in a development plan for the home. Nydsley Residential Home DS0000007797.V252182.R01.S.doc Version 5.0 Page 15 The home does not deal with service users personal finances. Records were seen which confirmed that equipment is maintained; gas and electricity supplies in the home are safe and serviced appropriately. Fire detection and fire fighting equipment is tested and maintained regularly. Accidents are recorded. Staff receive training with regard to all health and safety matters. Nydsley Residential Home DS0000007797.V252182.R01.S.doc Version 5.0 Page 16 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 1 8 x 9 1 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 1 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x x 1 x 3 x x 3 Nydsley Residential Home DS0000007797.V252182.R01.S.doc Version 5.0 Page 17 Are there any outstanding requirements from the last inspection? 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 Timescale for action 29/10/05 2. 3. OP9 OP18 13 (2) 13 (6) 4. OP33 24 Care plans and risk assessments must be dated and signed by the author and wherever possible signed by the service user and or their representative. Individual medication cassettes 29/10/05 must be labelled with the service users name. Staff must received training 29/10/05 with regard to adult protection and this must form part of induction training. The registered person must 31/03/06 implement a system which reviews the quality of the service provided and which includes the views of service users and their representatives. A copy of the report of such a review must be made available to the Commission for Social Care Inspection and service users Timescale of 30.09.04. Not met. Nydsley Residential Home DS0000007797.V252182.R01.S.doc Version 5.0 Page 18 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Nydsley Residential Home DS0000007797.V252182.R01.S.doc Version 5.0 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.V252182.R01.S.doc Version 5.0 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!