Inspection on 05/07/05 for Old School House And Courtyard Nursing Home

This inspection was carried out on 5th July 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.

Other inspections for this house

Old School House And Courtyard... 20/02/07

Old School House And Courtyard... 07/12/05

Old School House And Courtyard... 26/01/05

Old School House And Courtyard... 30/06/04

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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 Old School House and Courtyard Nursing Home Main Road Gilberdyke East Yorkshire HU15 2SG Lead Inspector Jo Bell Unannounced 5 July 2005 09:30 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 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. Old School House and Courtyard Nursing Home J53-J04 S945 Old School House V223561 170505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Old School House and Courtyard Nursing Home Address Main Road Gilberdyke East Yorkshire HU15 2SG 01430 441803 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr Stephen Waltham and Mrs Sheila Waltham Mrs Elaine Joy Hall Care home with nursing 46 Category(ies) of DE(E) Dementia - over 65 (46) registration, with number OP Old age (46) of places PD(E) Physical disability - over 65 (46) TI (E) Terminally ill (46) Old School House and Courtyard Nursing Home J53-J04 S945 Old School House V223561 170505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 26th January 2005 Brief Description of the Service: The home provides nursing and residential care for up to 46 service users with dementia needs, physical disabilities, and those requiring palliative care. The home is situated on the main road in the small village of Gilberdyke. The home has ground floor access throughout and easy access to the grounds outside. Old School House and Courtyard Nursing Home J53-J04 S945 Old School House V223561 170505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place on Tuesday 5th July 2005. The manager was available to assist with the inspection. A tour of the building took place and during the five hour inspection twelve residents, four relatives and seven staff were spoken with. 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. Old School House and Courtyard Nursing Home J53-J04 S945 Old School House V223561 170505 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Old School House and Courtyard Nursing Home J53-J04 S945 Old School House V223561 170505 Stage 4.doc Version 1.30 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 standard(s) 3 Residents needs are assessed by a suitably qualified person prior to entering the home. EVIDENCE: Assessments are undertaken by either the proprietor who is a registered mental nurse or the home manager (registered general nurse) depending on the needs of the resident. Care managers carry out assessments on those residents who are not self funding. One resident confirmed that her care manager completed an assessment and she stayed in the home initially for one week prior to moving in permanently. One lady said she remembers the manager coming to her home and asking lots of questions about her health and welfare, another resident recalls coming into the home for a trial visit and filling in an assessment whilst at the home. The assessment documentation was inspected and covered all aspects of physical, social and psychological care, these were user friendly and completed appropriately. A plan of care was then developed using this information. Two relatives confirmed they were aware of the assessment process which was explained to them in detail. Old School House and Courtyard Nursing Home J53-J04 S945 Old School House V223561 170505 Stage 4.doc Version 1.30 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 standard(s) 7,8,10,11 Residents health care needs are met within an environment where privacy and dignity is maintained. EVIDENCE: Care plans are based on the initial assessment which takes place. Four care plans were inspected and all were completed appropriately. A review of the care plans was in place and either the resident or relative had signed the plan of care which had been discussed with them first. Risk assessments for moving and handling, prevention of falls, pressure sore assessments and the use of bed rails were in place. The home carries out individual assessments in addition to these. A progress sheet was completed and three residents spoken with were aware of who their named nurse and key worker was, and the role they had. Staff spoken with confirmed how the system of named nurse and key worker operated in the home. An occupational and diversional therapy plan are in place and completed in detail. Residents are registered with a GP, the home has links with the community psychiatric nurse and consultant psychologist, this was evidenced in the care plans. Access to either Goole, Scunthorpe or the hospitals in Hull are available. The dentist and chiropodist visit when needed. The home liaises with district Old School House and Courtyard Nursing Home J53-J04 S945 Old School House V223561 170505 Stage 4.doc Version 1.30 Page 9 nurses, tissue viability and the dietetic service. Nutritional assessments were carried out and the manager was knowledgeable on how to meet nutritional needs of residents. The accident book was completed correctly and the staff member who observes an incident or fall completes the book. Whilst at the inspection one resident had a fall which resulted in a small bump to the head. The staff telephoned the GP and arranged for a visit as a precaution. This was standard practice. Privacy and dignity in the home was maintained, this was evident throughout the inspection. Staff spoke in a pleasant manner to residents and the bathroom and toilet doors had appropriate vacant and engaged signs to ensure privacy was maintained when in use. All residents looked clean and tidy, one lady had visited the hairdressers that morning and another lady said she had enjoyed a bath. Residents were dressed in smart clothes which they had chosen. Staff were observed knocking on residents doors prior to entering and healthcare professionals consulted in private with residents. The wishes of residents regarding death and dying were well documented. A discussion with the manager confirmed that staff receive training in this area. A Macmillan cancer resource pack is available where staff have a workbook and they discuss a range of potential scenarios in relation to caring for a dying resident. The Macmillan nurse is in regular contact with the home, and the home has links with Dove House hospice. Old School House and Courtyard Nursing Home J53-J04 S945 Old School House V223561 170505 Stage 4.doc Version 1.30 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 standard(s) 12,13,14 Residents social and recreational needs are met. EVIDENCE: The home provides a range of activities which are provided using a team approach. Activities include music to movement, singalongs, word games, reminiscence sessions, bingo, crafts and trips out. An activity agenda is displayed in the entrance hall along with a suggestion box for relatives and competitions including guess how many sweets are in the jar. Residents have given permission to have their photographs displayed in this area. All activities are recorded in individual care plans and these are reviewed on a regular basis. It was evident during the day that residents very much enjoyed the activities provided. One lady who was in the lounge had some photographs of her trip to Hornsea a few weeks ago, she enjoyed a fish and chip lunch and an ice cream. The home organised a sponsored walk over the Humber Bridge again residents chatted about the pleasure they got from this. One lady said she preferred to go to the pub and enjoyed a glass of port wine and chatting to other residents. During the inspection a sing along took place in the lounge, photographs were also passed round and residents were keen to join in. A library service is available and one resident was observed choosing some books. The home is in the process of offering religious services, links are made with Catholic, Methodist and Church of England religious denominations. The manager is aware that she needs to further develop these links. Old School House and Courtyard Nursing Home J53-J04 S945 Old School House V223561 170505 Stage 4.doc Version 1.30 Page 11 Visitors are welcomed into the home at any time. The visitors book was completed and relatives spoken with said they were encouraged to visit, one man said he is always offered tea/coffee or lunch when he visits his relative. Visitors are able to see their relatives in either private or in one of the communal areas. Residents can bring their personal possessions into the home; this was evident when speaking with residents and visiting their rooms. An advocacy service is provided which is advertised in the entrance hall for any residents to contact. Residents discussed how they could get up and go to bed when they wanted and that mealtimes were flexible. Residents meetings take place on a regular basis and a number of residents said they contributed to these meetings. Old School House and Courtyard Nursing Home J53-J04 S945 Old School House V223561 170505 Stage 4.doc Version 1.30 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 standard(s) 16,18 Residents are confident that their complaints are listened to, and they feel safe living in this environment. EVIDENCE: The home has a complaints procedure in place which contains all the relevant information. All residents spoken with were aware of how to complain and who they needed to speak to. Staff spoken with were clear about how the complaints procedure worked. Residents felt they could resolve any issues before making a formal complaint as the manager was open and approachable. One relative said all the staff were wonderful and could not do enough for her sister. The home is not currently dealing with any complaints. The home have an adult protection policy in place which includes whistle blowing and the multi agency vulnerable adults document from the local social services department. Seven staff were spoken with and all were aware of what adult protection was and the different types of abuse an individual may be exposed to. Staff were clear about the action they would take if an incident occurred. Residents spoken with were happy and relaxed in their environment and said they felt well cared for and safe. Staff receive vulnerable adults training as part of their mandatory training. Old School House and Courtyard Nursing Home J53-J04 S945 Old School House V223561 170505 Stage 4.doc Version 1.30 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 standard(s) 19 The home is safe and well maintained. EVIDENCE: The environment is all on ground level, there is a residential area, then nursing and dementia area where residents can socialise together. The home has a refurbishment plan in place. Residents’ rooms inspected were clean, tidy and odour-free. The main lounge area where residents were enjoying some music had a slight smell of urine, this was discussed with the manager. Other communal areas were bright, airy and odour free. Residents spoken with said they enjoyed going outside and that all areas were well maintained. Old School House and Courtyard Nursing Home J53-J04 S945 Old School House V223561 170505 Stage 4.doc Version 1.30 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28 The home provides appropriately qualified staff in sufficient numbers. EVIDENCE: Staffing levels in the home are good. The manager is supernumerary and the deputy works on the floor. For forty six residents there are on average two trained staff and seven carers. All residents spoken with felt there was always enough staff and they did not have to wait to be attended to. Staff caring for residents with dementia have undertaken some training and the manager feels residents needs can be met. The home feels that staffing levels need to be maintained as there are a mix of residential, nursing, dementia care and terminally residents who need a range of care and attention. Staff spoken with felt that staff morale was high which was helped by having adequate staffing levels. The home have over 50 of care staff with an NVQ Level 2 qualification or above, this benefits the residents as the quality of care is more consistent and is regularly monitored. Old School House and Courtyard Nursing Home J53-J04 S945 Old School House V223561 170505 Stage 4.doc Version 1.30 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32 The home is well managed and run. EVIDENCE: The manager of the home is a registered general nurse who has completed her NVQ Level 4 in management. She has worked at the home for over eight years and runs the home in an efficient and professional manner. All seven staff spoken with felt she was open, approachable and accessible at all times. The manager spends time observing practice on the floor and clearly residents and relatives feel her presence is beneficial. The manager is aware of the homes aims and objectives and has a good rapport with staff, residents, relatives and healthcare professionals. The manager has a clear commitment to training and development of all staff. This was confirmed when speaking with staff. Old School House and Courtyard Nursing Home J53-J04 S945 Old School House V223561 170505 Stage 4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 x COMPLAINTS AND PROTECTION 2 x x x x x x x STAFFING Standard No Score 27 3 28 3 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x 3 3 x x x x x x Old School House and Courtyard Nursing Home J53-J04 S945 Old School House V223561 170505 Stage 4.doc Version 1.30 Page 17 no 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 Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP19 Good Practice Recommendations The smell of urine in the main lounge should be removed Old School House and Courtyard Nursing Home J53-J04 S945 Old School House V223561 170505 Stage 4.doc Version 1.30 Page 18 Commission for Social Care Inspection 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 Old School House and Courtyard Nursing Home J53-J04 S945 Old School House V223561 170505 Stage 4.doc Version 1.30 Page 19 - 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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