Inspection on 05/09/05 for Priceholme

This inspection was carried out on 5th 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.

Other inspections for this house

Priceholme 02/05/07

Priceholme 10/01/06

Priceholme 26/01/05

Priceholme 13/08/04

Similar services:

Snydale Care Home

Abbey The

Larchfield Manor

Hawkhills

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Priceholme Givendale Road Scarborough North Yorkshire YO12 6LE Lead Inspector M.A. Tomlinson Unannounced 5 September 2005 09:30 th 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. Priceholme J53-J04 S7666 Priceholme S244602 310805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Priceholme Address Givendale Road Scarborough North Yorkshire YO12 6LE 01723 361022 01723 500159 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) Methodist Homes for the Aged Mrs Elizabeth Dawson Care home only 33 Category(ies) of DE(E) Dementia - over 65 (6) registration, with number OP Old age (33) of places Priceholme J53-J04 S7666 Priceholme S244602 310805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Registered for thirty-two elderly service users, six of whom may also have dementia. Date of last inspection 26th January 2005 Brief Description of the Service: Priceholme is one of group of care establishments operated by the Methodist Homes for the Aged (MHA) and was built for purpose. The property is located in a residential area on the north side of Scarborough and is conveniently situated for all of the main community facilities. It is adjacent to a Methodist Church that has strong connections with the home and is within walking distance of local shops. Personal care and accommodation is provided for a maximum of thirtythree older people some of whom may also have mild to moderate dementia. Nursing care is not provided. Should such care be required on a short-term basis then it will be provided by the community healthcare services. The detached property has large landscaped gardens that have seating for use by the service users. There are parking spaces for several vehicles and unrestricted on-road parking is also available. The service users accommdation is located on two floors, the upper floor being accessed by a passenger lift and stairs. The care home has 31 single and one double bedroom all of which have en suite facilities consiting of a toilet and a washhand basin. One specific bedroom is used for short-term care. There is a choice of lounges and sitting areas and a diningroom is located on the ground floor. The home has special equipment and is appropriately designed for use by service users who have mobility problems. The home has a stated Christian ethos based on the Methodist denomination. This does not, however, exclude admission for service users with other, or no, religeous beliefs. Priceholme J53-J04 S7666 Priceholme S244602 310805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the first of two unannounced statutory inspections of Priceholme to be undertaken by the Commission for Social Care Inspection during this inspectoral year. The inspection took six and a half hours including one hour of preparation time. The registered manager was available throughout the inspection. An inspection of the property and a number of statutory records was carried out. The majority of staff on duty were spoken to. Eight service users were spoken to both individually and as a group. 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. Priceholme J53-J04 S7666 Priceholme S244602 310805 Stage 4.doc Version 1.40 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 Priceholme J53-J04 S7666 Priceholme S244602 310805 Stage 4.doc Version 1.40 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) 1,3 and 6 Prospective service users, or their representatives, were provided with adequate information on which they could make a considered and informed decision as to whether they wished to live in the home. EVIDENCE: The home had developed a comprehensive Service Users’ Guide that formed part of the information pack provided for all new service users. From the information provided prospective service users and the families were able to make a considered decision on whether the home was appropriate for them and was able to meet their needs. All of the service users had been provided with a Statement of the Conditions and Terms of their residence in the home. Either the service user concerned or their representative had signed it in agreement. Whilst the home is registered to admit up six people with dementia, the registered manager was very clear as to the level of care that could be provided for such service users. In general only service users with mild or moderate dementia could be care for. The manager provided examples where a service user’s dementia had required them to move to more specialised accommodation. The home’s Statement of Purpose and the Service Priceholme J53-J04 S7666 Priceholme S244602 310805 Stage 4.doc Version 1.40 Page 8 Users’ Guide did not, however, fully define the types and level of dementia that could be addressed by the staff. The care records of four service users were examined. There was recoded evidence that the service users had been assessed prior to their admission into the home. This was generally undertaken either by the manager or one of the senior members of staff. The assessments were reasonably comprehensive and in addition to identifying the prospective service user’s primary needs it also identified their interests and abilities. The service user concerned or their representative had signed the assessment in agreement. Where possible prospective service users had been encouraged to visit the home or stay on a short-term basis until they made a decision regarding admission. Several of the service users spoken to confirmed that they had done this. Intermediate care was not provided by the home. Priceholme J53-J04 S7666 Priceholme S244602 310805 Stage 4.doc Version 1.40 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 standard(s) 7,8,9,10 and11 The service users’ health and social care needs were well met with good support being provided by the staff and health and social care professionals. EVIDENCE: All of the service users had been provided with a personal care plan developed jointly between them and the home. Some also had a care plan implemented by their placing agency. It was noted that the home had not been provided with a care plan or an assessment for a service user who had been admitted on a ‘holiday basis’ from one of the other MHA establishments. It was observed, however, that a senior member of staff endeavoured to obtain the required information from the service user concerned shortly after their arrival at Priceholme. The care plans were reasonably comprehensive and subdivided the service users’ needs into manageable elements of care. The care plans also included a profile of the service user and a range of risk assessments. The care plans were linked into the daily records and from discussions with the staff, it was evident that they were seen as important tools by which the staff could deliver a consistent package of care. All of the service users spoken to were aware of their care plans and of the records maintained on them. Priceholme J53-J04 S7666 Priceholme S244602 310805 Stage 4.doc Version 1.40 Page 10 From an inspection of the records and discussions with the service users, it was evident that the service users health care needs were met through good levels of input from health care professionals. During the morning of the inspection, for example, a Medical Practitioner, a District Nurse and a Physiotherapist visited service users. The District Nurse said that in her opinion the home provided a good service and that the staff were always willing to take advice from her. It was evident that the service users were encouraged to take physical exercise and that it was included in some activity groups. The service users were registered with a range of medical practices and, according to the manager, a good service was provided by all of these practices. The records also confirmed that the service users had access to support services such as opticians, dentists and chiropodists. Where necessary these services would visit the home. The home continued to use a monitored dosage system for the administration of the service users’ medication. The medication was appropriately secured and the administration records were up to date. No controlled drugs were in use. Several service users fully or partially self-administered their medication and had been provided with lockable cabinets in their rooms in which to keep it. The service users confirmed that the staff treated them with appropriate respect and were never rude. They also confirmed that they had locks on their bedroom doors to ensure their privacy. Several, however, said that they had chosen not to lock their doors. Arguably the most important facility, according to the service users, was the provision of en suite facilities. The home had a policy and procedure regarding the care of service users during their final days of life. It was evident, however, from discussions with the staff that considerable emphasis was placed on this particular facet of care by ensuring that the service user concerned had continuous support and was never left alone. In some cases the assistance of other service users had been obtained to sit with the dying person. From discussions with the service users that this had been done willingly. A service of thanksgiving was invariably held in the home following the death of a service user. Priceholme J53-J04 S7666 Priceholme S244602 310805 Stage 4.doc Version 1.40 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 standard(s) 12,13,14 and 15 The service users were provided with a range of social activities that promoted good standards of mental and physical wellbeing. EVIDENCE: The service users expressed satisfaction with their quality of life in the home and particularly commended the efforts of the staff to provide a homely and relaxed environment. The majority of the service users had an idea prior to their admission into the home of the facilities and services provided. Whilst some felt rather depressed at the prospect of old age, others saw life in the home as an opportunity to retain their independence and lead a reasonably active life. For example, one service user said that they went out every day to buy a newspaper, cleaned their room and did their own laundry. They said that they enjoyed being busy. The service users confirmed that there was a good programme of activities both within and external of the home. The home employed two activity organisers to implement this programme of social events. On the day of the inspection service users were being taken to a seaside chalet by volunteers (Friends of Priceholme). According to the service users this was arranged during two weeks each year and every service user had the opportunity to participate. The service users gave examples of other activities that stimulated them mentally and improved their dexterity. Priceholme J53-J04 S7666 Priceholme S244602 310805 Stage 4.doc Version 1.40 Page 12 The service users confirmed that they were able to have visitors at any time. It was observed that visitors generally took the service user out. The majority of the service users had regular visitors. The menus indicated that the service users were provided with a varied and balanced diet. All of the service users expressed satisfaction with the standard of the meals although there had been occasions where issues of dissatisfaction had been discussed with the manager. These were, according to the service users, invariably addressed. The main meal of the day was taken at lunchtime. It was evident that emphasis was placed on the use of fresh meat, vegetables and fruit. There was a genuine choice of main course and the service users had made a choice prior to the meal. All of the service users spoken to were aware as to what was on the menu. Whilst the meat was ‘plated up’, the vegetables were served in tureens. The service users said that they preferred this as they could serve themselves and it allowed them to make a choice as to what, and how much, they wanted. The staff assisted the service users with patience and respect. The dining room was enhanced by the use of table clothes and matching napkins. The conversations during the meal were natural and spontaneous. Priceholme J53-J04 S7666 Priceholme S244602 310805 Stage 4.doc Version 1.40 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and 18 The service users had access to the complaints procedure and felt that their views and opinions were taken seriously by the staff and, where possible, acted upon. EVIDENCE: An appropriate complaints procedure was in place and was readily available to services users and visitors to the home. From discussions with the service users it was apparent that any issues that may become complaints were quickly identified by the staff and acted upon. Each wing of the care home had a service user who acted as a representative on behalf of the other service users accommodated in that area. One of the representatives confirmed that they regularly sought the views of the service users and that these issues were regularly discussed with the manager. The representative provided examples of issues that had been addressed. It was observed that the manager employed an open style of management and actively encouraged service users and visitors to discuss problems before they became formal complaints. A policy and procedure on Adult Protection was available. The majority of the staff had received training on the subject. Priceholme J53-J04 S7666 Priceholme S244602 310805 Stage 4.doc Version 1.40 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,20,21,25 and 26 The service users were provided with an appropriate and comfortable environment in which they could lead a meaningful lifestyle at their own pace. EVIDENCE: The premises were clean and were maintained, decorated and furnished to a good standard. The service users expressed satisfaction with their accommodation and considered the en suite facilities to their rooms as being essential. The range and number of sitting areas and lounges provided the service users with a choice as to where and with whom they preferred to sit. Whilst several of the service users were incontinent, there was no physical evidence of this. It was evident from a discussion with a domestic that they considered the standard of cleanliness to be important. The service users’ rooms were cleaned very day and the carpets were frequently shampooed. The service users confirmed that the high standard of cleanliness was the norm. Since the previous inspection the staff on-call room, which is not used for such, had been converted into a short-stay bedroom with en suite facilities. Priceholme J53-J04 S7666 Priceholme S244602 310805 Stage 4.doc Version 1.40 Page 15 During the coming weeks the main kitchen is to be refurbished and contingency plans were in place to ensure that the service users continued to be provided with meals of an appropriate standard. Priceholme J53-J04 S7666 Priceholme S244602 310805 Stage 4.doc Version 1.40 Page 16 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) 27,28,29 and 30 The level of staffing was adequate to ensure that the primary needs of the service users were met at all times of the day and night. Staff morale was good thereby resulting in an enthusiastic workforce that worked positively with the service users in order to improve their quality of life. EVIDENCE: The day staffing hours taken from the home’s records indicated that there had been no regression in terms of hours since the previous inspection. The night staffing continued to consist of two staff on duty with the manager or a senior member of staff on call. The staffing roster confirmed this. The service users confirmed that there always staff readily available both during the day and the night and that they responded to the call system promptly. The staff team represented a reasonable balance in terms of age experience and gender. Whilst the staff had specific roles, it was evident that they had common aims insofar as ensuring the safety and welfare of the service users. The home continued to employ a robust recruitment and selection procedure that involved full vetting of a prospective member of staff before they took up their post in the home. The staff records confirmed that the staff had been Priceholme J53-J04 S7666 Priceholme S244602 310805 Stage 4.doc Version 1.40 Page 17 provided with training in statutory subjects such as first aid and moving and handling. Of the nineteen care staff, ten had either achieved, or were in the process of achieving, a National Vocational Qualification. Some staff said that they were reluctant to undertake such a qualification due to the time involved. It was evident that good lines of communication existed in the home and that formal shift handovers were undertaken by staff during which every service user was briefly discussed. Priceholme J53-J04 S7666 Priceholme S244602 310805 Stage 4.doc Version 1.40 Page 18 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) 31,33,35 and 38 The manager had a good understanding of how the service could be improved and was aware of how this improvement would be resourced and managed. EVIDENCE: The registered manager continued to employ a democratic style of management and encouraged the staff to undertake responsibilities in keeping with their role. It was evident from discussions with the manager that all decisions in the home were taken for the benefit of the service users. The service users had established a good relationship with the manager and several respectfully referred to her as ‘the boss’. The service users said that they would not hesitate in taking a problem directly to the manager. Priceholme J53-J04 S7666 Priceholme S244602 310805 Stage 4.doc Version 1.40 Page 19 Service users’ fees had been paid directly by bank transfer to the Headquarters of Methodist Homes for the Aged. Where it had become necessary for staff to handle service users’ personal monies records had been maintained. From discussions with the staff and an inspection of the premises, it was evident that the manager had taken all appropriate action to ensure that the service users and staff were provided with a safe environment. Priceholme J53-J04 S7666 Priceholme S244602 310805 Stage 4.doc Version 1.40 Page 20 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 2 x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 4 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 3 COMPLAINTS AND PROTECTION 3 3 4 x x x 3 4 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 x 3 x 3 x x 3 Priceholme J53-J04 S7666 Priceholme S244602 310805 Stage 4.doc Version 1.40 Page 21 N/A 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 None 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. 2. Refer to Standard 1 7 Good Practice Recommendations The homes Staement of Purpose and the Service Users Guide should be reviewed and amended to clearly show the degree of dementia that can be addressed by the staff. Service users admitted from other MHA establishments on a short-term basis should be accommpanied with an assessment and a current care plan. Priceholme J53-J04 S7666 Priceholme S244602 310805 Stage 4.doc Version 1.40 Page 22 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 Priceholme J53-J04 S7666 Priceholme S244602 310805 Stage 4.doc Version 1.40 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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. 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