Inspection on 22/01/07 for Quarry Bank

This inspection was carried out on 22nd January 2007.

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.

Other inspections for this house

Quarry Bank 17/10/08

Quarry Bank 29/10/07

Quarry Bank 30/01/06

Quarry Bank 07/09/05

Quarry Bank 14/02/05

Quarry Bank 06/09/04

Quarry Bank 09/03/04

Similar services:

Abbey The

Snydale Care Home

Hawkhills

Larchfield Manor

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 Quarry Bank Woodfield Lane Hessle East Yorkshire HU13 0ES Lead Inspector Pam Dimishky Key Unannounced Inspection 22nd January 2007 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 DS0000019712.V328282.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. DS0000019712.V328282.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Quarry Bank Address Woodfield Lane Hessle East Yorkshire HU13 0ES 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) 01482 648803 F/P01482 648803 Mr Anthony Mould Paul Nicholas Mould Miss Donna Marie Hutchinson Care Home 23 Category(ies) of Dementia (3), Dementia - over 65 years of age registration, with number (23), Old age, not falling within any other of places category (23) DS0000019712.V328282.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 1. Service users in category DE to be 60 to 65 years of age. Date of last inspection 30th January 2006 Brief Description of the Service: Quarry Bank is a privately owned care home for older people; a ‘sister’ home is situated nearby. The home is accommodated in a large, old, detached house that is located in a residential area of Hessle. It accommodates both male and female residents over the age of 65, including residents with dementia, and up to three residents aged 60 to 65 years with dementia. The accommodation includes two lounges, a dining room and a conservatory; there are five single rooms and nine shared rooms. All areas of the home are accessible to residents via the use of a passenger lift, portable chair lift and ramps. There is a pleasant garden with greenhouse and seating area, which is also accessible to residents. A large ramp enables wheelchair access to the front entrance of the home. A small car park is located to the front of the building. The home is close to a bus route and the railway station and is close to local amenities that include shops, pubs, cafes, hairdresser banks and a post office. The home’s current scale of charges range from £328.80 to £386. Additional charges include hairdressing (£5.50 - £12.00),chiropody (£10.00), papers (various prices), toiletries (various prices) and trips out (various prices). DS0000019712.V328282.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over 5.75 hours with one inspector. This was an unannounced inspection and one requirement and three recommendations made at the last inspection remain outstanding. The inspector looked round all of the building and a number of records were also inspected. A number of residents, two relatives, two members of staff and the manager were spoken to and other residents and staff observed. What the service does well: What has improved since the last inspection? DS0000019712.V328282.R01.S.doc Version 5.2 Page 6 A programme for maintenance, refurbishment and redecoration of the home is in place and is ongoing. Since the last inspection the hall stairs and landing have been redecorated and the hall and staircase have new carpet. A daily diary is now being kept for the kitchen, which includes a cleaning schedule and food provided each day. The home’s ongoing training programme ensures staff are qualified and up to date. 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. The summary of this inspection report can be made available in other formats on request. DS0000019712.V328282.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 DS0000019712.V328282.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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The assessment procedure includes a proper assessment being made of residents moving into the home to ensure the home can meet their needs. EVIDENCE: The manager visits prospective residents either in their own home or hospital to assess whether the home can meet their needs; a letter is sent to the resident confirming the home can meet their assessed needs. For residents placed through the local authority, the home obtains a copy of the care management assessment and care plan. Case records examined included the assessment made by the home, which is very detailed and covers all the areas listed in the national minimum standards. From the home’s assessment, and if appropriate care management’s assessment and care plan, the home then develops its own care plan. One contract was seen in the three case records examined and had been signed by the family. The manager stated contracts were in placed for the other two residents but these could not be found at the time of the inspection. (copies of these contracts were forwarded to the Commission following the inspection). Visitors informed the inspector they DS0000019712.V328282.R01.S.doc Version 5.2 Page 9 had been involved in the assessment process and their relative had been able to visit the home before moving in. The home is not registered for people requiring intermediate care. DS0000019712.V328282.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents individual health, personal, and social care needs are identified and met by the home. EVIDENCE: Three case records were examined and seen to include a detailed needs assessment, from which the care plan is developed, and where appropriate care management assessment care plan. Good daily notes made of the care provided evidence the care plan is being met. Key workers take ownership for their case records and are responsible for updating and changing care plans. Although both the manager and relatives of one resident confirmed the care plan is developed in conjunction with the resident and agreed by them, two plans had not been signed. However, the key worker discussed the care plan individually with the resident during the course of the inspection and obtained the residents’ signatures indicating their agreement. The home has arrangements in place to access support services, including district nurse, community psychiatric nurse, chiropodist, optician, dentist, who visit the home and also provide advice. DS0000019712.V328282.R01.S.doc Version 5.2 Page 11 The home uses a monitored dosage system (MDS) for administering medications and three residents’ medications, and administration records were checked and found to be in order. However, staff had not commenced using the blister packs on the right days, leaving some tablets in the pack. The manager stated the tablets will be returned to the pharmacy when the medication is re-ordered and she is to discuss the matter with the staff. The records of medications returned to the pharmacy was examined and seen to be in order. Since the last inspection a book for recording the issuing of controlled drugs has had the pages manually numbered. The book is almost complete and the manager stated she is to obtain a properly pre-printed book for the purpose, which will meet the Royal Pharmaceutical Society’s guidelines for recording the administration of controlled drugs. The pharmacist supplying medications to the home has not visited since July 2004 to check medications, medication records and storage despite the manager making numerous requests. The manager was advised to continue her efforts to persuade the pharmacy to meet its contractual obligations. Residents said they felt they were treated with respect and staff interviewed were able to demonstrate how they maintain residents privacy and dignity. DS0000019712.V328282.R01.S.doc Version 5.2 Page 12 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. 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 this service. Daily life and social activities in the home meet the expectations and preferences of the residents. EVIDENCE: The home has a policy for residents maintaining contact with relatives and friends. Care staff, relatives and friends take residents for days out of the home; on occasions, one resident stays overnight with her son and another receives regular telephone calls from his sister in Canada. Key workers and relatives assisted residents with their Christmas shopping and relatives were also present for the Christmas lunch and entertainment at Darleys public house. Relatives of one resident said how much they had enjoyed the Christmas party held in the home. The home made arrangements for most residents to attend the local church for the Christmas carol concert. The Blind Institute visit throughout the year and demonstrate aids that are available for people with impaired sight. Visitors are made welcome at any reasonable time and residents can choose whom they see and do not see. A monthly programme of activities, compiled by a member of the care staff, is displayed in the entrance hall for residents and visitors. On the day of the inspection a music afternoon was being held and some residents were up and dancing with staff. Although the programme does not cover every day, staff informed the inspector activities take place every day. One resident who is DS0000019712.V328282.R01.S.doc Version 5.2 Page 13 good at painting has been trying to involve other residents with painting and art work with limited success. A communion service is held every month in the home and residents attend church for special religious festivals eg Christmas, Easter. Questionnaires completed by the residents indicated there is always/usually activities taking place they can take part in. Two weeks menus included with the pre-inspection questionnaire indicate choices for breakfast, lunch and tea. The daily menu is displayed in the dining room and the cook visits residents every morning for their choice for the day. Residents were observed having lunch of beef stew and dumplings, with vegetables, followed by chocolate sponge and custard; they appeared to enjoy their meal which was nicely presented and plentiful. One resident said he had two breakfasts and two puddings at lunchtime other residents were observed having an alternative to the chocolate sponge. During the course of the inspection a resident asked the manager if more rice dishes could be provided and whether borscht was available; she agreed to make arrangements with the cook indicating individual choices are being met. It was also evident residents can choose where they dine. DS0000019712.V328282.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home has a satisfactory complaints system, vulnerable adults policies and procedures and programme for staff training which ensures residents are protected from abuse. EVIDENCE: No complaints have been recorded since the last inspection a year ago. The home had commenced recording the smallest of “niggles” which enabled the manager to monitor any patterns that may have emerged. However, despite being an agenda item for staff meetings, these too have not been recorded. It was clear from conversations with residents and relatives that anything of concern, brought to staff or the manager’s attention, is always resolved but it would be good practice to keep a record and evidence of how matters are resolved. A copy of the complaints procedure is displayed in the entrance hall. All staff have training in protecting vulnerable adults from abuse and the home has a policy and procedure as well as a copy of the Hull and East Riding multiagency guidelines for the protection of vulnerable adults. DS0000019712.V328282.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The standard of the environment within this home is generally good providing residents with an attractive, clean and homely place to live. However, the call alarm system does not extend to communal areas of the home which does not therefore maximise residents independence. EVIDENCE: The location and layout of the home is suitable for its stated purpose. There is an ongoing refurbishment and redecoration programme and since the last inspection the entrance hall, stairs and landing have been redecorated and the hall and stairs has had new carpet fitted. Planning permission has been obtained for an extension to the home, and the manager stated quotes to do the work are being obtained. There is no call alarm system operating in either lounge, dining room or conservatory which does not maximise the independence of the residents whilst in those areas. Bedroom 12 has a large skylight window immediately above one bed in this shared room. However, the room is occupied by only one person at present and the manager stated it has been ascertained this resident prefers the light to come into the room; a DS0000019712.V328282.R01.S.doc Version 5.2 Page 16 blind, or similar arrangement, should be fitted to the window to give choice to the resident(s) occupying this room. All bedrooms are comfortably furnished and some were seen to be personalised with the residents’ belongings and memorabilia. The manager has obtained a “Safer Food Better Business Record” book for recording kitchen practice including cleaning schedules, temperature records and food preparation. Bathroom hot water temperatures are checked and recorded weekly and a thermometer is used to test water temperatures on each occasion a resident is bathed. Alcohol gel, soap and paper towel dispensers are installed in bathrooms as part of infection control practice. The home has obtained an “odour blaster” which is proving to be reasonably successful in their efforts to maintain an odour free environment; visitors to the home are encouraged to give feedback regarding any areas they identify with an odour. However, despite the best efforts of staff, three rooms had an unpleasant odour at the time of this inspection. DS0000019712.V328282.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 &30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff are well trained and competent, and deployed in such numbers to meet the needs of the residents at all times. However, although overall recruitment practice is good job application information needs to improve to ensure residents are protected from the risk of abuse. EVIDENCE: Nineteen residents reside in the home at the present time who are cared for by three staff on early and late shifts and two at night. Dependency levels overall are reduced since the last inspection and takes into account five residents who are self caring. The manager stated she keeps the dependency levels under review at all times and increases staffing levels to meet the identified needs of the residents. The home has a very good training programme and the manager stated 74 of staff have achieved NVQ level II or above; one staff member is currently taking level IV and fourteen staff have a first aid certificate. Staff files for the last three recruits were seen to include all the information required by regulation. However, job applications did not provide actual dates for employment history, only years. The manager stated she would ensure future applications included the actual dates of employment and she would explore any gaps during interview. Criminal record bureau checks are being applied for before new recruits commence work and only following a pova first check do they actually commence work under supervision; this person also acts as mentor and undertakes 12 weeks induction before the employment is reviewed by the manager and a contract issued. Staff are motivated by the home’s bonus scheme for good staff performance and for DS0000019712.V328282.R01.S.doc Version 5.2 Page 18 NVQ qualifications. The two members of staff interviewed were well qualified not only in mandatory subjects but also in specialist areas. They talked about giving residents choices, their rights, being treated as individuals and being aware of cultural differences. They were able to demonstrate how they maintain residents privacy, dignity and confidentiality. All care staff observed during the course of the inspection were relaxed and seen to have good, caring interaction with the residents. Residents spoke highly of the staff and the care they receive; this was also endorsed by visiting relatives. DS0000019712.V328282.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is being managed well and there is leadership, guidance and direction to staff to ensure residents receive consistent quality care; the health, safety and welfare of residents and staff are promoted and protected. EVIDENCE: The manager has worked at Quarry Bank since 2001 and is competent and experienced to run the home. She has NVQ levels II and III in care, the D32/33 NVQ assessors Award and both she and the registered provider have the Registered Managers Award; the manager completes NVQ IV in care at the end of March. The home has the Investors in People award and parts one and two of the local authority quality development scheme which is subject to an annual performance review. The manager does monthly audits and checks the building daily. Residents financial interests are safeguarded by the homes policies and procedures. Small amounts of money held by the home on behalf DS0000019712.V328282.R01.S.doc Version 5.2 Page 20 of three residents were checked and found to balance with the records; receipts are kept for all expenditures. Copies of staff meeting minutes for June, October and November 2006 were seen and indicate these are not well attended. Staff interviewed confirmed they are receiving monthly supervision. There is an ongoing programme for updating staff with mandatory training and fourteen staff hold a current first aid certificate. Staff interviewed said only lighter residents are moved by two members of staff following a risk assessment and in accordance with the home’s policy and procedure for lifting. Only one resident needs a hoist at present and staff are up to date with moving and handling training. All staff have fire safety training twice a year which is done in house by using a video and completing a questionnaire. Fire alarm and emergency lighting records were checked and up to date. Accident records were checked and seen to be appropriately recorded; the manager was to explore reference to a doorstop being used in the case of one accident record. The pre-inspection questionnaire indicated maintenance records are up to date. A random check confirmed the current landlord’s gas safety certificate is dated 11/1/07, the passenger lift had a thorough examination 7/9/06 and a contractor has been booked to check the hoists. DS0000019712.V328282.R01.S.doc Version 5.2 Page 21 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 3 X X X X N/a HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 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 2 17 X 18 3 2 X X 3 x X X 3 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 2 X 3 X 3 X X 3 DS0000019712.V328282.R01.S.doc Version 5.2 Page 22 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 OP22 Regulation 23 Requirement The communal areas must all have a call alarm facility (Outstanding requirement) Timescale for action 31/03/07 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 OP9 OP9 Good Practice Recommendations A bound register with numbered pages should be used to record the administration of controlled drugs The manager must continue her efforts to arrange with the supplying pharmacist to make checks in the home of medication, the records and storage and for the pharmacist to provide a report Staff must be trained to ensure residents medication is removed from the blister pack on the correct day It is good practice to record all areas of concern no matter how small The skylight in bedroom 12 should have a means of giving the resident(s) the choice of keeping out the light, particularly at night Ensure job applications include a full service history and DS0000019712.V328282.R01.S.doc Version 5.2 Page 23 3 4 5. 6 OP9 OP16 OP19 OP29 7 OP31 any gaps are explored The manager should continue with her efforts to obtain an NVQ level IV (or equivalent) in care DS0000019712.V328282.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Hessle Area Office First Floor, Unit 3 Hesslewood Country Office Park Ferriby Road Hessle HU13 0QF National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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. 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