Inspection on 30/01/06 for Quarry Bank

This inspection was carried out on 30th January 2006.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Quarry Bank 17/10/08

Quarry Bank 29/10/07

Quarry Bank 22/01/07

Quarry Bank 07/09/05

Quarry Bank 14/02/05

Quarry Bank 06/09/04

Quarry Bank 09/03/04

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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 Unannounced Inspection 30th January 2006 09:45 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 Quarry Bank DS0000019712.V279229.R01.S.doc Version 5.1 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. Quarry Bank DS0000019712.V279229.R01.S.doc Version 5.1 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 01482 648803 Mr Anthony Mould Paul Nicholas Mould Miss Donna Marie Hutchinson Care Home 23 Category(ies) of Dementia - over 65 years of age (23), Old age, registration, with number not falling within any other category (23) of places Quarry Bank DS0000019712.V279229.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 7th September 2005 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. 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. Quarry Bank DS0000019712.V279229.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over 6.5 hours (including preparation) with one inspector. This was an unannounced inspection and requirements and recommendations made at the last inspection have almost been met. One requirement, which will be addressed on completion of the proposed extension, and three recommendations (one is ongoing until the end of the year) remain outstanding. The inspector looked round all of the building and a number of records were also inspected. Six of the twenty-one residents were spoken to and others were observed. What the service does well: What has improved since the last inspection? Quarry Bank DS0000019712.V279229.R01.S.doc Version 5.1 Page 6 Improvements are seen to be ongoing. The replacement conservatory is now in place and improvements in the garden are taking place ahead of the proposed extension being built. There is an ongoing programme for refurbishment and redecoration and two bedrooms have been redecorated with new curtains fitted; five new commodes have also been obtained. 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. Quarry Bank DS0000019712.V279229.R01.S.doc Version 5.1 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 Quarry Bank DS0000019712.V279229.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2,3 and 6 The admission 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. The assessment made by the home is very detailed and covers all the areas listed in the national minimum standards. From the home’s own assessment, and if appropriate care management’s assessment and care plan, the home then develops its own care plan. The home is not registered for people requiring intermediate care. Quarry Bank DS0000019712.V279229.R01.S.doc Version 5.1 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10 Residents care plans have sufficient detail to provide staff with the information they need to satisfactorily meet residents assessed needs and there is evidence of good multi-disciplinary working taking place to support the care given. However, it was evident one resident’s oral hygiene needs had not been met. The systems for the administration of medication are good with clear and comprehensive arrangements being in place to ensure residents’ medication needs are met. All staff have received training in administration of medications making sure appropriate procedures are followed to safeguard residents. However, until the supplying pharmacist has visited the home to check medications, records and storage residents safety in the use of medication cannot be guaranteed. EVIDENCE: Three care plans were examined and the needs assessments, from which the plan is developed, were seen to cover all the areas detailed in the national minimum standards ensuring care and social needs are met; care management assessments and care plans and risk assessments made by the home are also included. One of the care plans included the need for the resident to be assisted daily with cleaning their dentures and it was evident this need had not Quarry Bank DS0000019712.V279229.R01.S.doc Version 5.1 Page 10 been met. However, the manager addressed this shortfall during the course of the inspection. Care staff make good daily records of the care provided and key workers make detailed weekly notes although these were not all up to date. The manager reviews and updates care plans monthly or as needed. The district nurse, community psychiatric nurse, continence advisor, optician, dentist and chiropodist are all visiting the home providing support and advice with evidence good multi-disciplinary working is taking place on a regular basis. Social services arrange annual reviews or as requested by the home and these reviews were seen to have taken place recently in the records examined. Care plans are signed by the resident indicating their agreement to the care to be delivered. Policies and procedures are in place for dealing with medications and all staff have completed the Boots medication training. No resident self-medicates at present. Three drug administration records, the associated medications and the drugs return book were checked and found to be in order. Records for the administration of controlled drugs are being kept in a note-book which does not meet the Royal Pharmaceutical Society’s guidelines for entries to be made in a register with numbered pages. Despite reminders from the manager, the supplying pharmacist has not made any checks of the medications, records and storage since July 2004. These visits are well overdue and the manager should continue her efforts in arranging for these checks to be made so residents’ safety in using medications is guaranteed; a report must also be provided to the home. The home has adequate mobile screens for shared rooms and residents said their privacy and dignity is always maintained. Quarry Bank DS0000019712.V279229.R01.S.doc Version 5.1 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13 and 15 Residents are able to take advantage of activities provided by the home and are able to participate in community and family life. Meals are nutritious and balanced and offer a healthy and varied diet for 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 daily telephone calls from her daughter in Australia. One resident’s care plan recorded a request to be taken to the shops and receipts were seen for clothing he had purchased soon after from a shop in Hull city centre. Key workers and relatives assisted residents with their Christmas shopping and relatives were also present for the Christmas lunch at Darleys and the Christmas party held in the home. Visitors are made welcome at any reasonable time and can be received in private. Residents can choose whom they see and do not see and information regarding visiting is included in the service user guide. A member of the care staff compiles a monthly activities programme which is displayed in the entrance to the home. Although some residents told the inspector nothing happened and they were bored, it was evident the programme has a variety of events, and staff confirmed there is something for Quarry Bank DS0000019712.V279229.R01.S.doc Version 5.1 Page 12 residents to do every day, but sometimes they choose not to participate. Music afternoons are held twice a week and residents are able to dance to the music, some with the assistance of the staff. The hairdresser also holds a weekly bingo session in the home. A communion service is held every month in the home and residents attend church for special festivals eg Christmas, Easter. Regular trips to Darleys for a pub lunch and to play bingo are a regular feature in the activities programme. The blind institute visit throughout the year and demonstrate aids that are available for people with impaired sight. The menu for the day is displayed in the dining room and the cook visits residents daily to identify their choices for the day. On the day of the inspection residents were observed enjoying pork stew and dumplings, or sausages, mashed potato and vegetables followed by rice pudding. A record is kept of the lunch and tea provided each day to each resident; the teatime menu for the day of inspection was fishcake, chips and beans or jacket potatoes with a choice of filling or sandwiches followed by fruit and cream or cake. Quarry Bank DS0000019712.V279229.R01.S.doc Version 5.1 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 the following standard(s): 16 and 18 The home has a satisfactory complaints system with evidence that residents feel that their views are listened to and acted upon. Vulnerable adults policies, procedures and staff training ensure that residents are protected from abuse. EVIDENCE: A record of complaints is being kept by the home and includes the smallest of “niggles” residents may have. Apart from one, all entries were seen to be satisfactorily resolved and the manager later confirmed this too had been satisfactorily resolved. Residents spoken to said they felt quite comfortable in raising any concerns they had with the manager knowing these would then be sorted out. A copy of the complaints procedure is included in the information pack given to all residents and a copy is displayed in the entrance hall. Information is also included in the procedure how to refer a complaint to the Commission for Social Care Inspection. 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. Small amounts of money held by the home on behalf of three residents were checked and found to be correct; receipts are kept for any expenditures. Quarry Bank DS0000019712.V279229.R01.S.doc Version 5.1 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 the following standard(s): 19,22 and 26 The standard of the environment within this home is generally good providing residents with an attractive, clean and homely place to live. The call alarm system does not maximise residents independence in communal areas of the home. EVIDENCE: The location and layout of the home is suitable for its stated purpose. There is a proposed refurbishment programme for the year and the manager is planning the redecoration of bedrooms with matching bed linen and curtains. An extension to the property has been agreed and some of the refurbishment programme will take place as part of this work. Improvements continue to be made to the gardens with a pond being filled in and seating area created in its place at the time of the inspection; the replacement conservatory has been completed since the last inspection. There is no call alarm system operating in the lounges, dining room or conservatory and the manager stated this will be installed as part of the work for the new extension. Bedroom 12 has a large skylight window immediately above one resident’s bed in this shared room. No Quarry Bank DS0000019712.V279229.R01.S.doc Version 5.1 Page 15 one is occupying the bed at present and the manager stated she is looking to provide some covering for the window to obscure the light on bright, sunny mornings. All bedrooms have carpets and are comfortably furnished. Five new commodes had just arrived and some bedside cabinets were being put together at the time of the inspection indicating ongoing refurbishment is taking place routinely. The staircase carpet, which is proving difficult to clean, is scheduled for replacement. Residents said they had brought items of memorabilia into the home and this was noted in the bedrooms inspected. The kitchen was inspected and the freezer was found in need of defrosting and the adjacent refrigerator needed cleaning. Records for refrigerator and freezer temperatures were not inspected but the manager confirmed a daily record is being kept. The manager has arranged for a floor tile to be replaced in the doorway to the kitchen so the floor can be satisfactorily cleaned. The home is trialling a new method for controlling odours in the home. The product is sprayed directly onto carpets and is proving to be effective. The manager is encouraging visitors to inform her of any areas in the home where they notice an offensive odour and this is proving helpful in keeping on top of any problems in this respect. Despite the home’s best efforts, one bedroom had a slight odour. Quarry Bank DS0000019712.V279229.R01.S.doc Version 5.1 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 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 Sufficient staff are deployed at all times to meet the needs of residents. Current recruitment practice is good and ensures residents are protected from the risk of abuse. Staff are well trained and therefore competent to do their jobs. EVIDENCE: At the time of this inspection 21 residents were living in the home. Staff rotas indicate three care staff work the early and late shift and two on the night shift. In addition there is a cook and cleaner employed; the manager works supernumary. Training is ongoing and last year subjects have included bereavement awareness, fire lectures, first aid updates (nine staff have completed the Red Cross training and others have emergency first aid), dementia, and moving and handling. Further training is booked for all staff to attend during February and includes continence, pressure relief, and infection control. All staff have enrolled or are qualified to NVQ level II or III. Evidence of qualifications obtained by staff is seen in the number of certificates displayed at the entrance to the home. Two new members of care staff have been appointed since the last inspection and their records indicated all the information required by legislation has been obtained, including references, and Criminal Records Bureau (CRB) checks applied for (one has been returned). New staff only work under supervision in the home until the CRB check is returned and induction is complete. Quarry Bank DS0000019712.V279229.R01.S.doc Version 5.1 Page 17 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 and 38 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 recently completed the Registered Managers Award; the manager is currently taking NVQ level IV in care which she aims to complete by the end of 2006. The home has the Investors in People award and the local authority quality development scheme parts I and II. Staff meetings are held monthly and minutes for the December meeting were seen. There is an ongoing programme to update staff with mandatory training and all staff have a certificate for first aid, including nine who have attended the Red Quarry Bank DS0000019712.V279229.R01.S.doc Version 5.1 Page 18 Cross four day course and are qualified first-aiders; someone qualified in first aid is available at all times. All staff have a fire safety lecture twice a year using a video and answering a questionnaire. A health and safety notice is displayed near the staff room and the manager has a written statement of the policy, organisation and arrangements for maintaining safe working practices. Data sheets for a new product for odour control are being kept as part of the Control of Substances Hazardous to Health (COSHH) requirements. Accident records were checked and noted to be appropriately recorded. Window opening restrictors are in place on all windows. The hot water outlet temperature was checked for the assisted bath on the ground floor and found to be running at below the allowed temperature. None of the other bathrooms are currently used by the residents. Records indicate the water temperature is checked weekly and a thermometer is in place in the bathroom to test the water prior to immersion. The manager stated the passenger lift and other people lifting equipment is being serviced and examined at the required intervals. Fire alarm tests take place weekly and emergency lighting checks fortnightly; the home has a fire risk assessment with evidence of being reviewed. The landlords gas safety certificate is dated 20/1/06. Quarry Bank DS0000019712.V279229.R01.S.doc Version 5.1 Page 19 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 3 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 2 x x 1 x x x 2 STAFFING Standard No Score 27 3 28 3 29 x 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 x x x x x x 3 Quarry Bank DS0000019712.V279229.R01.S.doc Version 5.1 Page 20 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 As part of the work in building the extension the communal areas must all have a call alarm facility The staircase carpet must be cleaned or replaced Timescale for action 31/12/06 2. OP26 16 30/06/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard OP8 OP9 OP9 Good Practice Recommendations Ensure residents oral hygiene is maintained according to their care plan 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 DS0000019712.V279229.R01.S.doc Version 5.1 Page 21 Quarry Bank 4. 5. 6. OP19 OP26 OP31 The skylight in bedroom 12 should have a means of keeping out the light, particularly at night The kitchen cleaning programme must ensure refrigerators are kept clean and freezers are regularly defrosted The manager should continue with her efforts to obtain an NVQ level IV (or equivalent) in care Quarry Bank DS0000019712.V279229.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Hessle Area Office First Floor, Unit 3 Hesslewood Country Office Park Ferriby Road Hessle HU13 0QF 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 Quarry Bank DS0000019712.V279229.R01.S.doc Version 5.1 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. 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!