Inspection on 07/09/05 for Quarry Bank

This inspection was carried out on 7th September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Quarry Bank 17/10/08

Quarry Bank 29/10/07

Quarry Bank 22/01/07

Quarry Bank 30/01/06

Quarry Bank 14/02/05

Quarry Bank 06/09/04

Quarry Bank 09/03/04

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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 Quarry Bank Woodfield Lane Hessle East Yorkshire HU13 0ES Lead Inspector Pam Dimishky Unannounced 07 September 2005 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. Quarry Bank 20050906 Quarry Bank IR J53 v225705 s19712 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Quarry Bank Address Woodfield Lane Hessle East Yorkshire HU13 0ES 01482 648803 01482 648803 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 Anthony Mould Miss Donna Marie Hutchinson Care Home 23 Category(ies) of OP Old Age (23) registration, with number DE(E) Dementia over 65 (23) of places Quarry Bank 20050906 Quarry Bank IR J53 v225705 s19712 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 14th February 2005 Brief Description of the Service: Quarry Bank 20050906 Quarry Bank IR J53 v225705 s19712 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over seven hours (including preparation) with one inspector. This was an unannounced inspection and recommendations from the previous inspection were looked at and remain outstanding; no requirements were made at that inspection. The inspector looked round all of the building and a number records were also inspected. Ten of the twenty-one residents were spoken to and others were observed. What the service does well: What has improved since the last inspection? The quality of the daily notes, recording details of the care provided, have improved since the last inspection. A new replacement conservatory was being erected on the day of the inspection and, due to the planned extension to the home, the garden and lawn have had improvements made. Quarry Bank 20050906 Quarry Bank IR J53 v225705 s19712 Stage 4.doc Version 1.40 Page 6 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 20050906 Quarry Bank IR J53 v225705 s19712 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Quarry Bank 20050906 Quarry Bank IR J53 v225705 s19712 Stage 4.doc Version 1.40 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 standard(s) 3 and 6 The admission procedure includes a proper assessment being made of residents moving into the service 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 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. Staff have been trained and have certificates of competence in caring for one resident who required a special feeding technique; the resident has now improved to such a degree a normal diet is now being taken. The home is not registered for people requiring intermediate care. Quarry Bank 20050906 Quarry Bank IR J53 v225705 s19712 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 and 10 Residents care plans have sufficient detail to provide staff with the information they need to satisfactorily meet residents assessed need and there is evidence of good multi-disciplinary working taking place on a regular basis. 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 ensuring appropriate procedures are followed to ensure the safety of residents. EVIDENCE: The care plan is developed from the needs assessment made by the home and care management and details the action needed to be taken by care staff to ensure residents care and social needs are met; risk assessments are also included. Care staff make daily records of the care provided and the quality of the recordings have improved since the last inspection. Key workers make weekly notes and the manager reviews and updates care plans monthly or as needed. District nurses, community psychiatric nurse, continence advisor, optician, dentist and chiropodist are all visiting the home providing support and advice and indicating good multi-disciplinary working is taking place on a regular basis. Social services arrange annual reviews or as requested by the Quarry Bank 20050906 Quarry Bank IR J53 v225705 s19712 Stage 4.doc Version 1.40 Page 10 home. 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 records, the associated medications and the drugs returns book were checked and found to be in order. The records for controlled drugs are being kept in a note book but a proper controlled drugs register is not in use. Despite reminders from the manager, the supplying pharmacist has not made any checks of the medications and storage since July 2004. The home has adequate mobile screens available for shared rooms but these are not kept in the bedroom. Quarry Bank 20050906 Quarry Bank IR J53 v225705 s19712 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 Residents are able to take advantage of activities provided by the home and are able to participate in community and family life. Residents are encouraged to maintain their independence through being given choice and control over their lives. Meals are nutritious and balanced and offer a healthy and varied diet for residents. EVIDENCE: The home has a policy for residents maintaining contact with relatives and friends who also take residents for days out of the home; one lady stays overnight with her son on occasions. Another resident stated “the home is very good – better than being at home and nobody interferes in what you are doing.” Visitors are able to be received in private and residents can choose whom they see and do not see; visiting can take place at any reasonable time and information is included in the service user guide. Church visits to the home take place monthly and residents attend church for special festivals, eg Christmas, Easter. Trips to Darleys pub feature monthly in the activities programme and this can simply be for lunch and to play bingo. Some residents were taken to Hornsea recently for a fish and chip lunch and an entertainer visits the home regularly. The blind institute visit regularly throughout the year and demonstrate aids which are available for people with impaired sight. The manager also mentioned that Body Shop parties are held Quarry Bank 20050906 Quarry Bank IR J53 v225705 s19712 Stage 4.doc Version 1.40 Page 12 in the home which include a raffle and prizes; Bare Essentials were expected in the home the day after the inspection to sell toiletries, tights etc. 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 sausage, chips and beans was listed for lunch followed by fruit and whip. The cook’s menu book was seen to indicate that choices are being offered and two weeks menus indicated the choices available for all meals, breakfast, lunch and tea. Sherry is offered with Sunday lunch. The manager stated that the menus have been checked by the dietitian. Quarry Bank 20050906 Quarry Bank IR J53 v225705 s19712 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 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. All entries were seen to be satisfactorily resolved. 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 included in the procedure for referring 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 multi-agency guidelines for the protection of vulnerable adults. Residents’ monies were unable to be checked at this inspection due to a delivery of beds blocking the cabinet in which it is kept. Quarry Bank 20050906 Quarry Bank IR J53 v225705 s19712 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) 19,22 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 have been made to the gardens with a new lawn and flower-beds ahead of the building work commencing. At the time of this inspection a new replacement conservatory was being erected which will make a further pleasant area for residents to sit. There is no call alarm system in the lounges, dining room or conservatory and the manager said this is programmed to be installed as part of the new extension. Bedroom 12 has a large skylight window and the resident’s bed is situated immediately below. The window has no blind or Quarry Bank 20050906 Quarry Bank IR J53 v225705 s19712 Stage 4.doc Version 1.40 Page 15 curtain and must be quite disturbing on bright, sunny mornings; the manager said she would look to provide some covering for the window. All bedrooms have carpets and are comfortably furnished (three new beds arrived during this inspection). The staircase carpet needs cleaning and repair or replacement. There is evidence that residents are encouraged to personalise their room with small items of furniture and memorabilia. Quarry Bank 20050906 Quarry Bank IR J53 v225705 s19712 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) 27,29 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 recent 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, moving and handling and infection control is booked for November 2005. Eleven care staff have NVQ level II, four have NVQ level III, a further two are working towards level III and three have commenced level II. All staff have enrolled or are qualified to NVQ level II or III. Quarry Bank 20050906 Quarry Bank IR J53 v225705 s19712 Stage 4.doc Version 1.40 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 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 and 38 The home is being managed well and there is leadership, guidance and direction to staff to ensure residents receive consistent quality care. Systems for resident consultation are good with evidence that indicates that their views are both sought and acted upon. 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 is taking NVQ level IV in management and care which she expects to complete by next year. The home has the Investors in People award and the local authority quality development scheme parts I and II. Minutes were seen of staff and residents meetings which are held approximately six times a year. There is an ongoing programme to update staff with mandatory training and all staff have a certificate for first aid, including nine members of staff who have Quarry Bank 20050906 Quarry Bank IR J53 v225705 s19712 Stage 4.doc Version 1.40 Page 18 attended the Red Cross four day course and are qualified first-aiders; someone qualified in first aid is available at all times. 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. Accident records were checked and were seen 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 used by residents. The passenger lift and other people lifting equipment is being services 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 carpet in the entrance to the home was seen to be posing a risk of tripping and must be re-stretched. Staff were observed pushing one resident in a wheelchair without having footrests in place and the manager spoke to the member of staff concerned; all staff have been trained in how to push residents when in wheelchairs. Quarry Bank 20050906 Quarry Bank IR J53 v225705 s19712 Stage 4.doc Version 1.40 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 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 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 1 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 2 x x 1 x x x 1 STAFFING Standard No Score 27 3 28 x 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 2 x 3 x x x x 1 Quarry Bank 20050906 Quarry Bank IR J53 v225705 s19712 Stage 4.doc Version 1.40 Page 20 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. 2. Standard 10 22 Regulation 16 23 Requirement Screens must be provided in shared rooms 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 and repaired or replaced The carpet at the entrance to the home must be restretched to prevent the risk of tripping All staff must ensure wheelchair footrests are in place before moving residents Timescale for action On receipt of this report On completion of the extension 31.12.05 On receipt of this report At all times 3. 4. 5. 6. 26 38 38 16 13 13 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 9 19 31 Good Practice Recommendations A controlled drugs register should be obtained for use in the home The skylight in bedroom 12 should have a means of keeping out the light, particularly at night The registered manager should continue with training at 20050906 Quarry Bank IR J53 v225705 s19712 Stage 4.doc Version 1.40 Page 21 Quarry Bank NVQ level IV in care and management which should be achieved by 31.12.05 Quarry Bank 20050906 Quarry Bank IR J53 v225705 s19712 Stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection 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. 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