Inspection on 29/08/06 for Snaith Hall Nursing And Residential Home

This inspection was carried out on 29th August 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 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

Snaith Hall Nursing And... 14/08/07

Snaith Hall Nursing And... 07/02/06

Snaith Hall Nursing And... 14/07/05

Snaith Hall Nursing And... 12/10/04

Snaith Hall Nursing And... 07/05/04

Snaith Hall Nursing And... 04/03/04

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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 Snaith Hall Nursing And Residential Home Pontefract Road Snaith Goole East Yorkshire DN14 9JR Lead Inspector Ms Anne-Marie Foster Key Unannounced Inspection 29th August 2006 09:30 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 Snaith Hall Nursing And Residential Home DS0000000953.V309364.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. Snaith Hall Nursing And Residential Home DS0000000953.V309364.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Snaith Hall Nursing And Residential Home Address Pontefract Road Snaith Goole East Yorkshire DN14 9JR 01405 862191 01405 869817 Snaithhall@lineone.net www.snaithhallcarehome.co.uk James Patrick McEnroe Mrs Adrienne Elizabeth McEnroe Mr James Patrick McEnroe Care Home 36 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) Category(ies) of Dementia (36), Dementia - over 65 years of age registration, with number (36), Old age, not falling within any other of places category (36), Physical disability (36), Physical disability over 65 years of age (36), Terminally ill (36) Snaith Hall Nursing And Residential Home DS0000000953.V309364.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Registration includes 5 day places Date of last inspection 7th February 2006 Brief Description of the Service: Snaith Hall is a care home providing residential and nursing care for up to 36 service users. The home is owned by Mr and Mrs McEnroe, and is situated centrally in Snaith, close to local shops and amenities .The home is split into two parts; up to 12 service users receive care within the Hall, a Grade II listed Georgian manor. The Garden Wing accommodates a further 24 service users. There is a large conservatory adjoining the Hall, and a covered walkway joins the Hall to the Garden Wing. A large, private, enclosed garden is available for service users to enjoy. Weekly fees at 13/6/2006 are £291.00 - £533.00. Snaith Hall Nursing And Residential Home DS0000000953.V309364.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced site visit was carried out over seven hours. The manager and deputy manager were available to assist the inspector. Information used for the inspection process was gathered from a variety of sources, as well as this site visit, and included comment cards from general practitioners, notification of events such as accidents or illnesses sent to the Commission by the home, and a pre inspection questionnaire provided by the home. The inspector spoke with service users, staff and visitors at the home on the day, and observed staff ‘in action’ carrying out their duties. Five staff files were inspected and five service users were ‘case tracked’ with their care plans and files inspected. A tour of the home was made which included all communal areas, the laundry, the kitchen and with permission, service users rooms. What the service does well: What has improved since the last inspection? Several rooms identified as needing repairs and deep cleaning have been attended to since the last inspection, which has resulted in the home being more hygienic. Bedrail checks are carried out regularly at the home and this action is now recorded in the care plans. These checks will identify any faulty bedrails and reduce any risks to the service user. The management now have a more robust recruitment system whereby they do not start new employees without obtaining two written references, and a Criminal Record Bureau check. The pre admission assessment process has been improved; the deputy manager now goes out to meet any prospective service user for example in Snaith Hall Nursing And Residential Home DS0000000953.V309364.R01.S.doc Version 5.2 Page 6 their own home or hospital, and no service users move into the home unless their needs can be met. Care plans have been improved and are individualised and specific to the service users and will help staff to deliver appropriate care. The homes adult abuse policy has been reviewed and re written. This now reflects the latest local authority guidance. This information has also been distributed to staff in order to help them be more aware of, and able to report, any concerns relating to adult abuse. 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. Snaith Hall Nursing And Residential Home DS0000000953.V309364.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 Snaith Hall Nursing And Residential Home DS0000000953.V309364.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6 Quality in this outcome area is good. Prospective service users do not move into the home unless their needs can be met. This judgment has been made using available evidence including a visit to this service. EVIDENCE: The deputy manager now goes out to assess prospective service users in their own home or in hospital. The care files for eight service users were looked at and good assessments were in place that linked in to the care plans. This assessment will help to ensure that no service user moves into the home unless their needs can be met. There is no provision for intermediate care places at present. Snaith Hall Nursing And Residential Home DS0000000953.V309364.R01.S.doc Version 5.2 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 Quality in this outcome area is good. Service users are protected by a robust medication system, and their health, personal and social needs are well met. This judgement has been made using available evidence including a visit to this service EVIDENCE: The inspector looked at eight of the service users care plans, which have recently been improved. The care plans are very good. They contain individualised information; good risk assessments and they are reviewed on a monthly basis or more frequently if necessary. They will help staff to deliver the most appropriate care to meet the service users’ needs. There is a good standard of health and personal care and staff are dedicated and enjoy their work. Service users told the inspector that “the staff are so kind” “ my needs are met” and “ staff are dedicated”. The home makes arrangements so that service users can access other health care services for example the chiropodist and hospital out patient appointments; and enables the service users’ health care needs to be met. The medication system was inspected, this included the stock of controlled drugs, expiry dates of Snaith Hall Nursing And Residential Home DS0000000953.V309364.R01.S.doc Version 5.2 Page 10 medicines and general medicine procedures and medication records. The senior nurse reported no problems with the ordering or disposal of medications and service users are protected by a robust medication policy and procedure. Staff have a very positive approach to their work, they were seen to carry out their tasks in a quiet, calm way, taking care to ensure that the service users privacy and dignity were maintained, and that they were treated with respect. Snaith Hall Nursing And Residential Home DS0000000953.V309364.R01.S.doc Version 5.2 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): 12,13,14 and 15 Quality in this outcome area is good. Service users are helped to exercise choice and control over their lives, and enjoy a flexible lifestyle. This judgement was made using available evidence including a visit to this service. EVIDENCE: There are flexible day to day routines at the home, and service users have the opportunity to exercise their choice in relation to food and mealtimes, activities of daily living and religious observance. The home employs an activities organiser and also has a volunteer to help with organising stimulating recreational activity. Service users capabilities, likes and interests are taken into account. Eight service users were spoken with, and seven said that they had enough to do during the day. The deputy manager is making an assessment of this situation to see if this area could be further improved upon, so that the lifestyle experienced within the home satisfies the social, cultural, religious and recreational needs. The home ensures that community contacts are maintained, plus there is a community spirit within the home as well, as many of the service users and staff come from, or live in Snaith; people can receive visitors as they wish and the home has strong links with the local churches; service users are helped to exercise choice and control over their lives. Snaith Hall Nursing And Residential Home DS0000000953.V309364.R01.S.doc Version 5.2 Page 12 Lunch was observed on the day of the site visit, it is served in the two dining rooms or in service users rooms, as they prefer. Service users were keen to report that the lunch was good and that “ there is plenty of choice”. The menu looked wholesome and balanced, and staff were available in good numbers to assist as necessary, and service users received an appealing meal served in pleasant surroundings. Snaith Hall Nursing And Residential Home DS0000000953.V309364.R01.S.doc Version 5.2 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 Quality in this outcome area is good. Service users are supported and protected by the homes complaints policy. This judgement has been made using available evidence including a site visit to this service. EVIDENCE: The home has a clear, available complaint’s policy, and staff, service users and their visitors told the inspector that they knew how to make a complaint and would feel confident that they would be listened to and their complaint taken seriously. Two staff members agreed that they would have no problem in making a complaint if necessary and that the managers had an ‘open’ approach and would listen and act upon any complaint. The records of complaints showed that one complaint had been dealt with effectively since the last inspection. The Commission for Social Care Inspection have received no information that relates to complaints about the home. The home has obtained the latest local authority guidance document that relates to adult abuse and this information has been cascaded down to all staff, and along with staff abuse awareness training, will further benefit the service users and help to protect them from abuse. Snaith Hall Nursing And Residential Home DS0000000953.V309364.R01.S.doc Version 5.2 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 and 26 Quality in this outcome area is adequate. Service users live in a safe home, however some cleaning and redecoration should take place to promote their comfort. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The location and layout of the home suits its purpose. It is accessible and safe. Whilst the garden is well maintained there are some areas that look overgrown and are off putting, particularly around the front and rear entrances, where weeds grow between the paving slabs and around the walkways. The grounds must be kept tidy to enable service users and their visitors to enjoy a wellmaintained environment. Whilst the home has a programme of routine maintenance and redecoration, several areas of the home looked tired, dated, and in need of redecoration in particular two of the bedrooms that the inspector went into with the deputy manager. The sideboard and serving hatch area in the dining room of the Garden Wing needed a thorough clean. This refurbishment and cleaning is necessary to help promote the comfort of the Snaith Hall Nursing And Residential Home DS0000000953.V309364.R01.S.doc Version 5.2 Page 15 service user, and reduce risks from cross infection. The rest of the home was clean on the day of inspection, the laundry room was inspected and found to be satisfactory and a robust laundry system with sluicing facility is in place. This will help to maintain hygiene standards and reduce the risk of cross infection. The deputy manager was able to confirm that the bedrooms requiring cleaning and repair, identified at the previous inspection, were now in order and the inspector found these to be satisfactory. Snaith Hall Nursing And Residential Home DS0000000953.V309364.R01.S.doc Version 5.2 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 Quality in this outcome area is good. Service users are in safe hands, and the numbers and skill mix of staff are good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The staff rota supplied to The Commission for Social Care Inspection indicated that satisfactory numbers of staff are employed. During the site visit it was also noted that good numbers of care staff were on duty, and were available to assist as necessary. More than half of the care staff have obtained the National Vocational Qualification level 2 certificate in care, and service users are in safe hands. Service users and their visitors confirmed that the health, personal and social needs are met. The home has a robust recruitment policy and procedure and five staff files were inspected. All were found to contain the documentation required by regulation e.g. Criminal Records Bureau checks and two good written references; and so service users are supported and protected by the homes recruitment system. The managers and staff confirmed that the home provides ample training opportunities, which staff enjoy, and this helps them to be further competent to do their jobs. The inspector was able to see evidence of this training in some of the staff files but not all, and the managers need to continue in their efforts to develop a training plan which could be used to further evidence that up to date training has been attended. Snaith Hall Nursing And Residential Home DS0000000953.V309364.R01.S.doc Version 5.2 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): 31,33,35 and 38 Quality in this outcome area is good. Service users live in a safe home that is run and managed in their best interests. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered manager is qualified, competent and experienced to run the home and to meet its stated purpose, aims and objectives. The home has a quality assurance programme in place, and carries out an annual quality survey by, questionnaire, of service users, their visitors and other professionals for example district nurses/ social services representatives, in order to seek their views about how the home is achieving its goals. This information will be useful for the management to help them ascertain that they are running the home in the best interest of service users. Snaith Hall Nursing And Residential Home DS0000000953.V309364.R01.S.doc Version 5.2 Page 18 Service users’ monies are managed by the home’s manager and deputy manager, this system was inspected and good written records of all transactions are maintained and money is kept safely; service users’ financial interests are safeguarded. The inspector was provided with the necessary certification that relates to the good maintenance of gas, electrical and fire safety systems. A recent environmental health inspection report, plus the homes policy and procedures for maintaining safe working practices, were all found to be in order and up to date, which indicates that the health and welfare of service users and staff are promoted and protected. The home regularly check the bed rails of service users, and are now recording these checks; this was identified as a problem at the last inspection. These records will help to further identify problems and prevent service users from potential harm. Snaith Hall Nursing And Residential Home DS0000000953.V309364.R01.S.doc Version 5.2 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 X 3 X X N/a HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 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 3 17 X 18 3 2 X X X X X X 2 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Snaith Hall Nursing And Residential Home DS0000000953.V309364.R01.S.doc Version 5.2 Page 20 Are there any outstanding requirements from the last inspection? No 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 Refer to Standard OP19 OP26 OP30 Good Practice Recommendations It is recommended that grounds and pathways should be kept tidy and safe for service users and visitors. It is recommended that a thorough clean of the hatch and buffet area in the Garden wing dining room be carried out. It is recommended that the staff-training matrix be developed, and that staff files contain the evidence of up to date training. Snaith Hall Nursing And Residential Home DS0000000953.V309364.R01.S.doc Version 5.2 Page 21 Commission for Social Care Inspection York Area Office 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 Snaith Hall Nursing And Residential Home DS0000000953.V309364.R01.S.doc Version 5.2 Page 22 - 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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