Inspection on 02/05/07 for Snapethorpe Hall

This inspection was carried out on 2nd May 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 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

Snapethorpe Hall 24/11/08

Snapethorpe Hall 23/05/06

Snapethorpe Hall 16/01/06

Snapethorpe Hall 30/08/05

Snapethorpe Hall 29/09/04

Snapethorpe Hall 07/06/04

Similar services:

Snydale Care Home

Staveley Birk Leas Nursing Home

Fairmount Nursing Home

Currergate Nursing Home

Brookfield

Castlethorpe Care Home

Elmleigh Convent

Woodlands Respite Care Centre

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

CARE HOMES FOR OLDER PEOPLE Snapethorpe Hall Snapethorpe Gate Broadway Lupset West Yorks WF2 8YA Lead Inspector Stephen French Key Unannounced Inspection 2nd May 2007 10:00 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 Snapethorpe Hall DS0000006209.V333570.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. Snapethorpe Hall DS0000006209.V333570.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Snapethorpe Hall Address Snapethorpe Gate Broadway Lupset West Yorks WF2 8YA 01924 332488 01924 332499 snapethorpehall@schealthcare.co.uk www.schealthcare.co.uk Southern Cross Healthcare Services Limited 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) Care Home 62 Category(ies) of Dementia - over 65 years of age (62), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (62), Physical disability over 65 years of age (62) Snapethorpe Hall DS0000006209.V333570.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. A maximum of 31 beds for the combined categories of MD and DE Can provide accommodation and care for a named service user under 65 years of age. 23rd May 2006 Date of last inspection Brief Description of the Service: Snapethorpe Hall is a purpose built residential care and nursing home which provides places for up to 62 older people who may also need nursing care or have a physical disability or who are suffering from dementia. The home is divided into two separate units over two floors, one providing care for elderly mentally ill people and one providing general nursing and personal care. All bedrooms are single en-suite and each floor has its own lounge and dining room. From the hallway and downstairs lounge, a very pleasant patio and garden area can be accessed. The home provides a passenger lift for those who require it and allows easy access to both floors. The home is situated on the outskirts of Wakefield, is easily accessible from the M1 motorway and there is a regular bus service to the city centre. Car parking is available to the front of the home. An activities programme, including organised outings, is available and is co-ordinated by the homes activities organiser. The home employs the services of a visiting hairdresser who is available several times each week. The provider informed the Commission for Social Care Inspection on 2nd May 2007 that the fees range from £380 to £500 per week. Additional charges include hairdressing, private chiropody, newspapers and some selected activities. Information about the home and the services provided are available from the home in the Statement of Purpose and Service User Guide. Service users can access these and inspection reports from the home. Snapethorpe Hall DS0000006209.V333570.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced visit carried out on the 2nd May 2007. The inspector arrived at the home at 08:20 am and left 3:30pm. During this visit the inspector spoke to some of the people living at the home, relatives, some of the staff and the home’s management. The inspector read care records, audited a sample of medication, reviewed staff recruitment and training records and carried out a brief tour of the building. Five relatives spoken to at the time of the visit were very pleased with the care that the home provided comments included, “the home is smashing, its very clean and the staff are very caring. “The staff are very good and always helpful” Comments received from people living at the home included “The staff are very nice”, “Staff always willing to help” and “ The food is nice”. Prior to the inspection 20 questionnaires were sent to the home to obtain peoples views about living at the home, ten completed questionnaires were returned. Some people in the home are very frail and would not be able to complete a questionnaire. There were fifty seven people resident in the home on the day of this visit. Relative surveys were also sent out and none were returned. Other information used in the inspection process included notifications from the provider to the Commission for Social Care Inspection about deaths, illnesses, accidents and incidents at the home, copies of the monthly management visit reports produced by the provider and a pre inspection questionnaire completed by the manager. The visit has concluded that people’s needs, both personal and recreational, are met. People reside in a relaxed and informal homely environment. Snapethorpe Hall DS0000006209.V333570.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? What they could do better: Daily entries in the care files should reflect the social and psychological well being of the people who live in the home. In order that a clear audit trail of medication held within the home can be made staff should record the stock balances of any medication brought forward from the previous month. To further improve the environment in which people live the areas identified during the visit as requiring redecoration should be completed. Snapethorpe Hall DS0000006209.V333570.R01.S.doc Version 5.2 Page 7 To ensure there are adequate numbers of staff on duty to meet the needs of the people living in the home the provider should monitor their dependency levels and increase the staffing accordingly. 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. Snapethorpe Hall DS0000006209.V333570.R01.S.doc Version 5.2 Page 8 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 Snapethorpe Hall DS0000006209.V333570.R01.S.doc Version 5.2 Page 9 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): 3,6 Peoples’ needs are assessed prior to them entering the home. People who use the service experience good quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to the service EVIDENCE: The manager stated that prior to any person being admitted to the home she receives a community care assessment from the person’s social worker. This assessment determines the level of care the person will require. She, or her deputy then visits the person in their own home or hospital. The purpose of the visit is to complete a pre-admission assessment to ensure the home and its staff are able to meet those needs. The manager also said that should a person be admitted to hospital she visits them before they are discharged to ensure their needs have not changed Snapethorpe Hall DS0000006209.V333570.R01.S.doc Version 5.2 Page 10 whilst in hospital. Completed pre-admission assessments were seen for people admitted to the home, confirming that the home is following its admission procedures. The manager said that the home does not offer intermediate care. Snapethorpe Hall DS0000006209.V333570.R01.S.doc Version 5.2 Page 11 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): 7,8,9,10 Although the people’s health care needs are being met, the medication procedures need to be improved to ensure people are not placed at risk. People who use the service experience adequate quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to the service EVIDENCE: The manager said that each person has a care plan, which has been compiled from information gathered from the preadmission assessment, community care assessment and the person moving into the home and their relatives. As part of the visit four peoples care plans were examined. Within the care files there are assessments for such things as nutrition, moving and handling, skin assessments and falls risk assessments, these have been reviewed at regular intervals. Snapethorpe Hall DS0000006209.V333570.R01.S.doc Version 5.2 Page 12 Care plans are in place for problems identified within the risk assessments, and give very descriptive instructions to staff of what they need to do in order to maintain the persons health care needs. Evidence was also seen that if a persons nutritional status changed i.e. they began to loose weight, then a care plan was put into place and their GP was contacted for advise. A daily entry is made in the care files by staff which describes what care the staff has given on that day, these need to be more descriptive of the persons psychological and social wellbeing. Evidence was seen in the care files inspected that the staff have accessed members of the multidisciplinary team such as dieticians, chiropodists, opticians and members of the mental health care team. Relatives spoken to confirmed that they are kept informed of important matters and that they are consulted about the care their relative receives. Although it is mainly qualified nursing staff and senior care staff who compile and evaluate the peoples care plans, care staff spoken to were aware of the content of the care plans and said they would refer to these if they required information on how to maintain peoples health and well being . People who live in the home spoken to said that their privacy was respected and staff were very kind towards them. Medication seen on the day of the visit was stored correctly. Policies and procedures are in place to ensure the ordering, storage, administration and disposal of medication is done safely. The stock balances of ten peoples medication was examined against the medication administration records held by the home. Five peoples stock balances did not tally with the records held by the home. On further investigation it was found that the previous balances from medication left over from the month before had not been transferred onto the present months administration records accurately. This could put the people living in the home at risk and the manager said she would address this straight away. Snapethorpe Hall DS0000006209.V333570.R01.S.doc Version 5.2 Page 13 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 People who live in the home are able to exercise choice and control over their lives. People who use the service experience good quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to the service. EVIDENCE: The home employs an activities organiser for thirty hours per week. She is responsible for arranging all the social activities, which take place in the home. Records are kept in the care files of what activity each person has attended. People spoken to, and minutes of meetings held with relatives, said that they were happy with the activities on offer, which included movement to music, table games and crafts. The manager said that local schools visit the home at seasonal times. Snapethorpe Hall DS0000006209.V333570.R01.S.doc Version 5.2 Page 14 During the visit relatives were observed entering the home and the manager said that there were no restrictions on visiting times. This was also confirmed by relatives spoken to during the visit. The home operates a four-week menu and people can eat either in their own room or in one of the dining rooms. On the day of the visit the lunch consisted of Toad in the hole or sausage casserole with potatoes and seasonal vegetables, followed by sponge and custard for desert. An alternative to the main menu is available and this includes a selection of hot and cold dishes. Staff were observed assisting those people who required help during meal times in a sensitive manner. All the people spoken to, apart from one person, said how nice the meals were and that there was always a choice available. One person said that the quality of food was not good at times and complained of fish fingers being as hard as “bullets”. Snapethorpe Hall DS0000006209.V333570.R01.S.doc Version 5.2 Page 15 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): 16,18 People are confident that their complaints will be listened to and that appropriate action will be taken by the manager to resolve this. People who use the service experience good quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to the service EVIDENCE: The home has a complaints policy, a copy of which is displayed in the main reception area of the home and the manager said that each person is given a copy. People spoken to said that they were aware of the policy and were confident that the manager would resolve any problems they had. The manager said that any complaints received by the home would be investigated by her or the area manager and the complainant would be made aware of the outcome of any investigation. The manager said that since the last visit to the home by the Commission for Social care Inspection they have received seven complaints. The record of complaints were examined and these were found to have been handled appropriately. The manager said that staff receive training in adult protection as part of their induction training as well as periodically; staff training records checked confirmed that staff had received this training. Snapethorpe Hall DS0000006209.V333570.R01.S.doc Version 5.2 Page 16 Staff spoken to by the inspector, gave good responses to questions asked on this subject and were aware of their responsibilities in reporting any suspicions they had. There have been three referrals made to Wakefield Adult protection team concerning people living at the home. These were investigated and appropriate action was taken by the home to protect other people living there. Snapethorpe Hall DS0000006209.V333570.R01.S.doc Version 5.2 Page 17 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): 19,21,24,25,26 People live in a comfortable safe environment to which only minor redecoration is needed. People who use the service experience good quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to the service EVIDENCE: As part of this visit a tour of the building was conducted, this included a number of people’s bedrooms, communal lounges, dining rooms and bathrooms and toilets. Areas of the home are in need of some minor redecoration which will further improve the environment for people who live in the home. Snapethorpe Hall DS0000006209.V333570.R01.S.doc Version 5.2 Page 18 People’s bedrooms were personalised with their own belongings such as ornaments, pictures and small pieces of furniture. Two people who were visited in their room by the inspector stated that they were very happy with their accommodation. The unit where people with enduring mental health problems live is currently being redecorated to provide a more stimulating environment. Bedroom doors have been painted in pastel colours and door furniture such as letter boxes and door knockers have been added to help people recognise their rooms. The manager said that one corridor is going to be decorated to resemble an area of a garden and will have a trellis and a garden seat on which people can sit. Tactile pictures are to be added to other corridors so people can touch them as they pass by to help stimulate interest. The dining rooms and lounges on each unit are decorated to a good standard and are very homely. There are a number of bathrooms in close proximity to bedrooms and communal areas. These have a variety of specialist baths which staff can use to assist people with mobility problems bath safely. The cleanliness of the home was very good and there were no unpleasant odours detected, the house keeping staff should be commended on this. Snapethorpe Hall DS0000006209.V333570.R01.S.doc Version 5.2 Page 19 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 People’s needs are met by adequate numbers of competent trained staff. People who use the service experience good quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to the service EVIDENCE: The staff duty rota was checked for the months of March and April and these confirmed the staffing as being, Residential unit AM; 1 Senior carer and 1 to 2 care staff PM; 1 Senior carer and 1to 2 care staff Night time 1 carer Nursing unit AM; 1 qualified nurse and 4 care staff PM; 1 qualified nurse and 3 care staff Night time 1 qualified nurse and 1 carer Snapethorpe Hall DS0000006209.V333570.R01.S.doc Version 5.2 Page 20 Unit for people with enduring mental health problems AM; 1 qualified nurse and 4 care staff PM; 1 qualified nurse and 4 care staff Night 1 qualified nurse and 2 care staff Staff sickness and holidays are covered by staff doing overtime, agency staff are also used and in the last eight weeks six shifts have been covered by agency staff, four of these have been qualified nursing staff. Currently the home has nine of the thirty one care staff who have completed an N.V.Q level 2 training course and a further sixteen staff are working towards the award. Five staff details were checked and these confirmed that the home is carrying out the appropriate checks prior to employing staff. The manager said that new staff employed by the home complete an induction course within six weeks of the joining the home; records examined confirmed this. Evidence was seen in the training records checked that staff have received training in such things as moving and handling, adult protection, dementia and food awareness. People who live at the home and some relatives spoken to said that there was plenty of staff around to give them a hand if they needed although at times they were very busy. Care staff said that they felt there were not enough staff on duty at times particularly at night on units where there are people who require two staff to assist them. The manager said that she monitors the dependency of people who live in the home and would increase the number of staff if she felt this was needed. Snapethorpe Hall DS0000006209.V333570.R01.S.doc Version 5.2 Page 21 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): 31,33,35,36,38 The home is well managed and the views of the people who live there are taken into account People who use the service experience good quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to the service EVIDENCE: The manager is a qualified nurse who has only been in post since January 2007.She has many years of experience of working with older people and is aware of the aims and objectives of the home. She is supported in her role by a deputy manager and the area manager visits the home on a monthly basis or more frequently if required. Snapethorpe Hall DS0000006209.V333570.R01.S.doc Version 5.2 Page 22 The manager said that she completes monthly audits on all areas of the home to ensure that they meet the expectations of the people who live at the home. Monthly audits include areas such as, the presentation of the home, Care documentation, health and safety, social activities and staff training. Completed documentation was seen for all of these. Meetings with the people who live in the home and the manager are held monthly. During these meetings people are able to discuss any issues they may have and an action plan is drawn up to address any shortfalls. Minutes of the meeting held on the 30/4/07 were seen and items discussed included catering, housekeeping and care. Relatives spoken to confirmed that meetings took place at regular intervals. People are able to keep small amounts of personal monies within the home. This enables them to be able to purchase small items such as sweets, newspapers and pay for hairdressing. It is expected that staff will receive at least six supervisory sessions per year with a senior member of staff. During these sessions they are able to discuss, amongst other things, training issues and the aims and objectives of the home. Supervision records examined during the visit confirmed that these have been taking place at regular intervals. Movement and handling training has been provided to the majority of staff members this year. Staff confirmed this when interviewed. There are policies and procedures in place surrounding health and safety and the manager is aware of her responsibilities towards the people who live in the home and the staff. Regular fire safety checks are carried out and recorded. Staff receive training in fire prevention. Certification in relation to servicing of gas, electricity and electrical equipment was in place and up to date. Snapethorpe Hall DS0000006209.V333570.R01.S.doc Version 5.2 Page 23 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 2 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 3 17 X 18 3 3 X 3 X X 3 3 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 3 X 3 X 3 3 X 3 Snapethorpe Hall DS0000006209.V333570.R01.S.doc Version 5.2 Page 24 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. Refer to Standard OP7 OP9 Good Practice Recommendations Daily entries in the care files should be more descriptive of the people’s social and psychological well being. The stock balances of the previous months medication should be recorded on the Medication administration records to enable a clear audit trail of medication to be undertaken. The areas identified during the visit should be redecorated in order to further improve the environment in which people live. The registered provider should monitor the dependency of the people who live in the home and increase the staffing, particularly at night, accordingly. 3. 4. OP19 OP27 Snapethorpe Hall DS0000006209.V333570.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Brighouse Area Team First Floor St Pauls House 23 Park Square Leeds LS1 2ND 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. Extracts may not be used or reproduced without the express permission of CSCI Snapethorpe Hall DS0000006209.V333570.R01.S.doc Version 5.2 Page 26 - 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. 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