Inspection on 07/02/06 for Snydale Care Home

This inspection was carried out on 7th February 2006.

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

Snydale Care Home 28/11/06

Snydale Care Home 03/07/06

Snydale Care Home 18/07/05

Snydale Care Home 11/10/04

Snydale Care Home 30/07/04

Snydale Care Home 10/02/04

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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 Snydale Care Home New Road Old Snydale Pontefract West Yorks WF7 6HD Lead Inspector Elizabeth Hendry Unannounced Inspection 7th February 2006 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 Snydale Care Home DS0000006217.V282987.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. Snydale Care Home DS0000006217.V282987.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Snydale Care Home Address New Road Old Snydale Pontefract West Yorks WF7 6HD 01924 895517 01924 897482 traceyholroyd@aol.com 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) Mr S Holroyd Mrs T Holroyd, Mr A Westerman Mrs Diane S Rose Care Home 52 Category(ies) of Old age, not falling within any other category registration, with number (52), Physical disability over 65 years of age of places (52) Snydale Care Home DS0000006217.V282987.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Can accommodate two named service users with physical disabilities under 65 years. Can accommodate one named service user under category Terminally Ill (TI(E)) Can accommodate up to two service users with physical disabilities who are aged 60 years or over on admission. 18th July 2005 Date of last inspection Brief Description of the Service: Snydale Nursing Home is registered as a care to provide care, including nursing, for up to fifty-two older people. It is located in the small village of Old Snydale, which is between Normanton and Featherstone. The accommodation is set out on two floors. The main sitting room and dining facilities are located on the ground floor. There is level access at the main entrance and hydraulic passenger lifts allows easy access to the first floor accommodation. The home provides well furnished and comfortable accommodation. Snydale Nursing Home is situated of the main road and is accessed via a long drive that leads up to the care home. There are off street parking facilities for visitors and a large garden at the back of the home provides a pleasant environment for service users to sit out in good weather. A local bus service passes right by the front entrance at the bottom of the drive every hour. Snydale Care Home DS0000006217.V282987.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the homes second bi annual inspection, which took place over the course of a day. Time was spent talking with service users, members of staff and the management team. Records, policies and procedures and care plans were viewed and a tour of the premises was undertaken. Inspectors would like to thank the residents, staff and the management team for their hospitality during this visit. What the service does well: What has improved since the last inspection? Since the last inspection, service users are consulted on a daily basis regarding their personal preferences for each meal. Senior managers within the home have undertaken adult protection training in order to cascade this information to members of the care team. Snydale Care Home DS0000006217.V282987.R01.S.doc Version 5.1 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. Snydale Care Home DS0000006217.V282987.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 Snydale Care Home DS0000006217.V282987.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): Systems currently in place for assessing the needs of service users prior to admission are not satisfactory. EVIDENCE: Of those pre admission assessments viewed all were found to lack sufficient information to determine the suitability of the home for the prospective service user. The Registered provider said that the registered manager is responsible for undertaking pre admission assessments prior to a place being offered within the home. This assessment usually takes places within the individual’s current accommodation, whether this is in hospital or their own home. Snydale Care Home DS0000006217.V282987.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 and 9 The care planning system does not provide staff with sufficient information they need to fully meet the service users needs. Systems in place for the management of service user’s health and medication is poor, potentially placing service users at risk. EVIDENCE: Inspectors evidenced care plans for six service users. Insufficient information was held within these care plans resulting in staff not having a clear understanding of the needs and personal abilities of each service user. Manual handling assessments did not contain sufficient guidelines for staff to follow when moving people and an illegal manoeuvre was observed during the inspection. Documentation held within each care plan evidenced had not been signed or dated by the assessor. Key health care information was absent from service users files and when questioned staff had different views as to the exact requirements and abilities of each individual. Snydale Care Home DS0000006217.V282987.R01.S.doc Version 5.1 Page 10 Medication administration records were checked and referenced against medication held within the home. Discrepancies between these records was found. Handwritten entries on medication administration records did not contain countersignatures. All drugs entering the home are checked and recorded on the medication administration records. A proportion of drugs entering the home had not been appropriately recorded, and did not reflect that of the prescription issued by the G.P. A discussion took place with the registered providers and nurse on duty regarding the importance of the correct and accurate recording of all medication entering the home. Snydale Care Home DS0000006217.V282987.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 and 15 Current arrangements for the provision of activities within the home are not satisfactory. Dietary needs of service users are well catered for with a balanced and varied selection of food available that meets the service users tastes and choices. EVIDENCE: Service users spoken with said that there was not much choice as to what activities they can take part in within the home. One service user commented that when they did have an activities timetable very often they did not happen anyway. The registered providers spoke of looking at developing an activity schedule with assistance form the residents in order to determine their personal preferences. Residents spoken with were complimentary as to the quality of the meals provided within the home. The registered providers said that choices are offered for all meals, records viewed within the kitchen identified choices made by each service user. Snacks and drinks are available at regular times throughout the day. Snydale Care Home DS0000006217.V282987.R01.S.doc Version 5.1 Page 12 During the inspection afternoon tea was observed, service users were not offered a choice of hot drink and were simply given tea without any communication regarding choice from the care assistant on duty. Snydale Care Home DS0000006217.V282987.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 homes complaints policy ensures service users views are listened to and acted upon. Systems in place for the protection of service users from possible abuse are not satisfactory. EVIDENCE: The homes complaints policy and procedure was viewed and found to contain sufficient information in a manner that was easy to read and act upon. Complaints were well recorded; outcomes were clearly documented with timescales and signatures of both the investigator and the complainant. The registered provider spoke of attending an adult protection training course along with other members of the senior management team. At the time of the inspection no adult protection training had been provided to members of the care staff despite a previous requirement being issued. Snydale Care Home DS0000006217.V282987.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 and 26 Recent and ongoing investment in the redecoration and furnishing of the home has improved the standard of the environment. Arrangements in place for the cleaning of the home require review to ensure service users live in a clean and hygienic environment. EVIDENCE: A comprehensive tour of the home was undertaken. On the day of the inspection the ground floor hallway was in the process of being redecorated. A discussion took place with one of the registered owners regarding the maintenance of the building; he confirmed that the home has an ongoing programme of redecoration and furnishing. Of the rooms recently redecorated and furnished all were found to be of a good standard, and provided the service users with an attractive and homely bedroom. Some bedrooms were seen to have been personalised by the resident. Snydale Care Home DS0000006217.V282987.R01.S.doc Version 5.1 Page 15 Following recommendations issued at the last inspection, improvements have been made to the fire escape route on the first floor staircase, which now ensures ease of escape should the need arise. The registered provider spoke of experiencing problems in maintaining a suitable water temperature that meets the preferences of individual service users and ensured their safety. Of those bathrooms inspected, one had a water temperature of 20 degrees, the second 35 degrees and the third 47 degrees. The inspector highlighted the need to ensure consistent suitable water temperatures throughout the home. Concerns were raised with the registered providers over the cleanliness of the home and the presence of unpleasant odours within some communal areas and service user bedrooms. While the inspector appreciates that the home is undertaking general maintenance and redecoration, a number of areas were identified that required addressing. A number of bedroom doors did not close properly, and two of the bedrooms viewed did not have a working lock. Communal areas to the ground floor comprises of three large well furnished sitting rooms, and a large dining room, which provides a comfortable environment in which to eat. Snydale Care Home DS0000006217.V282987.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): 29 Recruitment procedures are not consistently followed resulting in service users receiving care from staff who have not been appropriately vetted. EVIDENCE: Of the staff files viewed not all contained the required information. A discussion took place with the registered owners regarding the need to ensure that prior to commencing work, the home must be in receipt of two written references for each employee. Enhanced criminal records bureau disclosure references were evidenced for each employee in the home. The registered owner and office manager explained the homes recruitment procedure and confirmed that all members of staff are provided with a contract of employment. Snydale Care Home DS0000006217.V282987.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): 38 The health and safety of service users and staff is not fully protected. EVIDENCE: During the inspection, members of the care staff were observed undertaking an unsafe manual handling manoeuvre. After discussions with members of staff and reviewing staff training records it was identified that further training was required to ensure the safety of service users and staff. Manual handling assessments held within individual care plans did not contain sufficient information to enable staff to safely assist service users. Fire fighting equipment within the home evidenced regular testing. Portable appliance testing had been carried out on all equipment inspected. Window restrictors were found to be absent from some bedrooms, despite previous recommendations. Possible solutions to improve the security of the Snydale Care Home DS0000006217.V282987.R01.S.doc Version 5.1 Page 18 building in relation to the boiler room area was discussed with the registered owners. Snydale Care Home DS0000006217.V282987.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 X 1 X X X HEALTH AND PERSONAL CARE Standard No Score 7 1 8 1 9 1 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 X 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 1 2 X X X X X X 2 STAFFING Standard No Score 27 X 28 X 29 1 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X X X X 1 Snydale Care Home DS0000006217.V282987.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 OP3 Regulation 14(1,a) Requirement The registered person shall not provide accommodation to a service user at the care home unless, so far as it shall have been practicable to do so the needs of the service user have been assessed by a suitably qualified or suitably trained person. Individual care plans must set out in detail all areas of need, the action taken to meet that need and the outcome. Care plans must be signed and dated. The registered person shall, make the service users plan available to the service user, keep the service users plan under review, where appropriate and , unless it is impracticable to carry out such consultations, after consultation with the service user or a representative of his, revise the service users plan, and notify the service user of any such revision. The registered person shall ensure that the care home is conducted so as to promote and DS0000006217.V282987.R01.S.doc Timescale for action 10/04/06 2 OP7 15(1) 10/04/06 3 OP7 15(2)(a,b, c,d) 10/04/06 4 OP8 12(1)(a) 10/04/06 Snydale Care Home Version 5.1 Page 21 5 OP9 13 (2) 6 OP12 16(2)(n) 7 OP18 13(6) 8 OP26 16(2)(j) 9 OP29 19(1) 10 OP38 13(5) 11 OP38 13(4)(a) make proper provision for the health and welfare of service users. The registered person shall make arrangements for the recording, handling, safe keeping, safe administration and disposal of medicines received into the care home. The registered person shall having regard to the size of the care home and the number and needs of service users, consult service users about the programme of activities arranged by or on behalf of the care home, and provide facilities for recreation including, having regard to the needs of service users, activities in relation to recreation, fitness and training. The registered person shall make arrangements, by training staff or by other measures, to prevent service users being harmed or suffering abuse or being placed at risk of harm or abuse. The registered person shall having regard to the size of the care home and the number and needs of service users make suitable arrangements for maintaining satisfactory standards of hygiene within the home. The registered person shall not employ a person to work at the care home unless the person is fit to work at the care home and has obtained in respect of that person the information and documents specified in paragraphs 1 to 7 of schedule 2. The registered person shall make suitable arrangements to provide a safe system, for moving and handling service users. The registered person must DS0000006217.V282987.R01.S.doc 07/02/06 20/03/06 20/03/06 10/03/06 20/03/06 20/03/06 07/02/06 Page 22 Snydale Care Home Version 5.1 ensure that hot water delivered to outlets accessible to service users is maintained at a safe temperature about which is presently considered 43 degrees. 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 OP12 OP15 OP19 Good Practice Recommendations The registered person should consider employing an activities co coordinator Service users are offered a choice of drinks. Ensure all bedroom doors shut and that working locks are in situ on all bedroom doors. Snydale Care Home DS0000006217.V282987.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Brighouse Area Office Park View House Woodvale Office Park Woodvale Road Brighouse HD6 4AB 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 Snydale Care Home DS0000006217.V282987.R01.S.doc Version 5.1 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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