Inspection on 27/02/07 for St Armand`s Court

This inspection was carried out on 27th February 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

St Armand`s Court 04/02/09

St Armand`s Court 27/01/06

St Armand`s Court 21/06/05

St Armand`s Court 09/11/04

St Armand`s Court 25/05/04

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Abbey The

Snydale Care Home

Hawkhills

Larchfield Manor

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

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

CARE HOMES FOR OLDER PEOPLE St Armand`s Court 25 Church Lane Garforth Leeds West Yorkshire LS25 1NW Lead Inspector Paul Newman Key Unannounced Inspection 27th February 2007 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 St Armand`s Court DS0000001497.V330313.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. St Armand`s Court DS0000001497.V330313.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service St Armand`s Court Address 25 Church Lane Garforth Leeds West Yorkshire LS25 1NW 0113 287 4505 0113 287 5591 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) Garforth Residential Homes Limited Mrs Jaqueline Hobman Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (40) of places St Armand`s Court DS0000001497.V330313.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 27th January 2006 Brief Description of the Service: St. Armands Court is a care home owned by Garforth Residential Homes Limited, and is situated in Garforth, a suburb of Leeds. The manager is one of the Directors of the Company. The home provides personal care and support to forty older people. Nursing care is not provided but the home is supported by local healthcare services. The home is purpose built, all rooms are single occupancy, and the grounds include gardens, car parking and the companys sister home, The Hollies. The home has two passenger lifts and communal facilities include a conservatory, two lounges and dining room. St Armand`s Court DS0000001497.V330313.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. In April 2006 the Commission for Social Care Inspection (CSCI) made some changes to the way in which care services are inspected. Care services are now judged against outcome groups. The inspection report is divided into separate sections for each outcome group for example User Focused Services. An overall judgement is made for each outcome group based on the findings of the inspection. The judgements reflect how well the service delivers outcomes to the people using the service. The judgements categories are “excellent”, “good”, “adequate” and “poor”. The judgements are recorded within the main body of this report. More detailed information about these changes is available on our website – www.csci.org.uk. The last inspection of the service was made in January 2006. The purpose of this inspection was to gain an overview of the care, services and facilities provided and also to assess progress in the way the home is dealing with issues that were raised in the last inspection report. The Owner completed a pre-inspection questionnaire and this information is an important part of the inspection process. During the inspection records were looked at, some parts of the home were seen, such as bedrooms, lounges and bathrooms; care staff were seen carrying out their work; conversations were held with the manager, four other members of staff, several residents and two relatives. Survey cards were sent to the home before the inspection and for residents, relatives or visitors to complete and return to the Commission for Social Care Inspection (CSCI). These cards provide an opportunity for people to share their views of the service with the CSCI. Comments received in this way are used as part of the evidence base for this report. What the service does well: The home continues to be consistently well managed, with a clear approach to the care of residents whose quality of life and best interests are the main concern of the manager and staff. The staff are well organised. They are experienced, well trained, know what they are doing and have a good knowledge of the residents they care for. They have good relationships with residents and relatives. Residents and relatives appreciate the staff and are confident in them. Residents’ rooms are personalised with their own belongings and they exercise choice about spending time in their bedroom or in communal areas. Varied menus provide choice and residents say that the food is good. Two written comments about the home from relatives said: St Armand`s Court DS0000001497.V330313.R01.S.doc Version 5.2 Page 6 • • ‘The manager has some wonderful ladies working for her, they do a great job, never once did I find Mum dirty or the bed unclean. Mum always had clean bed linen etc. I cannot speak highly enough of the manager and her team of carers’. I just want to say we are satisfied with Dad’s care. The staff and owner are always there if you need them, and you can discuss anything with them. There is always a welcome cup of tea’. What has improved since the last inspection? 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. The summary of this inspection report can be made available in other formats on request. St Armand`s Court DS0000001497.V330313.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 St Armand`s Court DS0000001497.V330313.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. JUDGEMENT – we looked at outcomes for the following standard(s): 3. Standard 6 is not applicable to this home. Quality in this outcome area is good. The admission process is good and includes introductory visits. Residents’ needs are properly assessed and needs are met by well-informed and knowledgeable staff. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager carries out an assessment of need for anyone interested in coming to live at the home. Admissions are planned for and the staff informed in advance of the needs of each particular person. People who are thinking about moving to the home, and their families, can spend time at the home talking to other people who live there and meeting the St Armand`s Court DS0000001497.V330313.R01.S.doc Version 5.2 Page 9 staff. This allows them to make their own minds up about whether or not this is where they want to live. Information is made available to staff so they can understand the social, personal and emotional needs of people who live at the home, and know what help to give. Standard 6 was not checked as the home does not offer an intermediate care service. St Armand`s Court DS0000001497.V330313.R01.S.doc Version 5.2 Page 10 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 and 10. Quality in this outcome area is good. People living at the home get the care they need and are treated with respect. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Every person living at the home has a ‘care plan’, which explains to staff what help to provide and how to give it. As part of the evidence gathering three residents were case tracked. This meant detailed checking of their files, speaking to the residents about the individual care provided to make sure that their care needs were being met, and speaking to the staff who deliver the care to make sure that they had a clear understanding of each individual’s needs. The care plans are straightforward and easy to read. The care needs are identified and give clear instructions and guidance to staff, and were up to date St Armand`s Court DS0000001497.V330313.R01.S.doc Version 5.2 Page 11 with regular monthly review. Risk assessments were clear, reviewed regularly and up to date. Specific health care needs were documented and audit trails of staff observations and concerns that they document about an individual’s health problem, any subsequent referral to the GP or other health care professional and the advice and treatment that followed could be made from the files. A community nurse who was visiting the home to treat a resident explained that arrangements for nursing support had recently changed and the nurses are now provided from the same GP practice where most of the residents are registered. Although it was early days, she felt that staff are very welcoming, positive and helpful. As part of the case tracking process the medication of the three residents was checked against the records. Medication prescribed for people living at the home is stored safely. Staff can only administer medication once they have received relevant training and are considered to be competent. Records are kept of all medication, which comes into the home, so that there is a clear audit trail of how much medication should be on the premises at any given time. Some errors were noted on the medication administration sheets for one resident and it was highly likely that the resident had refused medication on some occasions but this had not been recorded. The staff spoken with had a good knowledge of the residents they look after. People living at the home are treated with respect and enjoy a great deal of privacy. They are addressed by the name that they prefer. They can personalise their bedrooms. The laundry service is good and clothing is looked after well and the residents looked well presented. Resident’s said that they were settled and comfortable living in the home. They said that staff were kind and caring and respected their privacy. The observations of the staff as they related with residents supported these comments and in particular the work they did with the three residents that were case tracked during the inspection. Throughout the day staff were seen knocking on doors before entering and where they were providing personal care to residents in their rooms, they made sure the door was closed. Similarly residents’ privacy was protected when toileting was taking place in communal facilities. One of the relatives who returned a survey questionnaire also took the time to write a complimentary letter. The conclusion stated: • ‘The manager has some wonderful ladies working for her, they do a great job, never once did I find Mum dirty or the bed unclean. Mum always had clean bed linen etc. I cannot speak highly enough of the manager and her team of carers’ St Armand`s Court DS0000001497.V330313.R01.S.doc Version 5.2 Page 12 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 and 15. Quality in this outcome area is good. Residents are encouraged to make their own decisions about their lifestyle. Family, friends and visitors are welcomed at the home. There is a balanced menu that residents like and any special dietary needs are catered for. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Residents choose whether or not to join in with things going on in the home. The last satisfaction survey that was conducted by the home identified mixed feelings from residents, relatives and stakeholders about the activities provided at the home. In response to this the home has actively sought to employ an activity organiser. At one point they felt they had a suitable person but through the robust checking that is done found that the person was not suitable so further efforts are being made. Some residents spoken with or who returned CSCI questionnaires said they prefer to occupy their own time. A number of family members and visitors were seen at the home on the day of the inspection. Visitors say they feel welcome. The written information about St Armand`s Court DS0000001497.V330313.R01.S.doc Version 5.2 Page 13 the home makes it clear that family and friends are welcome to visit and the conversations with residents showed how important this was for them. One resident was going out with his daughter to pay some bills. During the inspection residents said that they are able to get up and go to bed when they wish, free to spend time privately in their rooms and were happy with the external services offered by the hairdresser, optician, dentist and chiropodist. A local minister holds monthly religious services that are well attended. The menus show that good wholesome food is provided. Residents spoken with said that the food was good, there was always plenty of it and that their likes and dislikes were known and kept to. There are regular snacks and drinks provided throughout the day. The meal served provided a choice, was well presented, hot and was enjoyed by all. St Armand`s Court DS0000001497.V330313.R01.S.doc Version 5.2 Page 14 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 and 18. Quality in this outcome area is good. Residents feel comfortable in raising concerns on a day-to-day basis and have access to a formal complaints procedure that is clear. Staff are trained in understanding and recognising abuse and there are clear procedures for them to follow. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The complaints procedure is in the service user guide that is given to all service users. It is also posted on notice boards around the home. All of the residents spoken with said that they felt comfortable in raising concerns with staff and that when they did, staff acted quickly to put things right. There were some good-humoured responses and some residents said they like to keep ‘staff on their toes’. The two relatives were aware of the complaints procedure, confident in approaching staff ‘for the smallest of things’ and said that anything raised would be sorted out. They said the staff and manager were very approachable. This was supported in the questionnaire surveys that were returned although one indicated that they were not aware of the complaints procedure. St Armand`s Court DS0000001497.V330313.R01.S.doc Version 5.2 Page 15 The home’s policies and procedures protect residents from members of the public who may be unsuitable to work with vulnerable adults. Staff are trained to provide care in a safe way and residents confirm that they feel safe. There is evidence that staff attend training on the prevention of abuse. People living at the home describe the staff as ‘very kind’. St Armand`s Court DS0000001497.V330313.R01.S.doc Version 5.2 Page 16 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 and 26. Quality in this outcome area is good. Residents live in a safe, comfortable home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All the communal areas, the kitchen, laundry and some bedrooms were seen. No health and safety hazards were noted and staff were seen doing their work properly dressed and equipped, and their practices make sure the home is clean, free from unpleasant smells and hygienic. There has been a significant amount of improvement work done in the home since the last inspection and more is planned. This has included: • An extra toilet equipped for the disabled on the ground floor. St Armand`s Court DS0000001497.V330313.R01.S.doc Version 5.2 Page 17 • • • • • All bedrooms re-carpeted and the vanity unit surfaces replaced. The staff office and medication room extended. Corridor floor coverings replaced. Chairs in the communal areas recovered and redecorated. New mattresses throughout the home. Further purchases are planned for security grills to the medication room, fridge for the storage of medicines, new commode buckets, new seats for commodes, a bathroom to be upgraded, curtains replaced throughout the building. This investment shows the owners commitment to maintaining good standards of care. St Armand`s Court DS0000001497.V330313.R01.S.doc Version 5.2 Page 18 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 and 30. Quality in this outcome area is good. There is a settled and stable staff team. Residents and relatives are satisfied with the care they receive and enjoy good relationships with staff. There is a commitment to staff training and training programme to make sure staff receive up dates and are given some more specialist training. Sound procedures are followed to recruit staff and to make sure they are vetted and checked. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People who live at the home feel that although very busy, there is generally enough staff on duty to meet their needs. The home appeared to be sufficiently staffed on the day of the inspection and people were getting the help and care they required. The home does not use agency workers, which ensures consistency for the residents of the home. Members of staff spoken with during the inspection seem settled in their job and enjoy working at the home. This has a positive effect on service users in that they are cared for by a content staff team who have their best interests in mind. The staff are well organised and there are well established systems of St Armand`s Court DS0000001497.V330313.R01.S.doc Version 5.2 Page 19 shift handovers, staff meetings that mean information about the residents is up to date. The home employs a high number of staff with recognised qualifications in care and who have undergone a great deal of training. The company continues to employ a training coordinator whose role is to make sure that the staffs’ training is up to date and in line with the National Minimum Standards that are set. The recruitment process promotes equal opportunities so that prospective employees are not discriminated against for their gender, race or disability. The personnel files for two newly appointed staff were checked and found to have all the required documentation. This shows that proper recruitment procedures are followed that make sure staff are properly checked and vetted before they take up appointment. St Armand`s Court DS0000001497.V330313.R01.S.doc Version 5.2 Page 20 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, 32, 33, 35 and 38. Quality in this outcome area is good. The home is well managed and a consistent management approach has given everyone working at the home a clear understanding of the home’s aims and objectives. Good systems are in place to monitor the quality of the service. The home is a safe place to live. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager of the home is organised, competent and runs the home to meet the needs of the people who live there. She has achieved management St Armand`s Court DS0000001497.V330313.R01.S.doc Version 5.2 Page 21 qualifications. There is always a senior carer on duty to take responsibility for the running of the shift and the safety and well being of the residents. The manager continues to be ‘hands on’ to make sure there is personal ‘on the job supervision’ as well as the established formal supervision system for the staff team. The staff and residents appreciate her management style and all said she was approachable and helpful. Residents, families and staff know who to got to if there is a problem and are very happy with the way in which the home is run. The home conducts a satisfaction surveys the last being in December 2006. This involves questionnaire surveys being sent to residents, relatives, staff and professional visitors. The last survey results were formulated into a report and an action plan made for any improvements that were identified. The report is available in the entrance hall for anyone to read. The atmosphere in the home was warm with a lot of good humour. Staff were busy and their relationships with the residents were good. Lockable facilities are provided in each bedroom so that individuals can keep cash and valuables. The home does not become involved in residents’ personal finances preferring this to be done personally by the residents, or by a relative or other representative like a solicitor. Any additional services that are received like hairdressing are invoiced monthly or paid for personally by the resident. Staff are trained to move and handle residents safely. Training is provided at the home and updated regularly to take into account current safe working practices. Staff know what to do in the event of a fire and how to protect the people they care for and they confirmed that they have been trained. A selection of safety certificates and maintenance records were looked at which showed checks were being made regularly. St Armand`s Court DS0000001497.V330313.R01.S.doc Version 5.2 Page 22 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 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 X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 X X 3 St Armand`s Court DS0000001497.V330313.R01.S.doc Version 5.2 Page 23 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. 1. Standard OP9 Regulation 13 Requirement Staff must complete the medication administration sheets to show if a resident has refused medication. Timescale for action 01/04/07 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. Refer to Standard OP12 Good Practice Recommendations Further efforts should be made to introduce a range of activities that suits all residents living in the home. The recruitment of a person to specifically organise activities should be considered. St Armand`s Court DS0000001497.V330313.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Aire House Town Street Rodley Leeds LS13 1HP 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 St Armand`s Court DS0000001497.V330313.R01.S.doc Version 5.2 Page 25 - 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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