Inspecting for better lives Key inspection report
Care homes for older people
Name: Address: St Armand`s Court 25 Church Lane Garforth Leeds West Yorkshire LS25 1NW The quality rating for this care home is:
two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Catherine Paling
Date: 0 4 0 2 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area.
Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection.
This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 28 Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 03000 616161 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home
Name of care home: Address: St Armand`s Court 25 Church Lane Garforth Leeds West Yorkshire LS25 1NW 01132874505 01132875591 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Garforth Residential Homes Limited Name of registered manager (if applicable) Mrs Jaqueline Hobman Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home 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 well 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, is next door. The home has two passenger lifts and communal facilities include a conservatory, two lounges and dining room. The home is also close to a range of local facilities. Information about the home is available in a detailed Statement of Purpose. The fees range from four hundred and twenty pounds and sixty four pence to five hundred and twenty eight pounds and forty two pence. This information was provided at the Care Homes for Older People Page 4 of 28 0 Over 65 40 care home 40 Brief description of the care home February 2009 inspection. The home should be contacted directly for up to date information about charges. Care Homes for Older People Page 5 of 28 Summary
This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. This was an unannounced visit by one inspector who was at the home from 10:00 until 16:20 on the 4th February 2009. The purpose of the inspection was to make sure the home was operating and being managed for the benefit and well being of the people who live there and in accordance with requirements. Before the inspection accumulated evidence about the home was reviewed. This included looking at any reported incidents, accidents and complaints. Care Homes for Older People
Page 6 of 28 A number of documents were looked at during the visit and all areas of the home used by the people who lived there were visited. A good proportion of time was spent talking with the people at the home as well as with the acting manager, the staff and the provider. An Annual Quality Assurance Assessment (AQAA) had been completed by the home before the visit to provide additional information. This is a self-assessment of the service provided. Survey forms were sent out to the home before the inspection providing the opportunity for people at the home, visitors and healthcare professionals who visit to comment, if they wish. Information provided in this way may be shared with the provider but the source will not be identified. A number of surveys were returned by the time of this visit. Comments received appear in the body of the report. What the care home does well: What has improved since the last inspection? The manager wrote in the AQAA - We have continued to make general material improvements to the home - both internally and externally, such as redecoration, carpeting, lounge chairs, commode chairs kitchen equipment and laundry equipment. Where recommendations for improvements were made in previous inspections, we have ensured these improvements/ changes have been implemented or are in the process of being implemented. Staff and managements knowledge has improved through continuing, relevant training and enhanced communication through regular staff meetings and supervision sessions. Communications with residents and the methods we use to gather feedback from them have been improved. We have continued to improve communications between residents, staff and relatives, by completing regular surveys, supervision and care reviews. Staff and management training in relevant qualifications, including NVQ, has continued, as well as introducing NVQ training for ancillary staff. We have continued to provide a comprehensive training plan for all staff and have sourced external training for areas such as NVQ and Mental Capacity Act, as well as introducing new induction formats to ensure consistency. The CHESS programme has been rolled out, along with the required training for management and staff and introduction of advanced care planning. We are committed to investing in our staff team and have achieved the Investors in People award. We have reviewed our survey format to make then more user friendly and surveyed all people who live, work and visit our service. We continually review our menus and have introduced a four week rotating menu to incorporate more choice. We have continued to improve our records and record keeping and achieved four stars following our Environmental Health Inspection and have reviewed our HACCAP procedures. We have Care Homes for Older People Page 8 of 28 monitored and reviewed our activities provision and improved on these where possible and have established a residents fund and have regular fund raising events. We have introduced auditing tools for care planning and medication. The manager has addressed issues identified at the last inspection and has continued to work at improving the service and facilities for people. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –03000 616161. Care Homes for Older People Page 9 of 28 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 28 Choice of home
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are provided with enough information to enable them to make and informed choice about moving into the home. The admission process is good and includes introductory visits. Evidence: The manager wrote in the AQAA - To help individuals and their families in making the right choice of home, we encourage day visits and prospective viewing from them. Day visits allow individuals and their families greater opportunity to to meet with and to talk to, many of the other residents and staff. Individual assessments are carried out at hospital or in the individuals home and through our care planning process and talking at length with individuals and their families, we can ensure their needs will be met and that they will be happy, should they make the decision to move to St Armands Court. Care Homes for Older People Page 11 of 28 Evidence: The information available to people is detailed and informative about the service and facilities at the home. We spoke to two people who had recently been admitted to the home. One person had already been aware of the home before they had decided to move in. People said that they had been visited by the manager before moving in when she had asked them questions about the care and support they would need. People said - Done well for me here Marvellous The pre-admssion assessments we saw were brief but there was also information from other sources. In addition, a further more detailed assessment is completed once someone has been admitted. We were also told that if someone had been in hospital a full re-assessment of care and support would be done when they moved back to the home to make sure that needs could still be properly met. We saw evidence of this in records. Care Homes for Older People Page 12 of 28 Health and personal care
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is enough detail in the care records for staff to know how to look after people properly. People are protected by safe medication practices. Evidence: The manager wrote in the AQAA - Our thorough administration policies ensure that regularly reviewed Care Plans are clear in every area, that all residents health needs are fully met. There have been no changes to medication policies, procedures and practices and these continue to be maintained to a very high standard. Staff are fully conversant with these and fully trained to provide the best service. Staff training in these areas such as care planning and medication remains a priority. We ensure that all residents receive comprehensive assessments regarding nutritional status and pressure care. At all times, we ensure residents are treated with respect and that their health, personal and social care requirements are set out in their own care plans. We have a good relationship with local healthcare professionals and we ensure residents are provided with pressure relieving equipment where needed. We have introduced advanced care planning for end of life care and ensured that all staff has received
Care Homes for Older People Page 13 of 28 Evidence: training in these areas. We see each resident as an individual with individual needs. We looked in detail at the care of a small number of people. People had care plans in place that had enough personal and specific detail for staff to know how to look after people properly. All care plans are reviewed in detail every month. This monthly review gives good information about the effectivness of the care plans together with any changes over the previous month. As part of the in-house monitoring systems the deputy manager audits care plans and notes any shortfalls which she discusses on an individual basis in staff supervision. There is a range of risk assesments completed for people that are detailed and are reviewed regularly. The manager told us that a nutritional risk assessment is also to be introduced for everyone which will help to make sure that people at nutritional risk do not have their needs overlooked. We also saw good daily records that showed the health and wellbeing of people. Where people had been visited by other healthcare professionals we saw clear and detailed records. The General Practitioner (GP) surgery serving the home is part of the Leodis initiative. This means that there is a weekly visit to the home by a GP and regular planned input from the practice nurse and individual health screening as well as other healthcare services. The home has also been part of the CHESS initiative (Care Homes End of life Support Services). Advanced care plans were in place meaning that peoples wishes about their end of life care were recorded and were respected. CHESS means that systems are in place to support people with the input of specialist services at the care at the end of their lives. Observed medication practices were safe. Everyone who is involved in the administration of medication is trained to take on this responsibility. We recommended that staff involved in the administration of medication should have an annual update to make sure that they maintain safe practice. Comments from healthcare professionals excellent People said I think the staff are wonderful (staff) always at hand Care Homes for Older People Page 14 of 28 Care Homes for Older People Page 15 of 28 Daily life and social activities
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported in maintaining contact with family and friends and to make choices about their day to day life. People have a good and varied diet that takes into account individual choices. Evidence: The manager wrote in the AQAA - A regular activities programme is in place, which is varied to suit individuals social needs, and this is well documented.All residents have an individual social care plan. External links with the community are maintained.All food is cooked on the premises and to a high standard, and incorporates special diets and preferences. Daily life at St Armands Court isnt just about activities: we also ensure there are regular supplies of drinks and snacks available for those who wish to enjoy them, throughout the day. Also, because food likes and dislikes vary, we work hard to ensure the right food choices are available to all residents. It is an over-arching policy here that we talk with and listen to residents, to ensure the home from home culture is embedded in everything we do.
Care Homes for Older People Page 16 of 28 Evidence: We saw that people spend their time in the way they want to. People were listening to music, reading with others chatting in small groups. Staff listened to what people wanted and organsed games of bingo during the afternoon making sure that all those who wanted to be involved got the chance. The cook makes a point of talking to everyone and goes round in the morning to ask people individually what they would like to eat. She was patient and gave people time to consider their choices. The lunchtime meal was well managed with people being given help and encouragement to eat. After the meal staff made sure that people were supported in a dignified manner to freshen them selves up. Care Homes for Older People Page 17 of 28 Complaints and protection
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is a robust complaints procedure. People are listened to and issues are acted on. People are protected by safeguarding procedures. Evidence: The manager wrote in the AQAA - At St Armands Court we have a robust complaints procedure in place through which, residents and their families can have a complaint investigated and resolved in a timely and thorough manner. Staff and management are trained to deal with complaints and the homes manager and owners are available at all times to listen to residents and families who may wish to make a complaint. While not all such concerns are simple to deal with, there are procedures in place to ensure that at the end of the day the issue is fully resolved. Staff are fully trained in the procedure for handling complaints and refreshment training is a part of the Homes ongoing training programme for management and staff.All complaints are handled in a strict timescale. We also encourage families to come in regularly and review their relatives care and bring up any concerns, we have found this has helped to minimise any misunderstandings. The complaints procedure is made available to everyone and it was clear with
Care Homes for Older People Page 18 of 28 Evidence: timesacels for responses to any issues raised. A log is kept of complaints recieved and records showed that they are dealt with properly. A record is also kept of any minor concerns and the action taken. Staff have training in adult protection. Training has also been provided around mental capacity and the deprivation of liberties. Care Homes for Older People Page 19 of 28 Environment
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a safe, comfortable and well maintained environment. Evidence: The manager wrote in the AQAA - We operate a comfortable, safe, well maintained and secure home for the benefit of our residents. Each resident is encouraged to enjoy their own space and privacy, if that is their wish and we do provide everyone living at St Armands Court with their own single room. For those residents wishing to do so, we actively encourage them to bring into the home, any of their own items of furniture, photographs or ornaments. We also offer different lounges throughout our spacious home, where resdients can enjoy activities that are taking place, or they may wish to select one of the lounges, where they can simply sit and read, enjoy the views into the garden or just enjoy a little peace and quiet. In the spring and summer staff actively encourage as many residents as possible to go out into the garden and to enjoy sitting or strolling around. Domestic staff ensure a clean and hygienic environment for all - both residents and staff.
Care Homes for Older People Page 20 of 28 Evidence: We visited all areas of the home used by the people who live there are the home was clean and odour free. People said that they felt the home is spotless. There are a small number of extra large and very spacious rooms on the third floor of the home. One of these is currently occupied by a wheelchair user and there was plenty of space for additional equipment and for him to move around the room easily. Bathrooms and toilets were not always clearly signed. The is aware of this and improved signage is planned for. Although soap dispensers are provided in communal areas and for staff disposable hand towels were not used. We recommended to the manager that these should be in use, in the interests of infection control. The laundry was clean and tidy and looked well organised. Care Homes for Older People Page 21 of 28 Staffing
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are cared for by trained and competant staff. There are enough staff to look after people properly. Evidence: The manager wrote in the AQAA - We take pride in the fact that we have a full complement of staff at St Armands Court (in line with requirements) and that many of them have been with us for a number of years. They have a wide range of skills between them - all beneficial to running a happy and caring home. We offer a good working environment and staff turnover is low. Staff are well trained, willing to learn and very understanding of the needs of residents. We retain staff. We have a regular and thorough staff training programme in place and will also look to introduce one off training sessions, should the need within the home demand that of us. Care Homes for Older People Page 22 of 28 Evidence: Our recruitment programme is of the highest standard. There is a stable staff team working at the home which means that there is consistency and stability for the people who live there. Staff are provided with the training they need so that they know how to look after people properly. All designations of staff are included in the whole range of training. For example, domestic staff have been working towards National Vocational Qualification (NVQ) in housekeeping support services and care of people with dementia. Recruitment procedures are robust with all the required checks completed before people start working at the home. Care Homes for Older People Page 23 of 28 Management and administration
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed and run in the best interests of the people who live there. Evidence: The manager wrote in the AQAA - St Armands Court is a family run home and currently managed by the owner Jackie Hobman. The sister home The Hollies was the first home Jackie opened in 1987 and is managed by her daughter Nicola Berry. Our values remain constant - and have done, since the business started in 1987. We strive to operate a care home that is run with compassion, one that every family would be happy to be associated with and where qualified, caring management and staff ensure privacy, dignity, choice, rights and independence and fulfilment for every resident of St Armands Court. Everything that is done at St Armands Court is centred around the best interests of the residents and this is the guiding principle that underpins everything we do. Welfare of residents is our priority. We ensure that all records and checks are kept up
Care Homes for Older People Page 24 of 28 Evidence: to date and carried out as required, we safeguard the financial interests of residents and overall, we are a forward thinking organisation; rather than rest on our laurels we will go the extra mile to determine whether or not there is a better way to do things. As well as our residents, we look after our staff, providing a good working environment and relevant training, in order to help them develop too. We have achieved the Investors in People award and this shows our commitment to invest in our staff team. The stable management at the home provides consistency and stabilty for the people who live there. The manager regularly surveys people and the most recent survey results were available together with an action plan. People said in the survey- Happy with everything Would like more outings There is a system of audits in place which continues to develop and a medication audit is to be introduced soon. All accidents are recorded. The manager was asked to review the method of recording accidents to make sure that it complied with data protection to make sure that information about people is held appropriately The staff said that they felt supported by the management on a daily basis and through regular supervision. Care Homes for Older People Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements
These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 26 of 28 Requirements and recommendations from this inspection:
Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours.
No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set.
No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service.
No. Refer to Standard Good Practice Recommendations 1 2 26 38 Disposable hand towels should be provided, in the interests of infection control. The current method of recording accidents should be reviewed to make sure that it complies with data protection. Care Homes for Older People Page 27 of 28 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 28 of 28 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
