Inspection on 14/01/09 for St Johns House

This inspection was carried out on 14th January 2009.

CSCI found this care home to be providing an Excellent service.

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 Johns House 29/01/07

St Johns House 31/01/06

St Johns House 14/02/05

Similar services:

Snydale Care Home

Abbey The

Larchfield Manor

Hawkhills

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 13/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: St Johns House Parker Lane Kirk Hammerton Nr York North Yorkshire YO26 8BT     The quality rating for this care home is:   three star excellent 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: Linda Trenouth     Date: 1 4 0 1 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 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (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.csci.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: St Johns House Parker Lane Kirk Hammerton Nr York North Yorkshire YO26 8BT 01423330480 01423331619 CliftonStAnn@aol.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Clifton St Annes Personal Care Services Ltd. Name of registered manager (if applicable) Mrs Andrena Piggins 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 Johns House is registered to provide accommodation and personal care for up to 36 people over the age of 65 years. The home is a large manor house converted and extended for its current use. The home is set within its own grounds and is situated on the outskirts of Kirk Hammerton village mid way between Harrogate and York. Clifton St Annes have owned the home since November 2004. Thirty-four of the thirty-five bedrooms are for single accommodation and the one double room is currently also used for single accommodation and would only be used as a double at the expressed wish of the people who would be sharing the room such as a married couple. These rooms along with the communal rooms are sited on the ground and first floors. The home has a stair lift, a full passenger lift and has level access from outside. Current information about services provided at St Johns House in the form of a statement of Care Homes for Older People Page 4 of 26 0 Over 65 36 care home 36 Brief description of the care home purpose, service user guide and the most recent inspection report published by the Commission for Social Care Inspection are available by contacting the home. The weekly fees are between 480 and 550 pounds. Care Homes for Older People Page 5 of 26 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: three star excellent 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: We visited the service over one day for approximately 6 hours. The inspection also included gathering information and evidence before and after the visit to decide the overall judgement. We looked at records, watched staff working, and talked to people who live at the home and their relatives. We also looked around the building. The main purpose of this inspection is to make sure the service provides a good standard of care. We have reviewed our practise when making requirements, to improve national Care Homes for Older People Page 6 of 26 consistency. Some requirements from previous inspection reports may have been deleted or carried forward as recommendations, but only when it is considered that people who use the service are not being put at significant risk or harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. We sent comment cards to people who use the service and to relatives to give them the opportunity to comment on the service. The manager of the home completed a self-assessment form called AQQA, which is information we asked for every year and is used as part of the inspection process. The returned self-assessment documentation provides information about staffing and people who use the service. Feedback was given during the inspection to the manager of the home. The fee for the home is between 480-550 pounds. Extras charged for are hairdressing, toiletries and chiropody. What the care home does well: What has improved since the last inspection? 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.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 26 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 9 of 26 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 have good information and are well assessed before they move into the home. Evidence: People are told what the service can provide and have their needs fully assessed. People who use the service told us that they were encouraged to visit the home and had been given good information, helping them decide if the home is right for them. The service ensures that care assessments are undertaken before someone is admitted to the home. From this information the service can decide if they are able to meet a persons needs. Relatives say that they felt that the assessments were thorough and this reassured them the home would be able to meet their relatives care needs. Care Homes for Older People Page 10 of 26 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples social and health care needs are met. Evidence: Each individual at the home has their own care plan, which looks at their care needs and how they would like to be cared for. People at the home told me that they are involved with decisions made in their care plan. They tell us that the staff are very conscientious and support them in the way they prefer. People are regularly reviewed this makes sure that any changes in their care needs are met promptly.There reviews are kept up to date by the staff at the home. The home has good links with the local health facilities in the community, regular visitors to the home include the local GP, district nurse, chiropodist, dentist and physiotherapist. Relatives felt that communication in the home was good and they were kept informed Care Homes for Older People Page 11 of 26 Evidence: of any changes in the health or peoples care needs. Mum cannot respond on the phone but the carers always let us know of any changes....if one of us is out they always contact another member of the family Relatives visiting the home comment, the staff are very, very good, the care they give is second to none People who live at the home said the following about the staff, The staff are so reliable and work so hard. They think of things I need before I need them. The staff are the best, they are always asking me if I am comfortable and checking I am alright The staffing in the home is solid, they do not have temporary staff working here who do not know what they are doing I find life is very difficult for me now, but the staff always help me in the way I like and are very kind and sensitive It was a hard decision to move here, leaving my own home, but the staff have made this has pleasant as possible People are able to take their own medication if they wish and a risk assessment is completed. This helps decide the best way to support individuals. Staff administer medication to people at the home and keep clear records that show this is conducted safely. The home has had an additional visit from the Pharmacist inspector who was happy at her final visit that the home had put safe procedures into place. The home has changed their medication system to a monitored dosage system, this is where the pharmacist pre loads the medication into a blister pack. This is to minimise any errors when administering medicines in the home. Care Homes for Older People Page 12 of 26 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported to enjoy a fulfilling life at the home. Evidence: People told us that they felt they were able to live the life they choose within the home. Some people preferred the peace of their own rooms and joined others for meals and some social occasions. For people who prefer more activity there are a variety of different lounges and spaces where they can meet with others and chat. Peoples social interests are reviewed in their care assessments. This helps the activities organiser and staff plan appropriate activities and events to interest people. Many activities are organised by the activities organiser and staff, including quizs, board games, dominoes and arts and crafts. Where people do not like group activities there is a commitment to make sure one to one activities are arranged. Other people still takes part in hobbies that they enjoyed in the past including, photography, walking and knitting. One individual said, I make hats, I enjoy this activity and they are sold to make a little money for the funds Care Homes for Older People Page 13 of 26 Evidence: Involvement within the community is also important and people visit the local pub and some individuals go to the local, Thursday club, in the village. The local school have visited and, pen friendships, have begun between the children at the school and people who live at the home. People told us, we go out to the local pubs in the area and we are going to do a pub guide We go out to lots of places, its nice to get out for a change Peoples spiritual needs are supported and during the visit communion was held in the home by the local vicar. People are supported to maintain their relationships with their family and friends, relatives tell us that they are made to feel welcome and comfortable at the home. There is an area of the home for families to meet in private and have family parties. The home can also offer overnight accommodation to relatives if they have travelled along way to visit. Important events are celebrated and one person said, it is lovely they always remember our birthdays and we have a cake The home encourages relatives and friends to visit the home and attend social events throughout the year. Every year the home has a Summer garden party, a Bonfire night party and a Christmas evening buffet. People are also encouraged to exercise their legal rights and encouraged to use their postal vote. People tell me that generally the food is good and that they feel they have a say in the menu planning. There are regular residents meetings, which relatives are invited to. This gives people chance to talk about the way things are being run in the home and air any concerns that they have. Recent meetings have looked at food, menus, ideas for outings. The manager makes sure that these areas are included in future planning at the home. We joined people for lunch and the meal was liver and onions, mash potatoes and cauliflower. This was followed by lemon tart and custard. People told us that the enjoyed their meal. It was confirmed that there is plenty to eat and that alternatives are served where requested at lunch, with choices available at breakfast, tea and supper. Care Homes for Older People Page 14 of 26 Evidence: The only concern was raised with the temperature of the food and the transportation from the kitchen. Presently the staff are carrying food a distance to the dining room. The manager confirmed that a heated food trolley is on order to solve this problem. Care Homes for Older People Page 15 of 26 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. People feel that their comments and concerns are taken seriously and will be acted upon. Evidence: There is a complaints procedure which is included in the service users guide, which is available in peoples rooms and on display in the home. All those spoken with felt confident that they could take their complaints to the manager, and that she would deal with them to their satisfaction. Relatives told me, the manager and staff are very approachable and we feel we can say if we are not happy. We work together for what is best for mum Staff knew that any complaint made to them should be reported to the registered manager. The CSCI has received one concern since the last inspection, this was about medication and the pharmacist inspector made an addition inspection to work with the home. The home promptly put all the recommendations into effect to make sure that people are safe. The home has received three complaints which were dealt with promptly. Care Homes for Older People Page 16 of 26 Evidence: Staff have completed training in protecting vulnerable adults from understanding abuse. Staff say that they would refer any concerns brought to their attention to the manager, who in turn would report the matter to the appropriate body for investigation. Care Homes for Older People Page 17 of 26 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 excellent 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 clean and comfortable home. Evidence: St Johns is set in its own gardens in a picturesque part of North Yorkshire. The gardens are well maintained and people at the home say they often sit out side in the nicer weather and go for walks in the grounds. They also have use of a pretty summer house. Recently a new gazebo has been purchased and further seatings areas created outside. The home is well maintained by the maintenance man who works full time at the home. The surroundings are well decorated and furnished. People have a range of areas to sit and move around the home with three lounges, conservatory and three dining rooms. People were very happy with their rooms, one person said, I have a lovely room and I have many belongings from my home that are special to me. Bedrooms that were seen were individualised and had many pictures, personal memorabilia and items of personal furniture. Care Homes for Older People Page 18 of 26 Evidence: The home was very clean, fresh and comfortable. The cleaning staff work hard to make sure the home looks good. One person told us, The home is always spotless, it doesnt matter when you visit. The staff told us that there is a regular maintenance audit with a checklist on each shift to make sure that standards are kept up to. Care Homes for Older People Page 19 of 26 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff are well trained and supported to do their job safely. Evidence: Staffing levels at the home are good. The are good levels of staff working throughout the day and night. Senior staff are also on call throughout the night if staff need further support. The home has separate staff who are responsible for catering, cleaning and the laundry. This ensures that care staff can use all their time to support and care for people at the home. People living at the home say, there are enough staff working here and they come quickly when I ring my bell. One person felt that at times he had to wait a little longer but acknowledged that this was no more than a few minutes, and he said this was only occasionally. Relatives told us that they visited regularly and had found the staffing levels good. There is a clear induction and training programme and many of the staff at the home have completed National Vocational Qualifications. The home has more than 76 of staff who have completed NVQ level 2 or above, the home is clearly committed to staff training and making sure people who work at the home care for people safely. Care Homes for Older People Page 20 of 26 Evidence: Staff say that they have regular supervision and feel that the management is supportive. Recruitment of staff at the home is done in responsible way with checks being undertaken to make sure that people are safe to work at the home. This further protects people who live at the home by making sure the right staff are recruited. Care Homes for Older People Page 21 of 26 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is run in the best interests of the people who live there. Evidence: The home is well managed. The registered manager is very experienced in care. She has completed the right training to make sure she can do her job safely. Relatives tell us that they have confidence in the manager and feel she is easy to approach and will deal with any concerns that they have. People who live at the home say, The manager is lovely she always has time to talk to us and it must be a very busy job Staff commented that they feel that the home is run well and that they are well supported. Care Homes for Older People Page 22 of 26 Evidence: People have their views taken into account, there are regular residents meetings, staff meetings, individual reviews and qualitative questionnaires which give people an opportunity to have their say. All these are taken into account in the future development of the home. Following recent questionnaires, where concerns about lack of parking spaces was identified the management are looking at developing a larger car park to the side of the home. Health and safety is regularly monitored by the manager and the staff. Records were reviewed in areas such as electrical and hoist safety. Health and safety records were well organised. Concerns however were expressed at the wedging open of doors, the manager must make sure this does not happen, but also seek advice from the fire officer to review certain doors which may be able to have an automatic closure fitted. The home has ensured it meets health and safety standards by conducting a legionaries, water safety check on the home. They also have worked hard to identify their environmental impact, commissioning a report from an independent company. Following this all appropriate waste from the site is now recycled. Care Homes for Older People Page 23 of 26 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 24 of 26 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 Care Homes for Older People Page 25 of 26 Helpline: 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 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 26 of 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. 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!