CARE HOMES FOR OLDER PEOPLE
Station View 16 - North Yorkshire County Council 16 Station View Starbeck Harrogate North Yorkshire HG2 7JA Lead Inspector
Mrs Irene Ward Unannounced Inspection 16th November 2005 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 Station View 16 - North Yorkshire County Council DS0000034592.V262973.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Station View 16 - North Yorkshire County Council DS0000034592.V262973.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Station View 16 - North Yorkshire County Council 16 Station View Starbeck Harrogate North Yorkshire HG2 7JA 01423 887128 01423 885935 Address 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) North Yorkshire County Council *** Post Vacant *** Care Home 39 Category(ies) of Old age, not falling within any other category registration, with number (39), Physical disability (3) of places Station View 16 - North Yorkshire County Council DS0000034592.V262973.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. All Service Users for Intermediate Care (up to a maximum of 8) will be accommodated within the Rehabilitation Unit Care services provided for Service Users under category PD should be on a short term basis only and for service users over the age of fifty (50) 2nd December 2004 Date of last inspection Brief Description of the Service: Station View is a care home owned and operated by North Yorkshire County Council and registered to provide a service for up to 39 older people aged over 65 years. There are 8 care places for rehabilitation included as a condition of registration. The home is purpose built and is located in the Starbeck area. There is good range of amenities close by such as shops and public houses. Harrogate and Knaresborough centres are within a short distance. The home is a single storey building with level access. All bedrooms are single and arranged in small units. There are several inner courtyards and garden patio areas. The home also operates a day-centre, which offers up to 36 places per day. It is line managed by the homes management team but it has its own dedicated staff team Station View 16 - North Yorkshire County Council DS0000034592.V262973.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This report relates to an unannounced inspection carried out on the 16th November 2005, which started at 09.30 hrs and finished at 15.00hrs. A tour of all areas of the home was not carried out, as a visiting GP to the home confirmed that there was an outbreak of scabies. Advice was given to the home to suspend any admissions and discharges. Only two units were inspected in the morning which included service users private accommodation and communal areas, a selection of records were looked at and a small amount of time was spent observing activity in the home, talking and listening to service users. The focus of the inspection was a number of key standards, inspecting the care records of six service users in detail to establish if they corresponded with service users experiences in the home. There were also discussions with the homes team manager who was the person in charge at the time of inspection. The Operations Manager for the home was present for the feedback What the service does well: What has improved since the last inspection?
All of the requirements apart from two have been implemented. Service users meetings have been reinstated. The home has had some refurbishment carried out in some parts of the home. Station View 16 - North Yorkshire County Council DS0000034592.V262973.R01.S.doc Version 5.1 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Station View 16 - North Yorkshire County Council DS0000034592.V262973.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Station View 16 - North Yorkshire County Council DS0000034592.V262973.R01.S.doc Version 5.1 Page 8 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6 Prospective service users can be confident before moving into the home that their needs can be met. EVIDENCE: A pre-placement visit form is completed prior to admission into the home for anyone being admitted into the home. A care plan completed by a care manager where applicable is also obtained. The Crisis Risk Assessment Management holds a meeting weekly before service users are allocated places. In cases of emergencies the care managers would carry out an assessment before an admission into the home. The information on assessment forms was detailed sufficiently to give good indication of the care needs of prospective service users. The team manager stated that the home does provide intermediate care for up to eight people. A multi-disciplinary team that includes physiotherapists and occupational therapists carries out assessments for rehabilitation. Service users in this unit normally stay for up to 6 weeks. This unit is separately staffed from the home. Station View 16 - North Yorkshire County Council DS0000034592.V262973.R01.S.doc Version 5.1 Page 9 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10 The health care needs of service users are generally well met, although attention is required to personal care. EVIDENCE: Six case files were inspected, including the most recent admission into the home, most contained detailed plans of care. However care plans did not detail service users medication including strength and dosage required. One care plan had not been completed in detail such as personal history, places lived, and work history, interests and hobbies had all been omitted. It was noted that the daily records in service users files, completed by staff were well documented and gave a better picture of how the home meets service users needs. Although when speaking to a service user it was observed that the Zimmer fame used by the service user was extremely sticky and dirty. This was fed back to the management. Risk assessments covering areas of daily living were available and up to date. The health care needs of service users were recorded on their individual care plans. Service users who self medicate
Station View 16 - North Yorkshire County Council DS0000034592.V262973.R01.S.doc Version 5.1 Page 10 have lockable facilities in their own rooms to keep their medication safe. For those service users that are unable to self medicate the home operates a monitored dosage system, which was inspected and was appropriately stored and records were accurately maintained. The home has eight GP practises that see to the health care needs of service users. All accidents are taken to the Harrogate District Hospital and out patients appointments are made there, as the hospital is quite close by. Station View 16 - North Yorkshire County Council DS0000034592.V262973.R01.S.doc Version 5.1 Page 11 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 15 Service users dietary needs are well met and satisfy service users tastes and choices. EVIDENCE: Service users confirmed that they are able to get up and go to bed as they wish. Service users spoken with commented that the food at the home was very good and that there were always choices at each mealtime. The menu was inspected which had just been piloted. The menu showed that there is always an alternative available. Service users confirmed that there is always a cooked breakfast for those who want one. There is also a cooked tea most days. Station View 16 - North Yorkshire County Council DS0000034592.V262973.R01.S.doc Version 5.1 Page 12 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Service users are confident that their complaints and concerns are dealt with and are acted upon. EVIDENCE: The home’s complaints procedure is available to service users and a copy of the complaints leaflet is given with the Charter of Rights and the Statement of Terms and Conditions of Residence. Service users commented that if they had a complaint or a concern that they would speak directly with staff on duty. It then would be acted upon. The home records any complaints made and details action taken by the home and the outcome to the complaint. The home has received a number of thank you cards from grateful relatives for the care that had been provided by the staff at the home. North Yorkshire County Councils Policies and procedures regarding adult abuse are in place and are followed. Station View 16 - North Yorkshire County Council DS0000034592.V262973.R01.S.doc Version 5.1 Page 13 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Service users rooms are comfortable, although the communal area of one flat requires refurbishing. EVIDENCE: Only two flats were inspected in the morning, as a visiting GP confirmed that there had been an outbreak of scabies. Not all of the premises were inspected on this occasion including service users own private space. The home was well lit and warm. However the light fitments to both the main bathroom on Flat 3 and the single toilet were missing and require to be replaced. The kitchen area/kitchen cupboards were “grubby” The paintwork in the corridors was chipped. There was an odour in one service users room and in the main entrance. The patio areas in Flats 3 and 4 were overgrown and unkempt. Station View 16 - North Yorkshire County Council DS0000034592.V262973.R01.S.doc Version 5.1 Page 14 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30 Service users are protected by the home’s vigorous recruitment procedures. EVIDENCE: Staff records showed that the operations manager undertakes thorough checks before staff commence working at the home. CRB checks have been carried out and staff have been checked against the POVA first list. All staff complete application forms. Two written references are obtained. Various training such as first aid, food health and hygiene, health and safety and so on is available and completed by staff. The rota showed that there are four care staff and one senior staff on duty each morning however this changes in the afternoon as the number of care staff goes down to three. Two staff are on waking duty each night for the whole building. In discussions held with the team manager and the operations manager in respect of the size and layout of the building, the local authority should give consideration to maintaining the appropriate numbers of staff at all times. The homes staffing hours are above the minimum hours required, however the home should look at how staff are deployed in the building to ensure that service users, health and safety is promoted and not put at risk and that their care needs are met at all times. Station View 16 - North Yorkshire County Council DS0000034592.V262973.R01.S.doc Version 5.1 Page 15 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 and 38 Service users’ health, safety and welfare are generally promoted and protected with one exception regarding fire precaution EVIDENCE: There is no registered manager and the local authority is required to give this matter urgent attention and submit an application to register a manager. Service users finances were inspected. The home operates the organisations procedures, which were being followed. Two service users monies were inspected. Both were accurately maintained. Receipts are obtained for all purchases made. A number of health and safety records were inspected all of which were up to date and accurately maintained. However weekly fire alarm tests had not been carried out in line with the requirements of North Yorkshire Fire Rescue Service. The Accident Book is not maintained in line with the requirements of Data Protection as accident logs are all kept in one file instead of being maintained in individual’s files
Station View 16 - North Yorkshire County Council DS0000034592.V262973.R01.S.doc Version 5.1 Page 16 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 3 HEALTH AND PERSONAL CARE Standard No Score 7 1 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 1 X X X X X X 1 STAFFING Standard No Score 27 1 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 1 X 3 X 3 X X 1 Station View 16 - North Yorkshire County Council DS0000034592.V262973.R01.S.doc Version 5.1 Page 17 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP7 Regulation 12 Requirement Care plans must be sufficiently detailed for staff in how they meet service users care needs. Including any details of medication. The staff at the home must ensure that service users zimmer frames and any such equipment are kept clean and well maintained. The toilets located near the day centre area must be refurbished. Areas such as corridors in Flat 3, patios and light fitments in one bathroom and toilet require attention All areas of the home must be kept clean and free from any odours. The registered person must ensure that sufficient staff are effectively deployed at all times in meeting the needs of service users. An application to register a manager must be submitted to the Commission. Fire Alarms must be tested on a weekly basis in line with the
DS0000034592.V262973.R01.S.doc Timescale for action 16/02/06 2 OP8 13(4)(c) 16/02/06 3 4 OP19 OP19 23 23 01/07/04 16/02/06 5 6 OP26 OP27 23 (d) 18(1)(a) 16/11/05 16/02/05 7 8 OP31 OP38 8 23(4) 31/08/04 16/11/05 Station View 16 - North Yorkshire County Council Version 5.1 Page 18 requirements of North Yorkshire Fire and Rescue Service. 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 OP38 Good Practice Recommendations Records of accidents should be maintained in line with the requirements of the Data Protection Act and held on the individual persons file. Station View 16 - North Yorkshire County Council DS0000034592.V262973.R01.S.doc Version 5.1 Page 19 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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