CARE HOMES FOR OLDER PEOPLE
Straven House Queens Road Ilkley West Yorkshire LS29 9QL Lead Inspector
Nadia Jejna Unannounced 22 04 2005 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 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. Straven House J52 S1170 Straven House V221080 220405 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Straven House Address Queens Road Ilkley LS29 9QL Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01943 607063 01943 600708 Bupa Care Homes Ltd Mrs J Bland Care home only 24 Category(ies) of Old age (21) Dementia - over 65 (2) Physical dis registration, with number - over 65 (1) Mental Disorder -over 65 (1) of places Straven House J52 S1170 Straven House V221080 220405 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: The place for MD(E) is only for the use of the service user named in connection with the variation application of 13.1.05 Date of last inspection 2nd December 2004 Brief Description of the Service: The home is an adapted detached property set in its own grounds on the outskirts of Ilkley. It is registered to provide care to twenty-four residents of either sex over the age of 65, care can be provided for up to two people with dementia and one person with a physical disability. Nursing care is not provided. Two shared rooms are used as singles therefore occupancy is limited operationally to twenty-two. Accommodation is provided on the ground and first floors. There is a passenger lift, which can be used by residents to access the first floor and the lower ground floor where the dining room, kitchen and laundry are located. There are large attractive gardens but not all areas are accessible to residents; three patio areas have been provided, one of which has raised flower beds and another which can be accessed via the dining room has views across the valley. Ramps are available in the gardens and provide level access for wheelchair users into the building. A local bus route is near by and Ilkley town centre is within walking distance although this is a steep road. Straven House J52 S1170 Straven House V221080 220405 Stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. Over an inspection year from April until March, regulated care homes have a minimum of two inspections a year; these may be announced or unannounced. The last inspection was announced and took place on the 2nd December 2005. There have been no further inspections until this unannounced inspection. The people who live in the home prefer the term residents, and this is the term that will be used throughout this report. The purpose of this inspection was to monitor the home’s progress since the last inspection and to assess whether the care given to residents meets minimum standards. During the inspection records were examined, some areas of the home were seen, such as bedrooms, lounges and bathrooms; care staff were observed carrying out their work, and discussions, both on an individual and joint basis, were held with three members of staff, the manager, one visitor, and eight of the residents. Survey cards were left at the home for residents and their relatives or visitors to complete and return to the Commission for Social Care Inspection (CSCI). The inspection started at 10:30 and ended at 17:00 on the 22nd April 2005 and a second visit of two hours was made to the home to provide feedback to the manager on 4th May 2005. What the service does well:
The home provides a good standard of care to residents in a comfortable and well-maintained environment. Residents said that they were happy with the care provided, that the food was good and the home was always clean and tidy. They said that the staff were kind and caring, polite and respectful and that call bells were answered promptly. One resident remarked that the home had a calm and relaxed atmosphere and that it appeared to be well organised and efficiently run. Training programmes are in place, which cover induction, foundation, NVQ (National Vocational Qualification) and mandatory training. A number of survey cards have been returned at the time of writing this report, which indicated that residents and their relatives were satisfied with the service being provided. Straven House J52 S1170 Straven House V221080 220405 Stage 4.doc Version 1.30 Page 6 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. Straven House J52 S1170 Straven House V221080 220405 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Straven House J52 S1170 Straven House V221080 220405 Stage 4.doc Version 1.30 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 standard(s) 3 and 5. Residents are encouraged to make an informed choice about the home through visits to look round. The home ensures that it can meet the needs of prospective residents before they are admitted. EVIDENCE: Prospective residents and or their relatives are welcome to visit and look round the home at any time. The most recently admitted resident said that their family had found the home for them and given them brochures to look at. Either the manager or the care manager visits prospective residents in order to carry out a pre admission assessment. The document used covers all areas of information required by this standard and those seen provided sufficient information for the decision to be as to whether or not the home would be able to meet the residents identified needs. Straven House J52 S1170 Straven House V221080 220405 Stage 4.doc Version 1.30 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 standard(s) 7, 8 and 9. The needs of residents were being met, however records did not evidence this. EVIDENCE: A senior care assistant said that the care plans should tell the reader all about the person and how to care for them physically and socially; that the staff had been working hard on the care plans and that they were aware there was still work to be done. Two care plans were looked at in detail. These did not show that all identified and assessed needs were being met. Examples were given to the manager during feedback and included where a resident had a problem with swollen ankles. Staff were able to describe the care interventions needed to alleviate the problem and what medication had been prescribed by the GP but an appropriate care plan had not been implemented. The information contained in other care plans was basic and did not provide clear and detailed information to the reader as to how individual’s needs and preferences were to be met. Some residents were not aware that there was a care plan in place and there was no evidence of their or their representatives involvement. Straven House J52 S1170 Straven House V221080 220405 Stage 4.doc Version 1.30 Page 10 Written assessments were in place around moving and handling and nutritional needs. Records of GP and district nurse visits were seen. Residents are enabled to attend hospital out patient appointments and to see other healthcare professionals such as dentists and opticians. The organisation is in the process of reviewing the medication polices and procedures. Discussions with the care manager indicated that safe practices are being followed. Appropriate records are maintained but the systems for monitoring stock levels of the ‘as required’ medications need to be revised as it could not be identified how many of one particular tablet had been carried over from the previous month. Senior care staff have received training from the organisation around dealing with medications as part of the senior care preparation courses. It was not clear if this training has been accredited. Straven House J52 S1170 Straven House V221080 220405 Stage 4.doc Version 1.30 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 standard(s) 12,13,14, and 15. Residents are enabled and encouraged to participate in and continue with their chosen social and leisure activities, to maintain links with their friends and family and to exercise choice and control over their lives. Meals are enjoyed by residents. But the system for ordering meals two days in advance leads to residents forgetting what they have chosen and could restrict choice. EVIDENCE: Residents said that they chose how to spend their days, what time to get up and go to bed, whether or not to stay in their own rooms or spend time in the communal lounges and where they preferred to eat their meals. An activities organiser plans sessions on weekday afternoons. Residents said that they enjoyed these and that at other times she would take them out for a walk or shopping. The activity organiser keeps a record of whatever activities have taken place and who participated. A wide variety of videos, DVD’s, books and board games were available. Straven House J52 S1170 Straven House V221080 220405 Stage 4.doc Version 1.30 Page 12 A visitor said that they were able to visit at any time; that the staff made them feel welcome and offered them drinks and meals. Residents are able to go out with their visitors if they wish to. Lunch was served to residents in the dining room, one of the lounges or their own room. The food was attractively served and looked appetising. Residents said that they enjoyed their meals, they were offered alternatives and that the food was lovely. Some commented that they did not know what they would be having. Staff said that the menu choices are made two days in advance and that residents sometimes forget what they have ordered. It was recommended that this be reviewed. Straven House J52 S1170 Straven House V221080 220405 Stage 4.doc Version 1.30 Page 13 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18 Residents are protected and feel safe living in the home. EVIDENCE: Abuse awareness training has been provided to care workers. A senior care assistant said that this had been given during induction and foundation training and that this subject was being revisited as part of NVQ (National Vocational Qualification). She said that she would have no hesitation in reporting any suspected or actual abuse to the senior person on duty or to the local authority. Copies of the local authority adult protection procedures are kept in the home. Residents said that they felt safe. Straven House J52 S1170 Straven House V221080 220405 Stage 4.doc Version 1.30 Page 14 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 21, 23, 24, and 26. Residents are living in a safe and well-maintained home, which is suitable for their needs. The home is clean and tidy. EVIDENCE: The building is well maintained. There is suitable access to the home and three patio/garden areas for residents of all abilities. One of these areas has raised flower beds and residents are encouraged to look after these. The communal areas have been furnished and decorated to a high standard. One of the lounges has lovely views over the town of Ilkley. All residents’ rooms are single and en suite. They have been decorated and furnished to a good standard. It was evident that residents are able to bring their own belongings to personalise their rooms. Residents said that the home is always clean and tidy.
Straven House J52 S1170 Straven House V221080 220405 Stage 4.doc Version 1.30 Page 15 Some of the bedrooms en suite facilities include baths. There is adequate provision of communal toilets and assisted bathrooms. Disposable gloves and aprons are available and there is adequate provision of liquid soap and disposable towels for staff use. The housekeeper and domestic staff are managing the laundry until the manager can recruit a person specifically to work in the laundry. Residents said that they were satisfied with the laundry service. Straven House J52 S1170 Straven House V221080 220405 Stage 4.doc Version 1.30 Page 16 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29, and 30. The home has adequate numbers of staff on duty. Robust recruitment procedures are followed to protect residents. Staff receive appropriate training in order to meet the needs of residents. EVIDENCE: A carer recruited six months ago said that they had provided two referees and that they had not taken up the post until the enhanced CRB disclosure and POVA check had been received by the home. Their staff file confirmed this. They said that they had received induction and mandatory training and that they were issued with copies of the organisations staff handbook as well as a copy of the General Social Care Council Code of Conduct. Training plans are in place, which include induction and foundation training supported by a senior carer, NVQ and mandatory training. Additional training that is planned for the future includes palliative care, and more training for staff on dementia and dealing with challenging behaviours. One resident has mental health problems, but training in this area has not yet been made available to staff. Adequate numbers of staff were on duty for the number and needs of residents in the home. The manager said that a recruitment drive had been successful and most shifts were now covered. Agency staff were still being used on occasions but this was much less frequent than it had been. Residents said that they felt there were enough staff on duty.
Straven House J52 S1170 Straven House V221080 220405 Stage 4.doc Version 1.30 Page 17 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, and 36. Residents live in a home that is managed efficiently and they are consulted regularly about their views and opinions. EVIDENCE: The manager has got appropriate qualifications and experience. A resident said that they thought the home was calm, relaxed and well organised. Staff said that both the manager and care manager are very supportive and available for advice at any time. They said that this was the case for both staff and residents. A visitor said that they felt confident to approach the management team at any time and that they were informed of any changes. Residents and relatives meetings are held at regular intervals and records are kept. Staff meetings are also held on a regular basis and staff said that these were an open forum for discussion.
Straven House J52 S1170 Straven House V221080 220405 Stage 4.doc Version 1.30 Page 18 A care worker said that they received two monthly supervisions from the manager. This involved them filling in a self appraisal and then meeting with the manager to discuss it, identify areas for improvement and formulating a training plan. Straven House J52 S1170 Straven House V221080 220405 Stage 4.doc Version 1.30 Page 19 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3
COMPLAINTS AND PROTECTION 3 4 3 x 3 4 x 3 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x 3 3 4 x x x 3 x x Straven House J52 S1170 Straven House V221080 220405 Stage 4.doc Version 1.30 Page 20 NO Are there any outstanding requirements from the last inspection? 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 7 Regulation 15 Requirement Timescale for action 30.11.05 2. 7 12 3. 30 18 The registered person must ensure that detailed care plans are in place around meeting service users identified and assessed physical and social care needs. The registered person must 30.11.05 ensure and should evidence that service users and or their representatives are involved with the care planning process. The registered person must 30.11.05 ensure that the staff training programme includes mental health and other specialist care needs of service users. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard 7 9 Good Practice Recommendations The registered person should make provision for staff to receive training around person centred care planning. The registered person should revise the systems for monitoring the stock levels of the as required drugs in use. The registered person should ensure that the training
J52 S1170 Straven House V221080 220405 Stage 4.doc Version 1.30 Page 21 Straven House 3. 4. 15 around administration of medications provided to senior carers contains all required areas of information covered in certifificated training courses. The registered person should revise the meal ordering systems in order to ensure that residents know on a daily basis what their meal choices are. Straven House J52 S1170 Straven House V221080 220405 Stage 4.doc Version 1.30 Page 22 Commission for Social Care Inspection Town Street Rodley LS13 1HP National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
© This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Straven House J52 S1170 Straven House V221080 220405 Stage 4.doc Version 1.30 Page 23 - 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!
