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Inspection on 27/01/06 for Sue Ryder Care Centre

Also see our care home review for Sue Ryder Care Centre for more information

This inspection was carried out on 27th January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Service users spoken with felt the home provides a good standard of care.

What has improved since the last inspection?

One member of staff has obtained a neurological qualification, and a further two members of staff are undertaking this training.

What the care home could do better:

Communication between healthcare professionals needs to be improved.

CARE HOME ADULTS 18-65 Sue Ryder Care Centre Holme Hall Holme On Spalding Moor East Yorkshire YO43 4BS Lead Inspector Jo Bell Unannounced Inspection 27th January 2006 09:30 Sue Ryder Care Centre DS0000000955.V276000.R01.S.doc Version 5.1 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 Sue Ryder Care Centre DS0000000955.V276000.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 Adults 18-65. 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. Sue Ryder Care Centre DS0000000955.V276000.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Sue Ryder Care Centre Address Holme Hall Holme On Spalding Moor East Yorkshire YO43 4BS 01430 860904 01430 869591 linda.chapman@suerydercare.com 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) Sue Ryder Care Mrs Linda Christine Chapman Care Home 40 Category(ies) of Physical disability (40), Physical disability over registration, with number 65 years of age (40) of places Sue Ryder Care Centre DS0000000955.V276000.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 10th August 2005 Brief Description of the Service: The premises, known as Sue Ryder Care Home, date approximately from 1742 and were previously used as a convent. It is a Grade II listed building set in extensive grounds and has a chapel in the grounds to which the local community attend. Accommodation is currently provided on three floors following a major building and refurbishment programme a few years ago. Bedrooms are provided on the first and second floors with lounges and other communal areas on the ground floor. The home is served by two passenger lifts. The home has achieved Practice Development Unit status accredited by the University of Leeds. The home no longer provides day care services. Sue Ryder Care Centre DS0000000955.V276000.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The 2nd unannounced inspection of the year took place on January 27th 2006. A complaint had been received by the CSCI regarding how the needs of the service users are currently been met. This prompted the visit. An acting regulation manager and inspector visited the home for three hours discussing the following: Service user care plans Regulation 37 forms Staff training Service users Healthcare services Subsequent to the inspection ten healthcare professionals were sent comment cards to ascertain their views on the service provided at Holme Hall. This information has been included in the report. The Healthcare Commission have been informed of the issues raised. The local Primary Care Trust are in discussions with the GP services regarding meeting the medical needs of the service users. This element of the complaint has not been concluded. At the inspection thirty two service users were resident in the home with two further service users to be admitted later that day for respite care. There were two registered nurses and eight care staff on duty. Service users looked well cared for and the atmosphere was relatively calm. Though there were a number of service users who had disruptive behaviour. Five service user care plans were inspected and evidence confirmed that there is regular input from a range of healthcare professionals. Service users are very dependent with complex needs. Service users who display challenging behaviour may be at risk of harming themselves through their behaviour. It was evident that the newest service user does not have medical cover from the GP service, and staff require further training in dealing with neurological illnesses. Communication with healthcare professionals needs to be improved. Three of the seven Standards assessed were fully met. What the service does well: Service users spoken with felt the home provides a good standard of care. Sue Ryder Care Centre DS0000000955.V276000.R01.S.doc Version 5.1 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. Sue Ryder Care Centre DS0000000955.V276000.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Sue Ryder Care Centre DS0000000955.V276000.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of these Standards were assessed. EVIDENCE: Sue Ryder Care Centre DS0000000955.V276000.R01.S.doc Version 5.1 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6&9 Care planning documentation is good and appropriate risk assessments are in place. EVIDENCE: Five care plans were inspected, these had detailed risk assessments and specific information relating to individual service users. Care plans had information relating to physical, social and psychological care needs. Daily records were completed and regular reviews took place. Risk assessments relating to moving and handling, falls, nutrition and specific issues were identified. Service users had involvement with the care plans which was evident when speaking with service users. Staff spoken with had a good rapport with the service users and had a good understanding of meeting their needs. Evidence of involvement from a range of healthcare professionals was in place. Sue Ryder Care Centre DS0000000955.V276000.R01.S.doc Version 5.1 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of these Standards were assessed. EVIDENCE: Sue Ryder Care Centre DS0000000955.V276000.R01.S.doc Version 5.1 Page 11 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 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 Service users’ healthcare care needs are not fully met. EVIDENCE: The home has access to some healthcare services through the community i.e physiotherapist, dietician, epilepsy nurse and occupational therapist. However, currently there is an unresolved issue between the Home and the GP practice whereby some service users do not have an allocated GP. The home is working closely with the PCT to resolve this issue. At the inspection it was evident that one service user who had recently moved to the home had not been allocated a GP. The home is working collaboratively with the PCT and one of the modern matrons to develop protocols and pathways for direct referral to some secondary services. Service users have comprehensive medical and nursing needs and the home must only admit these individuals if all their needs can be met appropriately. Sue Ryder Care Centre DS0000000955.V276000.R01.S.doc Version 5.1 Page 12 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 Complaints are dealt with appropriately which safeguard resident’s wellbeing. EVIDENCE: The home has a robust complaints procedure in place. The CSCI have received a complaint regarding the home meeting the medical needs of service users. As discussed in the report, elements relating to this are being considered by the Healthcare Commission and PCT. The outcome of this will be discussed with the Home and the complainant when a conclusion has been reached. It is evident from the inspection that service users healthcare needs are not consistently been met, and improved communication within the home and between healthcare professionals is required. Sue Ryder Care Centre DS0000000955.V276000.R01.S.doc Version 5.1 Page 13 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of these Standards were assessed. EVIDENCE: Sue Ryder Care Centre DS0000000955.V276000.R01.S.doc Version 5.1 Page 14 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33 & 35 Communication between healthcare professional needs to improve, and staff need specialised training to ensure service user needs can be met. EVIDENCE: At the inspection there were two registered nurses and eight care staff to meet the needs of thirty two service users. This was adequate, however it was evident that some service users had complex needs with a high level of dependency. The range of conditions included Huntingdon’s disease, brain injuries, multiple sclerosis and undiagnosed neurological illnesses. Currently one member of staff was undertaking neurological training with two more staff planned to undertake this specialised course, this will improve the knowledge and skills of the staff and be beneficial to the service users. It was evident through details in the comment cards received that courses from healthcare professionals had been provided, however these had not always been well attended. For example the epilepsy course had been attended by two care staff who had found this very beneficial. The epilepsy nurse stated that this information is not always available from the staff team to enable the neurologist to make treatment changes. It was evident that the home currently has service users who have epilepsy. Sue Ryder Care Centre DS0000000955.V276000.R01.S.doc Version 5.1 Page 15 The Diabetes specialist felt that the quality of contact depends directly on the number of staff on duty and the time of the visit, when problems have been experienced the GP has needed to be contacted. Whilst some comment cards were positive regarding communication, for example the consultant physician felt the home communicates clearly. Other comments were less positive, for example the neuro-physiotherapist felt that both verbal and written communication could be improved. This would be beneficial for service users. Sue Ryder Care Centre DS0000000955.V276000.R01.S.doc Version 5.1 Page 16 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 41 In general records are well maintained. EVIDENCE: The home was aware of how to store records correctly, these were generally maintained. It was evident that one service user did not have a completed chart which related to gastric feeding (PEG). His needs were extremely complex and it was unclear when this treatment started and who had administered this. Discussions with staff took place and it was evident that information had been omitted. This must be addressed. Sue Ryder Care Centre DS0000000955.V276000.R01.S.doc Version 5.1 Page 17 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 x 2 x 3 x 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 x ENVIRONMENT Standard No Score 24 x 25 x 26 x 27 x 28 x 29 x 30 x STAFFING Standard No Score 31 x 32 x 33 2 34 x 35 1 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 x x 3 x LIFESTYLES Standard No Score 11 x 12 x 13 x 14 x 15 x 16 x 17 x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score x 1 x x x x x x 1 x x Sue Ryder Care Centre DS0000000955.V276000.R01.S.doc Version 5.1 Page 18 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. 3. Standard YA35 YA19 YA41 Regulation 18 13 17 Requirement Staff must be suitably trained to meet individual needs Service users must have access to appropriate healthcare services All records pertaining to service users must be correct and kept up to date (PEG charts) Timescale for action 01/05/06 01/05/06 01/03/06 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 YA33 Good Practice Recommendations The home should communicate more effectively with specialist services. Sue Ryder Care Centre DS0000000955.V276000.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 © 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 Sue Ryder Care Centre DS0000000955.V276000.R01.S.doc Version 5.1 Page 20 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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