Inspection on 28/11/06 for Swanland House

This inspection was carried out on 28th November 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 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

Swanland House 27/11/08

Swanland House 30/01/06

Swanland House 27/10/05

Swanland House 27/01/05

Swanland House 06/09/04

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 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Swanland House 41 West End Swanland North Ferriby East Yorkshire HU14 3PE Lead Inspector Anne-Marie Foster Key Unannounced Inspection 28th November 2006 10:00 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 Swanland House DS0000019730.V314106.R01.S.doc Version 5.2 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. Swanland House DS0000019730.V314106.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Swanland House Address 41 West End Swanland North Ferriby East Yorkshire HU14 3PE 01482 634159 01482 633328 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) Mrs Elizabeth Anne Stevenson Mrs Elizabeth Anne Stevenson Care Home 20 Category(ies) of Dementia - over 65 years of age (20), Old age, registration, with number not falling within any other category (20) of places Swanland House DS0000019730.V314106.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 30th January 2006 Brief Description of the Service: Swanland House is a privately owned residential care home and is a Grade II listed building. The home is registered to offer care and accommodation for 20 older people. The interior is decorated to a high standard, in a traditional fashion. There are eight shared rooms and four single rooms. Many rooms have en suite facilities. There are very pleasant gardens around the home and ample parking spaces for visitors, as well as extra off street parking. The home is close to the centre of the village and its local amenities, including shops, chemist, cafe and hairdresser. The home is accessible to all service users by using ramps, a passenger lift and a stair lift. Weekly fees as at November 2006 are £328.80; this does not include hairdressing, chiropody, toiletries, newspapers and other sundries. Swanland House DS0000019730.V314106.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced site visit took place over six hours, with extra time for preparation. Information about the service was gathered from a variety of sources including the site visit. A pre inspection questionnaire that the home filled in and returned. Ten relatives comment cards were sent out and two of these were returned. Five comment cards were sent to local health professionals who have contact with the home, and three of these were returned. Eight service users and one relative were spoken with as well as all of the staff on duty. The inspector looked through a selection of service user and staff files along with the homes’ records. A tour of the home was made including communal areas and private rooms. The registered manager was available on the day to assist the inspector. As part of this unannounced inspection the quality of information given to people, about the care home, was looked at. People who live in the home were also spoken with, to see if they could understand this information and how it helped them to make choices. The information included the Service User’s Guide (sometimes called a brochure or prospectus), statement of terms and conditions (also known as contracts of care) and the complaints procedure. These findings will be used as part of a wider study that CSCI are carrying out about the information that people get about care homes for older people. This report will be published in May 2007. Further information on this can be found on our website www.csci.org.uk. What the service does well: Swanland House DS0000019730.V314106.R01.S.doc Version 5.2 Page 6 Swanland House provides a comfortable, safe and clean place to live. The home has a relaxed and positive atmosphere Service users are able to enjoy a flexible and varied routine, and they have a good wholesome, balanced diet. The home is well staffed, with there is a stable workforce, who provide good, consistent care. The home is managed by an experienced manager, who runs the home in the best interests of the service users. 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. The summary of this inspection report can be made available in other formats on request. Swanland House DS0000019730.V314106.R01.S.doc Version 5.2 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 Swanland House DS0000019730.V314106.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3 and 6 Quality in this outcome area is good. Service users are not admitted to the home unless their care needs can be met. An appropriately qualified person assesses these needs prior to admission. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home provides a ‘Statement of Purpose/Service User Guide’ to all prospective service users. It contains useful information about the home, such as choice of room, qualifications of staff, and how special needs can be catered for. People are then able to make a more informed decision about choosing to live there. Each service user gets a contract once they have decided to move to the home. This provides them with terms and conditions about their room and Swanland House DS0000019730.V314106.R01.S.doc Version 5.2 Page 9 fees. The inspector looked at a sample of service users’ files and found a copy of the contract. She also spoke with three service users and one relative. Each said that they remembered having a contract. If there are any changes to the contract such as a fee increase then the registered manager tells the service user and lets them know in writing too. The registered manager and /or senior care staff make an assessment of peoples’ care needs before they are admitted to the home. The manager or senior care staff are qualified to assess care needs, such as for example foot care, continence, mobility and social interests. They will only accept the prospective service user for admission if they are sure that the home can meet those needs. Four service users’ care files were looked at and these contained good assessments with plenty of detail. This assessment helps staff to plan the care for that person. The home does not provide intermediate care. Swanland House DS0000019730.V314106.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10 Quality in this outcome area is good. Service users live in a home where their care needs are addressed, and where good care planning is in place. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered manager has worked hard to improve the care planning and risk assessment systems to make them more concise and user friendly. Four service users’ care files were looked at and these were found to be comprehensive, easy to understand and meaningful. The care plans contained risk assessments, which help staff to identify areas where a service user could be at risk from harm so that they could take appropriate action to reduce any risk. These records help staff to understand and address the needs of the service users, so that they can provide the most appropriate care and then monitor Swanland House DS0000019730.V314106.R01.S.doc Version 5.2 Page 11 the result. Each plan is reviewed once a month, or earlier if necessary. The plan is then updated as needed to reflect anything that has changed. The registered manager and care workers work hard to promote the health of the service users. The registered manager is knows how to refer to other health professionals as necessary in order to get support and guidance to keep service users healthy. One service user told the inspector how helpful and supportive the staff were, whilst going with her to attend hospital appointments. Three comment cards received from GP’s were very positive about the way that the home worked. The inspector looked at the medication administration system. The senior care staff are trained to do the ‘drugs round’. The medication administration records were looked at. There were two gaps where drugs had been given and not signed for. This could lead to other staff thinking the drug had not been given when in fact it had. This was discussed and addressed on the day. The controlled drugs were looked at, and a sample was counted which balanced with the numbers in the record book. The recording of newly received stock however could be better. Whilst it made sense to the senior carer on duty, the way that new stock is recorded in the drug record is unusual and could be made clearer. The home uses the traditional method of storing medications in their original bottles rather than blister packed ‘monitored dosage’. This is because the home supports the local pharmacy that does not use this system and because care staff are completely comfortable with the current system, which works well. On the day of the site visit the inspector noted the interactions between service users and care workers. The care workers were seen treating service users in a polite, respectful way. Care workers were observed knocking on peoples’ doors before entering, and they called service users by their preferred name. Service users spoken with said that care staff “were polite and kind” and “they respect my privacy”. Swanland House DS0000019730.V314106.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15 Quality in this outcome area is excellent. Service users live in a home where they can enjoy a variety of activities, a flexible routine and retain contact with the community. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home provides a good variety of activities for the service users. One service user enjoys visits from the church and was able to take Holy Communion. On the day of the site visit the home had a visiting clothes shop, and service users were enjoying picking out new outfits for the Christmas party. The activities organiser attends twice a week and advertises up and coming events by poster in each service room, so that people can be aware of what activity is available. The home retains its links with the local community. Visits, day trips, the mobile library, and entertainers are arranged. Service users’ relatives and visitors can visit freely and are welcomed by the staff at the home. Two relatives’ comments were received and these were very positive about the home. They said the home kept them ‘in touch’ with what is going on. Swanland House DS0000019730.V314106.R01.S.doc Version 5.2 Page 13 The daily routine at the home is flexible. Service users can choose what time they want to get up and how they want to spend their day. Lunchtime was a pleasant and social occasion. The dining room and tables are well laid out and there is enough space for the service users to sit comfortably. There were enough staff available to assist service users who have difficulty with eating or concentration. Care staff made sure that they gave enough time for these people to eat their meal. Care staff assisted the other service users in a quiet, unhurried fashion. The meal was baked haddock with fresh vegetables, and it looked both appealing and wholesome .The cook said that they are proud that the home has no upper limit in its food budget and that only good quality food is bought. The cook takes time to talk with service users and finds out their likes and dislikes. Special diets, for example a diabetic, are catered for. The kitchen and dry food store were looked at, and were found to be clean and organised, with plenty of fresh fruit and vegetables available. Swanland House DS0000019730.V314106.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. Service users live in a home where they, and their relatives can be confident that any complaints they have will be listened to and taken seriously, and they are protected from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a clear complaints procedure laid out in the Service User Guide. Four service users spoken with were confident that any complaint they had would be taken seriously and acted upon. Each service user said that they would complain to the registered manager and also told the inspector “the manager would sort out any concern or complaint immediately” The complaints book was looked at; the home has not received a formal complaint since 2003 and The Commission for Social Care Inspection have not received any complaints about the home. The home also arranges residents meetings and questionnaires to give people an opportunity to say what they think. The home protects service users from abuse by having guidelines to follow and by providing training for staff. Through training staff can be made aware of how to protect service users from abuse. Care staff on duty were sure about how they would report any concerns, and said they would go directly to their manager. Swanland House DS0000019730.V314106.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is good. Service users live in a clean comfortable home, which is well laid out and suits its purpose. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The inspector made a tour of the home on the site visit. The home was found to be clean, warm and comfortable. Whilst the building is Grade II listed, it has been well adapted to suit its purpose, and rooms and communal areas are spacious and decorated to a high standard. The registered manager has a programme of maintenance and renewal to keep the home looking smart and comfortable. The gardens are kept tidy and are pleasant to look at. The building complies with the requirements of the local fire service and environmental health departments. Swanland House DS0000019730.V314106.R01.S.doc Version 5.2 Page 16 Service users told the inspector “my room is clean and just what I need” and “the cleaner works very hard and has good standards”. The kitchen and laundry were looked at. Each area was found to be very clean, organised and tidy. The laundry floor is impermeable and therefore easy to keep clean. Service user’s clothes are well cared for by the care worker team. The washing machine has a sluice facility and washes to high temperatures, which meet disinfection standards. Soiled laundry is handled appropriately in order to reduce any risks of cross infection. Staff have plenty of hand washing facilities and there are good stocks of gloves and aprons available so that they can protect themselves and service users. The kitchen was very clean. Fridge temperatures were recorded and were within normal limits, food was stored correctly in the fridge and was covered and dated accordingly to reduce any risk of contamination. Swanland House DS0000019730.V314106.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30 Quality in this outcome area is good. Service users are supported by the numbers of staff available to care for them, and by a thorough recruitment system. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The numbers and skill mix of staff are appropriate to the assessed needs of the service users. The inspector looked at several weeks of the staff rota, which showed sufficient numbers of staff available during the day and night. Additional staff are on duty at peak times of activity during the day. Half of the care staff have their National Vocational Certificate in Care (NVQ), and training is arranged for all staff, both in-house and externally. Service users are in safe hands and cared for by a knowledgeable workforce. The recruitment system was examined. Five staff files were looked at and these contained the documentation required by regulation, such as two written references, police checks, and employment history. All staff receive terms and conditions in their contract. Swanland House DS0000019730.V314106.R01.S.doc Version 5.2 Page 18 Staff training is made a priority at the home; staff confirmed that they have opportunities to attend training in addition to their initial induction. Recently staff have had moving and handling training, adult abuse awareness and dementia training which will re enforce, and update their knowledge about keeping people safe. Staff are competent and trained to do their jobs. Swanland House DS0000019730.V314106.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 and 38 Quality in this outcome area is excellent. Service users live in a safe home that is well managed and run in their best interests. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered manager, who is also the proprietor, has the registered managers award. The staff and service users said that the manager was open and approachable. The registered manager has a ‘hands on’ approach to running the home and enjoys a good relationship with both service users and staff. On the day of the inspection the manager was available to assist the inspector, but was also had time to help a frail service user to have a bath. Swanland House DS0000019730.V314106.R01.S.doc Version 5.2 Page 20 The home has a system in place to monitor the quality of the service it provides. There are regular residents meetings where people can ask questions or pass comments about how the home is running. The registered manager also gives questionnaires out to service users, their relatives and other contacts of the home. These questionnaires give people opportunity to comment on what kind of service the home is provided. The registered manager talks regularly to service users, and takes any suggestions for improvement seriously. The home is in receipt of the ‘Investor in People’ quality standard and ‘Quality Development Scheme’ award from the local authority. The home keeps small amounts of cash for service users. A ‘wallet’ system is used where cash kept along with records of any financial transactions. A sample of wallets and accounts were looked at and all monies tallied with the records. Service users financial interests are being safeguarded by this system. The registered manager ensures that all staff induction and refresher training includes the following: fire safety, food hygiene, infection control, first aid and moving and handling so that staff can be aware of up to date working practices. The registered manager ensures that the health and welfare of service users and staff are promoted and protected. The inspector looked at a sample of safety and maintenance certificates to check that suitably qualified people had carried out these jobs. The certificates were found to be up to date and satisfactory. These checks included the nurse call system, electrical safety/ fires safety and fire fighting equipment, hoist maintenance and gas safety check. Swanland House DS0000019730.V314106.R01.S.doc Version 5.2 Page 21 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 3 3 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 x 4 x 3 x x 3 Swanland House DS0000019730.V314106.R01.S.doc Version 5.2 Page 22 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. Standard Regulation Requirement Timescale for action 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 OP9 Good Practice Recommendations • • The way that the receipt of controlled drugs is recorded in the register should be made clearer. Staff should always sign for a medication that they have administered, and there should be no signature omissions in the medication records. Swanland House DS0000019730.V314106.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ National Enquiry Line: 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 © 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 Swanland House DS0000019730.V314106.R01.S.doc Version 5.2 Page 24 - 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!