Inspection on 04/10/06 for Symphony House

This inspection was carried out on 4th October 2006.

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

Symphony House 28/10/08

Symphony House 22/12/05

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Symphony House 43 / 45 Queens Park Parade Northampton Northants NN2 6LP Lead Inspector Mrs Linda Preen Unannounced Inspection 4th October 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 Symphony House DS0000064503.V313196.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. Symphony House DS0000064503.V313196.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Symphony House Address 43 / 45 Queens Park Parade Northampton Northants NN2 6LP 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) 01604 722772 Symphony Care Ltd Mr Darren Stephen Weeks Care Home 25 Category(ies) of Old age, not falling within any other category registration, with number (25) of places Symphony House DS0000064503.V313196.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Symphony Care Home is registered to provide personal care with nursing to male and female service users who fall within the following categories: Old age, not falling within any other category (OP) 25 To accommodate the person named in application number V34225 who is under the age of 60 years To accommodate the person named in application number V34226 who is under the age of 60 years The maximum number of persons to be accommodated at Symphony House is 25 22nd December 2005 2. 3. 4. Date of last inspection Brief Description of the Service: The home is situated in a residential area of Northampton, close to local shops and amenities. Accommodation is provided in a Victorian house that has been extended and has recently been refurbished by its new owners to a very high standard. All rooms have ensuite facilities and are single occupancy. It provides facilities for the elderly frail and for the terminally ill. Symphony House DS0000064503.V313196.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Two hours were spent prior to the inspection reviewing previous requirements and recommendations and collating information provided by the service. The Commission sent comment cards out to a random selection of residents and to General Practices providing a service to the home. The inspection took place over a period of five hours as part of the statutory inspection programme. Three residents were chosen in order that their experience in the home could be assessed. The method used was “Case Tracking”. This involved looking at their records, talking to them and also to the staff concerning the care received. In addition to this staff rotas and medication records were seen. 3 comment cards had been received from residents, 4 comment cards from relatives, two comment cards from General Practitioners and information was available from a questionnaire completed by the providers of the service. Fees range from £319 to £608 according to resident’s assessed needs. What the service does well: An emphasis is placed on providing individual care to residents and staff spend time with them on an individual basis, talking and listening to their needs. Meals are provided to a high standard with choices offered. Discussions take place with individuals to ensure that their appetites are stimulated and individual dishes provided if special diets are required. The home is furnished and decorated to a high standard and provides a very homely place in which to live. Residents spoken to complimented the staff on the care and attention given and also the standard of the food provided. One lady spoken to stated that she wouldn’t want to be anywhere else. Regular resident and relative meetings are held to ensure that everyone’s views concerning the home may be heard and minutes of these meetings were on display. An entertainments programme is in place with forthcoming attractions advertised on the notice board in the lounge. Residents reported enjoying a recent party to celebrate the first year of the home, and photographs from this were on display. They had enjoyed a singer on the previous Sunday and were looking forward to a company who provide activities coming to the home on the afternoon of the inspection. Symphony House DS0000064503.V313196.R01.S.doc Version 5.2 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. Symphony House DS0000064503.V313196.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 Symphony House DS0000064503.V313196.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 and 4 Standard 6 does not apply in this home. Quality in this outcome group is good. This judgement has been made using available evidence, including a visit to the service. Residents have the information required for them to make an informed choice about living in the home. EVIDENCE: A Statement of Purpose is available that sets out the details of the service to be provided. This is regularly updated to reflect any changes in the home. Residents are assessed by a qualified nurse prior to admission to ensure that their needs may be met in the home. A comprehensive assessment tool is used for this that includes all aspects of physical, mental, social and spiritual needs, and records individual choices of lifestyle. Residents and their relatives are involved in this assessment in the files seen. Symphony House DS0000064503.V313196.R01.S.doc Version 5.2 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, 10 and 11 Quality in this outcome group is good. This judgement has been made using available evidence, including a visit to the service. Residents have individual care plans to guide staff on their care. Systems are in place to ensure that the control of medication in the home is safe. Residents who are dying are treated with dignity and respect. EVIDENCE: Three residents were chosen in order that their care could be assessed using the case tracking method. This involves looking at records and talking to staff and residents concerning their care. All residents spoken to expressed their satisfaction at the care and attention provided. All appeared well groomed and well cared for and those nursed in bed appeared very comfortable. Care plans, which give staff guidance on meeting resident’s needs, were completed to a high standard. They contained detailed, specific information concerning resident’s needs and were reviewed on a monthly basis in order that they remained up to date. Symphony House DS0000064503.V313196.R01.S.doc Version 5.2 Page 10 Systems for the ordering, administration and disposal of medication were seen and found to be satisfactory. The home has specially trained staff to care for the needs of the terminally ill. Good relationships have been formed with the local palliative care team for specialist advice. An emphasis is placed on providing individual comfort for this group of residents. The home has been selected to take part in a trial of a new system of providing quality care to residents who are terminally ill, called “The Liverpool Care Pathway” This will ensure that this group of residents will be enabled to stay in the home and not be unnecessarily moved to hospital, whilst still receiving the necessary care and medication to enable them to have a peaceful, pain free death. Specialist training and support will be provided to enable staff to provide this care. Records were available of General practitioner and other health care professionals visits to the residents. Comment cards received from General Practitioners were positive concerning the service provided by the home. Symphony House DS0000064503.V313196.R01.S.doc Version 5.2 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): 12, 13, 14 and 15. Quality in this outcome group is good. This judgement has been made using available evidence, including a visit to the service. Activities and meals are provided in a way that enables residents to have daily variety and interest according to individual preference. EVIDENCE: Residents were sitting in one of the lounge areas or in their individual room according to personal choice. A programme of activities is provided, and is advertised on the notice board in the home. Residents reported enjoying a recent party to celebrate the first year of the home, and photographs from this were on display. They had enjoyed a singer on the previous Sunday and were looking forward to a company who provide activities coming to the home on the afternoon of the inspection. Records of their involvement and enjoyment of various activities are kept to inform future planning. A new activities coordinator has been employed and in discussion, demonstrated an awareness of respecting individuals past lifestyle, hobbies and interests. She confirmed that the providers had purchased equipment identified by her as being required. Menus are provided in discussion with residents and special diets catered for. Sample menus provided demonstrated that a varied, nutritious diet is offered. Choice is offered at all meals and further alternatives offered if neither of the main choices is liked. Residents spoken to complimented the cook on the Symphony House DS0000064503.V313196.R01.S.doc Version 5.2 Page 12 standard of food provided. In discussion, the cook confirmed that she was aware of individual likes and dislikes and that she tried to cater for individual requests when possible. She had recently provided a pasta dish for one resident who had said he enjoyed this at home. Although there are two residents from other ethnic minorities in the home, they currently prefer to have the same food as other residents. Visitors are welcome at any time and are invited to events within the home. Symphony House DS0000064503.V313196.R01.S.doc Version 5.2 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 the following standard(s): 16 and 18 Quality in this outcome group is good. This judgement has been made using available evidence, including a visit to the service. Residents may be assured that their comments and complaints will be addressed and that they will be protected from abuse. EVIDENCE: No complaints have been investigated by the Commission for Social Care Inspection. A complaints procedure is on display in the entrance to the home. Relatives who returned comment cards confirmed that they were aware of this procedure. Residents spoken to stated that the Registered Manager was always very helpful and listened to what they said. Staff recruitment procedures protect residents from potential abuse with Criminal Records Bureau checks and references being obtained for all staff. Training on abuse and the required reporting of such instances is included in the staff induction programme. Symphony House DS0000064503.V313196.R01.S.doc Version 5.2 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 the following standard(s): 19, 20, 23, 24, 25 and 26. Quality in this outcome group is excellent. This judgement has been made using available evidence, including a visit to the service. Residents are provided with a homely environment that is maintained to a high standard. EVIDENCE: A limited tour of the environment was undertaken. All rooms are single occupancy and have ensuite facilities. Resident’s rooms showed evidence of personalisation with pictures, ornaments and personal television/music systems seen. All areas of the home are clean and maintained to a high standard by separate housekeeping staff, who deep clean residents rooms on a rota basis. A range of communal lounge areas is provided for resident use and these are bright airy and well decorated. A maintenance man is employed to ensure minor repairs are dealt with as soon as possible. Symphony House DS0000064503.V313196.R01.S.doc Version 5.2 Page 15 All residents have ensuite facilities in their rooms and a range of assisted baths and showers have been provided throughout the home. One of the baths has been changed for a walk in shower since the last inspection, which some of the residents prefer. Symphony House DS0000064503.V313196.R01.S.doc Version 5.2 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 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): Quality in this outcome group is adequate. This judgement has been made using available evidence, including a visit to the service. Staffing is provided in sufficient numbers to meet resident needs but evidence of formal staff training is limited. EVIDENCE: Staffing is provided above the levels recommended by the Residential Forum Guidance to ensure a high level of attention to residents. Duty rotas and staffing levels provided as part of the Pre Inspection Questionnaire completed by the manager demonstrate that there are two Registered Nurses plus five care staff in the morning, two Registered Nurses and three carers in the afternoon and one Registered Nurse and two carers at night to care for twentyfive residents. A selection of staff files was sampled and as stated above recruitment practices and policies are in place to protect residents from potential harm. An Equal Opportunities policy is in force and copies of monitoring forms were seen in the files sampled. Staff from a range of ethnic backgrounds, all ages and of both sexes are employed. All staff undergo Induction training on commencement of employment. The Registered Manager was working with a new member of qualified staff on the day of the inspection to ensure that she was fully aware of the procedures in Symphony House DS0000064503.V313196.R01.S.doc Version 5.2 Page 17 the home and the specific needs of the residents before she was left in charge of the home. Four members of care staff already hold a National Vocational Qualification in care with a further six working towards this award. When these have completed, the home will comply with the recommended 50 of care staff with this qualification. This is in addition to the Registered Nurses employed. Although staff were reported as having received training in Moving and Handling, Fire, Health and Safety and abuse, there was no formal system of recording this training in the home, making it difficult to evidence. Only six staff currently hold a First Aid certificate, which means that there is not always a First Aider on duty in the home as is required. Recommendations were made in this respect. There is no system of staff appraisal or formal supervision in place to ensure staff receive support and have their training needs identified. A recommendation was made in this respect. Symphony House DS0000064503.V313196.R01.S.doc Version 5.2 Page 18 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, 32, 33, 35, 36 and 38 Quality in this outcome group is good. This judgement has been made using available evidence, including a visit to the service. The home is managed in a way that promotes the residents interests. EVIDENCE: The Registered Manager is a First Level Registered Nurse with many years experience of caring for this resident group. He is currently working towards the Registered Managers award, but is yet to complete this. He was reminded that it is a Requirement that all Registered Managers hold this or an equivalent qualification. Staff confirmed that both the Registered Manager and the Providers were supportive and available for advice and to listen to suggestions. Evidence was seen in all aspects of care, that resident needs are the foremost consideration, with emphasis being placed on the individual. One resident Symphony House DS0000064503.V313196.R01.S.doc Version 5.2 Page 19 spoken to confirmed that she attended residents meetings where a variety of items were discussed. The home does not have any involvement with resident’s finances. Records of the testing of fire alarms and emergency lighting were seen and found to be satisfactory. No Health and Safety issues were identified at this inspection. Symphony House DS0000064503.V313196.R01.S.doc Version 5.2 Page 20 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 X 4 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 4 3 X 3 3 4 4 STAFFING Standard No Score 27 4 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 4 X N/A 2 3 3 Symphony House DS0000064503.V313196.R01.S.doc Version 5.2 Page 21 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 OP28 Good Practice Recommendations Formal evidence of mandatory staff training and updates should be available for inspection. Work should continue to ensure that 50 of care staff hold a National Vocational Qualification in care. The Registered Manager should complete a recognised management qualification. A system of formal staff supervision at least six times a year should be implemented in order to monitor staff performance and training needs. A qualified First Aider should be on duty at all times. 2 3 4 OP31 OP36 OP38 Symphony House DS0000064503.V313196.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Northamptonshire Area Office 1st Floor Newland House Campbell Square Northampton NN1 3EB 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 Symphony House DS0000064503.V313196.R01.S.doc Version 5.2 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. 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