Inspection on 17/07/07 for The Flowers Hall

This inspection was carried out on 17th July 2007.

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

The Flowers Hall 24/08/06

The Flowers Hall 22/11/05

The Flowers Hall 29/06/05

The Flowers Hall 02/11/04

The Flowers Hall 13/07/04

The Flowers Hall 22/04/04

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 The Flowers Hall 80 Lascelles Hall Road Kirkheaton Huddersfield West Yorkshire HD5 0BD Lead Inspector Karen Summers Key Unannounced Inspection 09:00 17th July 2007 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 The Flowers Hall DS0000026275.V343154.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. The Flowers Hall DS0000026275.V343154.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Flowers Hall Address 80 Lascelles Hall Road Kirkheaton Huddersfield West Yorkshire HD5 0BD 01484 424184 F/P 01484 424184 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 Christine Anne Matthews Mrs Christine Anne Matthews Care Home 22 Category(ies) of Old age, not falling within any other category registration, with number (22) of places The Flowers Hall DS0000026275.V343154.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Can accommodate one service user in DE(E) category Date of last inspection 24th August 2006 Brief Description of the Service: The Flowers Hall is a privately run care home providing personal care and accommodation for up to twenty-two older people on the outskirts of Huddersfield. The home is set in its own grounds, reached by a private driveway. There is parking to the front of the building and a garden to the rear. Due to the location of the home, there is a lack of public transport. Accommodation is provided on two floors with bedrooms on the ground and first floor, which can be accessed by a passenger lift. Both shared and single rooms are available. The Commission was informed on 18 July 2007 that the home’s weekly fees ranged from £370 to £410. Additional charges are made for chiropody, hairdressing, the in-house shop and contributions towards outings. Information about the home and the latest Commission for Social Care Inspection report are available from the home. The Flowers Hall DS0000026275.V343154.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report refers to a key inspection which included an unannounced visit to the home on 17 July 2007, which took 6.75 hours. Mrs Christine Matthews, manager and owner, was present throughout the visit. During the visit, the inspector spoke to people who live there and a number of staff, read care records, staff recruitment, training and supervision records and also had a tour of the home. To reflect the views of those who use the service, satisfaction surveys were sent to 10 people living at the home, of which 4 were returned, 10 relatives/ advocate/friends, 5 of which was returned, also to local doctors and health care workers (social workers, community nurses), none of which were returned by the time of the inspection. Evidence used in the inspection process includes information supplied by the manager, at the request of CSCI, about people who live at the home, staff who work there and how the home is run. Notifications received since the last inspection about incidents at the home have also been taken into account. The inspector would like to thank those who contributed to the inspection, and also thank Mrs Matthews, the staff and people who use the service, for their time and hospitality. What the service does well: At the time of the visit, the atmosphere was relaxed and people were taking part in everyday social activities such as chatting, having cups of tea and generally passing the time of day. Ladies were having their nails filed and painted in the nail varnish of their choice, and music was also playing in the background that was the era of the people living at the home, and some were joining in, singing along. Care plans clearly identified the care needs, social interests and the likes and dislikes of the people. There was also evidence that people living at the home had been consulted and contributed to their care records. People who use the service said that they receive the care and support that they need. One person said that the care was very good. Without exception, everyone said that they receive the medical support they need, and there was evidence in the care records to show that doctors and district nurses visit the home on a regular basis. One relative commented that Flowers Hall had been excellent in their efforts to ensure their relative’s comfort and happiness. The Flowers Hall DS0000026275.V343154.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. The summary of this inspection report can be made available in other formats on request. The Flowers Hall DS0000026275.V343154.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 The Flowers Hall DS0000026275.V343154.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): 3 & 5. care. Standard 6 – the home does not take people who require intermediate People who use the service experience good quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to the service. People are assessed prior to moving into the home and are able to visit the home to establish whether or not it is the right place for them. EVIDENCE: The Flowers Hall does not provide intermediate care; therefore Standard 6 is not applicable. The care records of three new service users were examined, all of which contained a pre-admission assessment carried out by the funding Local Authority. Each assessment contained detailed information about the person’s current needs. In addition to this, there was evidence that the home had also carried out an assessment and, dependent on the author, some were more detailed than others. The Flowers Hall DS0000026275.V343154.R01.S.doc Version 5.2 Page 9 People who were spoken with said that they had visited the home before deciding to move in. Two out of four surveys received from people who use the service said that they received enough information about the home before they decided to move in. One person said that their friends brought them to have a look round, and another person said that they did not receive enough information about the home. The manager also confirmed that people were welcome to visit the home prior to them moving in. The surveys from the people who use the service all said that they had received a contract of the terms and conditions with the home. The Flowers Hall DS0000026275.V343154.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 – 10 People who use the service experience good quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to the service. The level of care people need, which includes their health, personal and social care needs, are clearly highlighted within their care plan. People are treated with respect. The recording and administration of medication is good. EVIDENCE: Care plans clearly identified the care needs, social interests and the likes and dislikes of people. There was also evidence that the people living at the home had been consulted and contributed to their care records. One of these people spoken with confirmed that the staff had spoken with them and they had agreed the care they would be having at the home. The daily record was an account of the person’s day and also referred to the needs that had been identified in the care plans. The Flowers Hall DS0000026275.V343154.R01.S.doc Version 5.2 Page 11 Two relatives commented in the surveys that the care home meets the needs of their relative, and three people said that the home usually meets the needs of their relatives. One said, “I have to remind them sometimes but generally everything is ok.” Another person said that their relative sometimes complains of having to wait for attention whilst another person said that, through conversation with their relative and from their own contact with the home, there has been no need that the home has not met. People who use the service said that they receive the care and support that they need. One person said that the care was very good. Without exception, everyone said that they receive the medical support they need, and there was evidence in the care records to show that doctors and district nurses visit the home on a regular basis. One relative commented that Flowers Hall had been excellent in their efforts to ensure their relative’s comfort and happiness. The medication and records of three people were inspected. To ensure that the medication which is not held in blister packs can be easily counted, staff are advised to record on the drug administration sheet running totals of the medication used. There was evidence that staff who administer medication have had training and the staff that were spoken with on the day also confirmed this. The Flowers Hall DS0000026275.V343154.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 – 15 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. People living in the home are able to maintain contact with their family and friends, and staff assist people in having a choice in most things they do. Meals are varied and nutritious. The lifestyle at the home appears to satisfy the needs of the people living there and encourages the involvement of family and friends. EVIDENCE: At the time of the visit, people were sitting chatting, having cups of tea and generally passing the time of day. Ladies were having their nails filed and painted in the nail varnish of their choice, and music was also playing in the background that was the era of the people, and some were joining in, singing along. A list of activities was displayed in the entrance of the home and in all of the people’s records a key is used to show when they have joined in an activity. To enable staff to evaluate people’s enjoyment of the activities, they are advised to record in the person’s individual records their enjoyment and contribution. In one of the care records, the recording of the social The Flowers Hall DS0000026275.V343154.R01.S.doc Version 5.2 Page 13 involvement of the person had been recorded on an ad hoc basis however, their care records stated that they did not wish to be included in activities and it was evident from the records that their wishes had been honoured. Surveys from people who live at the home said that there are activities arranged by the home that they can take part in. People also said that they liked going shopping and going out for a meal. There were a number of visitors visiting at the time, and the record in the visitors’ book confirmed that people visit the home at various times throughout the day. A visitor who was spoken to at the time said that she was always made welcome at the home and that she has been encouraged to keep in touch. One of the surveys received from a relative said, “Flowers Hall staff have been very helpful at all times and have installed a phone line for my aunt to keep in touch with friends and family.” During the morning, staff were heard asking people what they would like for lunch, “Cheese on toast, cheese and tomato sandwiches, egg mayonnaise or egg salad?” An alternative choice was offered for those who did not like what was on offer. The main meal of the day is served in the evening and people said that they preferred it that way. The surveys received from people who live at the home said that they liked the meals and that they were very nice. Four-weekly menus were seen which included fresh fruit and vegetables, and staff said that the menus were used in rotation. The Flowers Hall DS0000026275.V343154.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 & 18 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. People who use the service can be confident that their complaints will be listened to and taken seriously. People are protected from abuse. EVIDENCE: The complaints leaflet was seen in the entrance of the home and the manager also said that it is given to new people when they come to the home. A record is also kept of any complaints received and the action taken. The surveys received from relatives and people who use the service said that they knew how to complain and who to complain to. Compliments were also recorded and there were many cards of thank you and appreciation. Comments included, “Many thanks for looking after me while my daughter was on holiday.” “Thank you for looking after my relative with such kindness in what must often have been difficult circumstances.” “Thanks for making us so welcome when we visited. We shall miss you.” “Just to say thank you to you all for taking care of my mum so very well. I know she was very happy during her stay there and this was a great comfort to me, I do appreciate all you have done and once again thank you.” The Flowers Hall DS0000026275.V343154.R01.S.doc Version 5.2 Page 15 Apart from new staff that have recently started work at the home, records showed that all staff have had safeguarding training (protection of vulnerable adults training,) and the staff also confirmed this. Staff who were spoken with knew the procedure to follow should they suspect abuse of a person living at the home. At the time of the visit, the manager booked a course for the staff who had not had the protection training. The Flowers Hall DS0000026275.V343154.R01.S.doc Version 5.2 Page 16 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 & 26 People who use the service experience good quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to the service. People who use the service live in a homely, clean and well maintained environment. EVIDENCE: A limited tour of the building was made, including the bedrooms of people whose records were looked at. One of the bedrooms had a stale odour and staff said that they are taking steps to address this. The rest of the home was odour free. The people who use the service said that the home was always clean. The window also inside of the room identified above, opened more than 10cm and there could be a potential risk of someone falling out of it. The manager The Flowers Hall DS0000026275.V343154.R01.S.doc Version 5.2 Page 17 confirmed that she would ensure that the window restrictor was refitted that day. The home was decorated to a good standard. One of the surveys received from a relative commented that the person they visit sometimes comments about having to use a commode. They said, “Use of the commode seems a bit primitive, an en-suite wc would be a great improvement.” The manager said that the fire protection officer had visited and there was evidence of his correspondence on file. He had made some “good will” recommendations. The Flowers Hall DS0000026275.V343154.R01.S.doc Version 5.2 Page 18 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 – 30 People who use the service experience good quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to the service. There are sufficient numbers of staff to meet people’s needs. Staff receive training to assist them to carry out their responsibilities and they have had all the necessary checks before working with people so that they are kept safe. EVIDENCE: The duty rotas and staff training files were inspected and there was evidence to suggest that agency staff are employed when needed. Although four duties had been covered over the last week by agency staff, next week the home does not need cover. There was a vacancy for a night carer, of which interviews for the post were taking place on the day of the inspection. There was also evidence to suggest that the staffing levels and skill mix were sufficient to meet the number and needs of people living at the home. Mrs Matthews continues to support staff and work towards the standard of 50 of care staff having an NVQ level 2 qualification in care. Staff recruitment files contained the relevant information and documentation. Evidence was seen in the staff records and staff also confirmed that they had induction training. An induction booklet was seen and it was confirmed by the deputy manager that it conformed to the National Occupational Standards. The Flowers Hall DS0000026275.V343154.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 & 38 People who use the service experience good quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to the service. The home is run in the best interests of people who live there. People’s financial interests are safeguarded. The health, safety and welfare of people is protected. EVIDENCE: Mrs Matthews the manager has many years experience in the care of older people. She has the Registered Managers’ Award, and an NVQ level 4 in management and care. Staff that have recently joined the home had not had training in movement and handling and fire. One of the new staff that works two days a week The Flowers Hall DS0000026275.V343154.R01.S.doc Version 5.2 Page 20 confirmed that she had not had the training but was not allowed to lift anyone unsupervised. She also said that, when she had her induction, she was shown the fire procedure. Evidence was seen that fire alarms and emergency lighting are tested weekly, and that fire drills were done in December 2006, when six staff attended, and February 2007, when five staff attended. (Mrs Matthews confirmed that there were eighteen staff working at the home.) The names of the staff were not recorded, therefore it was difficult to see who had had a fire drill. Mrs Matthew is advised to record the names of the staff that take part in a fire drill. Records showed that fire lectures had been done in January and December 2006. Mrs Matthews is advised that the lectures and drills should take place twice a year for all staff and that their names are recorded. At the time of the inspection, Mrs Matthews contacted a training provider and, following the inspection, she confirmed that training dates had been arranged in August for all staff to have training in fire, movement and handling and first aid. Mrs Matthews also confirmed that all staff had recently attended a fire drill. Mrs Matthews said that staff had had infection control training and evidence was seen in their training files and also confirmed by the staff. The monies and records of three people were audited and were correct. Staff confirmed that they had received supervision and there was evidence in those records inspected, that it took place about every five months. The recommendation is six times a year. Quality assurance surveys were sent out by the home in February and June this year to people who live at home and their relatives/advocates, the results of which are published and could be seen on the notice board in the entrance of the home. Mrs Matthews is advised not only to record the results of the surveys but also to include what the home proposes to do in relation to the outcomes of the results (Eg people thought that they would like a cooked meal at lunchtime instead of teatime - proposal of the home to provide a cooked meal at lunchtime, and this will be reviewed at the next survey in three months’ time.) The Flowers Hall DS0000026275.V343154.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 X X 3 3 3 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 2 The Flowers Hall DS0000026275.V343154.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. 2. 3. Refer to Standard OP19 OP28 OP38 Good Practice Recommendations Windows above ground floor level should have restrictors fitted to ensure that they do not open more than 10cm. 50 of staff to have an NVQ Qualification in care. All staff should attend two fire lectures and two fire drills each year. The names of those staff that attend should be recorded to know who has had the training. 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