Inspection on 28/10/08 for The Spinney

This inspection was carried out on 28th October 2008.

CSCI found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Spinney 30/10/07

The Spinney 08/11/06

The Spinney 12/12/05

The Spinney 19/07/05

The Spinney 28/02/05

The Spinney 28/07/04

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Extracts from inspection reports are licensed from CQC, this page was updated on 30/01/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: The Spinney 21 Armley Grange Drive Leeds LS12 3QH     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Valerie Francis     Date: 2 8 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 25 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 25 Information about the care home Name of care home: Address: The Spinney 21 Armley Grange Drive Leeds LS12 3QH 01132792571 01132792571 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Diane Russell Type of registration: Number of places registered: Mr Richard Martin Duffy,Mrs Pauline Patricia Duffy care home 30 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home The home is situated in a quiet residential area of Armley between two main bus routes into the city centre. The shopping centres of Armley and Bramley are within a mile of the home but few people would be able to reach the shops without the assistance of transport. The Spinney is a large detached house. All but one room is single occupancy. Bedrooms are on two floors, some on the ground floor. Most rooms have en-suite facilities. There is a passenger lift access to the first floor. A small garden is at the back of the building and a paved patio area overlooking the street provide a sitting out area for service users. The proprietors have been successful in retaining a domestic feel to the internal areas of the home. The home has male and female occupants and is non-smoking. The building is not suitable for people who require a secure environment. 0 Over 65 30 Care Homes for Older People Page 4 of 25 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: One inspector carried out this inspection visit over a day starting at 09.30 am and finishing at 5.00 pm. During the inspection all of the key standards were looked at to assess the standard of care that people receive. Details provided during this visit of the weekly fees are between four hundred and four pounds and sixty seven pence and four hundred and fifty pound and ninety eight pence. Fees do not include hairdressing and private chiropody services. An annual quality assurance assessment (AQAA) was completed by the home and this information was used as part of the inspection. Surveys were sent to people and staff. During the visit we looked around the home, spoke to people who live at the home, Care Homes for Older People Page 5 of 25 staff, visitors and the manager and deputy. Care plans, risk assessments, healthcare records, meeting minutes, staff recruitment, training records and the premises were looked at. During the inspection three relatives were given questionnaires. All responses to surveys are included in this report. Feedback of the findings of the inspection was given to the manager and deputy. The proprietors are actively involved in the day-to-day operation of the home and work well with the registered manager. We have reviewed our practice when making requirements to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations but only when it is considered that people who use services are not being put at significant risk of harm. In future if a requirement is repeated it is likely that enforcement action will be take. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 7 of 25 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 8 of 25 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Assessments are carried out before a person moves in to ensure that the home can meet the persons needs. There is information to help people make a decision about using the homes service. Evidence: There is information about the home that is given to prospective people who use their service. This lets people to know if the home can meet their needs and helps with their decision to move in. The manager told us that both the statement of purpose and service user guide have been updated to make sure the information is current and it can also be made available in large print. We sampled a care plan for one person who recently moved in the home. The manager explained the assessment process. We found that the home receive a copy of the assessment carried out by the Care Homes for Older People Page 9 of 25 Evidence: placement agency before people move in. People and their families or social care professionals are involved in the assessment process and can make a decision how they want their care to be met. Staff told us that they are given good information before people move in, in most cases they have access to peoples written information. In the AQAA we were told that a pre-assessment are carried out and care plans is made from information gathered from various sources. We were told what they do well is to make sure staff training is up to date, so that people get care from staff who have training to meet peoples needs. The home feel that although they have good systems in place they always look for ways to improve, to make sure people get a good standard of care. Care Homes for Older People Page 10 of 25 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples care needs are met. However, care plans do not always have enough information which could led to care needs being missed. Medication systems are safe but there are some gaps in the record keeping. Evidence: Since the last key inspection the home has got a new system to record care plans. We were told that one person had a poor appetite and needed time to eat her meals and she was given milky drinks for additional supplement. We were also told that another person who needed help with personal care, with such as washing, dressing and undressing. Although peoples care needs were being met by staff this was not reflected in their care records. Each member of staff is allocated to two people and they are responsible for their care plans. Staff spoken to were aware of peoples care plans and were knowledgeable about people. Peoples care plan is regularly reviewed, this mean that any change in Care Homes for Older People Page 11 of 25 Evidence: peoples needs can be recognised and a plan of action are quickly put in place. We also saw that some plans had no details about a persons life history, the manager said he was aware of this and all effort is being made to improve this to make sure care plans are more person centered. The home work closely with health care professionals to make sure people health care is supported. Medicines are administered by staff who have had one day training in handling medication and training from the manager. We saw that some peoples medication administering sheet had gaps where their medication had not been signed for. There were records of receipts of medication ordered and storage of medication was safe. We were told by staff that peoples dignity is preserved at all time. All peoples care is done in their bedrooms and care and support is delivered discreetly. The home told us in the AQAA that they give a good standard of care to the people in their care. Care Homes for Older People Page 12 of 25 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have the opportunity to take part in activities, and are supported to keep in contact with their relatives and friends. People are also supported to make choices that affect their lives Evidence: We were told and saw that people have the opportunity to go out and take part in activities in and outside of the home. For example two people attend a local luncheon club. People and their relatives said that the home should look at providing people with dementia with more stimulating activities, so that they do not get bored. However, most people said that they had enough to keep them self occupied during the day. We were told that people from the local church visit people to give them communion. People and their relatives are encouraged to stay in touch. Some people had visitors during our visit. One persons husband was visiting. They all said that they were offered a hot drink on their arrival to the home and they were always made to feel welcome. We saw from the records and from discussions with people and their surveys that people have a choice of meals, the menu is displayed on the entrance wall. We saw that the food was hot and there was a choice of food including puddings. The food is prepared and served by care staff who had been designated to cook. We saw them Care Homes for Older People Page 13 of 25 Evidence: carrying hot food in large pans from the kitchen to the dining room. This practice is not safe and puts people and staff at risk of being scalded from hot food that is being carried to the dining room. The dining room tables were set with tablecloths cutlery condiments and napkins with name places. The manager said people had been given the opportunity to sit with their friends. However, this practice does mean that any new person would have to sit at a table that had a vacant place. We saw that people were offered more food if they want and support was given in a relaxed way, staff assisting people was discreet and talk to them throughout their meal. People used meal times as a time to socialise with their friends. People were not rush to finish their food. People told us that the food was good and they could have second helping if they wanted. The AQAA said staff had been made aware through training and in discussion of the standard of care to be delivered to people. Care Homes for Older People Page 14 of 25 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People know who to complain to and know that their complaint will be taken seriously and acted upon. People who use the service are protected from harm and abuse by the systems in place.. Evidence: The home has a complaint procedure which is available in the statement of purpose and service user guide. However, we did not see a copy displayed in the home. So that anyone who wishes to complaint has access to the procedure they should follow. The home keeps a record of all complaints. We saw a record which had all the action taken to address the issue raised and feedback given to the complainant. The home has an adult protection procedure. We found that staff have had training and have access to the procedure in recognising and responding to abuse. We spoke to staff about their awareness of abuse and what they would do. It was evident that they would protect the people in their care and they were aware of the procedure they should follow and who to contact. The manager had made arrangements for a new member of staff to have adult protection training, to make sure they know what to do when handling an abuse issue. In the AQAA we are told that any complaints are acted upon and people and their relatives can talk to us at any time if they have any concerns. Complaints forms are displayed in the reception desk and staff are trained in dealing Care Homes for Older People Page 15 of 25 Evidence: with complaints. Care Homes for Older People Page 16 of 25 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a home that is regularly upgraded to make sure that it is suitable and comfortable for people living there. The home is generally clean. Evidence: The home is on two floors, there is one double room which is now being used as a single room. We found the home to be homely and furniture and fitments were of a domestic type. It was evident through the tour of the premises that people had taken the opportunity to bring with them when they moved in some memorabilia of their past life, such as small pieces of furniture. The communal sitting rooms are furnished with comfortable chairs so people can relax when they sit in these areas. There are a variety of easy chairs some were owned by people living in the home. When looking around the home we found that hot water and radiators temperatures in bedrooms and some communal bathrooms were overly hot. This put people and staff at risk of burns from these outlets. There was some areas that would benefit from redecoration. The manager said the owner was aware and that plans were in place to redecorate some bedrooms. We found that the home was generally clean. In the AQAA we are told that that they maintain the environment to a high standard and appliances are serviced regularly and maintenance kept up to date. In the last Care Homes for Older People Page 17 of 25 Evidence: twelve months they have upgraded a bathroom by fitting a walk in shower room. Their plan in the next twelve months is to upgrade, redecorate and replace furniture in the lounges. Care Homes for Older People Page 18 of 25 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Overall the numbers of staff on duty at the time were able to meet the needs of the people living at the home. Staff training needs to be considered, to make sure they are knowledgeable about the needs of the people in their care Evidence: There were five staff on duty, two allocated for catering duty in the kitchen preparing and cooking the meals of the day. Care staff are regularly involved in non-caring duties, such as dealing with the laundry. There are three cleaners for five hours a day, five days a week. Over the weekend the care staff cover cleaning duties. One of the management team is available to people during the day. There are two waking staff during the night.At the time of the visit there appeared to be enough staff to meet the needs of the present group of people living there. We saw that despite staff were busy doing their tasks they made time to sit and talk to people and their visitors. Visitors were very complementary about the staff team, they said they were friendly and always ready to help. One person said there seems to be quite a large turnover of staff and sometimes they seem to lack the necessary qualifications to cater to the residents needs. However, the senior staff seem to be competent. One person in their survey said overall we are grateful for the care which is provided. People in their survery and during the visit said they were happy with the care given and staff looked after them very well. Staff said in their surveys and during the visit that that they are busy but Care Homes for Older People Page 19 of 25 Evidence: they work well together as a team. Staff records were sampled and staff spoken to, we found that recruitment checks are carried out before a person starts their employment, which protects people. Staff said that they had received induction training and been told that there was opportunity for further training, to help them do their job and care for people. Courses that they told us they had done included: moving and handling, health and safety, food hygiene. Training priorities were discussed with the manager. She was advised to make sure that the records are kept updated and that training programme included training around people’s specialist care needs such as dementia. Care Homes for Older People Page 20 of 25 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management of the home is organised and the interests of the people living at the home are seen as important to the manager and her staff. Evidence: There is a system for staff supervision and staff appraisal giving staff the time to discuss their work, personal development and issues that could affect their work. The manager has worked at the home for several years. It was evident throughout the inspection that the manager was knowledgeable about people and their care and the running of the home. The management team consist of the manager,deputy manager and two senior care workers. We were told that the manager and her staff is well supported by the owner. We found that there are good systems in place to protect peoples money. There are regular check carried out by the administration staff checking balance and invoicing. Staff have had training in health and safety such as infection control and moving and handling. Care Homes for Older People Page 21 of 25 Evidence: We were told in the AQAA that the manager and owner work together as a team and decisions are agreed and all maintenance records are kept up to date. Care Homes for Older People Page 22 of 25 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 23 of 25 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 25 13 Action must be taken to 30/12/2008 reduce the risk of scalding to people from the hot water outlets in bedrooms and communal bathrooms. To make sure people living in the home and staff are safe. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 7 People should have a care plan that is clear how people want their care needs and support met. To ensure all staff know what to do to meet their needs. The staff administering peoples medication should sign to indicate that they have been given. Staff training should be expanded to include dementia care. 2 3 9 30 Care Homes for Older People Page 24 of 25 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 25 of 25 - 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!