CARE HOMES FOR OLDER PEOPLE
The Yews 73 Kettering Road Burton Latimer Northants NN15 5LP Lead Inspector
Judith Roan Unannounced Inspection 23rd February 2006 12:00 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 The Yews DS0000012960.V278122.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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 Yews DS0000012960.V278122.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service The Yews Address 73 Kettering Road Burton Latimer Northants NN15 5LP 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) 01536 722561 01536 505483 Mr George Peng Khye Khaw Miss Elizabeth F David Mr George Peng Khye Khaw Care Home 13 Category(ies) of Dementia - over 65 years of age (6), Old age, registration, with number not falling within any other category (13) of places The Yews DS0000012960.V278122.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. The Home will limit its services to the following service user categories: No person falling within the category Older Persons (OP) can be admitted where there are already 13 persons of category OP already in the home. No person falling within the category DE(E) can be admitted where there are 6 persons in the category DE(E) already in the home. The total number of service users in the Home must not exceed 13. 2. 3. Date of last inspection Brief Description of the Service: The Yews is a privately owned care home providing personal care only for older people. The Yews is registered to admit up to 13 residents within the category of old age. Within this total up to 6 persons within the category of dementia (DE (E)) can be admitted. All persons admitted to the home are over the age of 65 years. One of the jointly registered owners, Mr Khaw, is also the registered manager and is responsible for the day to day running of the home. Bedrooms are situated on 2 floors. A stair lift provides access to the first floor. Communal areas include a dining room and 2 lounges. All communal areas are located on the ground floor. There is a large garden to the rear of the home for the enjoyment and pleasure of the residents. The managers office is located in a small building sited in the rear garden. Both the registered persons live within the grounds of the home, this is called The Cottage. The Yews DS0000012960.V278122.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The focus of inspections undertaken by the Commission of Social Care Inspection is upon the outcomes for Service Users and their views of the service provided. The primary method of inspection used was ‘case tracking’ which involved selecting 2 service users and tracking the care they receive through review of their records, discussion with them, the care staff and observation of care practices. The inspection took place during the late morning and afternoon, over a period of 3.75 hours and was carried out on an unannounced basis. What the service does well:
The home offers a friendly warm environment for residents, where the staff are very friendly and welcoming. Residents are encouraged to be independent and to maintain links with relatives, friends and the community. Residents and the relative spoken with were very complimentary about the service they received and had high praise for the staff. They all felt that there was good communication within the home. A full assessment and opportunities for prospective residents and/or their relatives to visit the home are part of an active admissions procedure. Care practices ensure that care plans are updated with changing needs so that care staff can deliver appropriate care. There are good working relationships between the manager and primary health care team. Residents can be assured that they will receive a sensitive service with their rights respected and dignity maintained. Medication administration within the home meets standards. The complaints procedure enables resident’s views to be heard and acted upon. Good maintenance ensures that the home is safe, clean and hygienic. The manager provides a clear vision for the home, and staff demonstrated an awareness of their roles and responsibilities ensuring that the home is run in the best interests of the residents. Essential training is provided for all staff, including the registered manager. Staff training is detailed and comprehensive,
The Yews DS0000012960.V278122.R01.S.doc Version 5.1 Page 6 with over half the staff group having achieved NVQ (National Vocational Qualification) level 2. What has improved since the last inspection? What they could do better:
The home continues to develop their standards of care to residents. A review on how skilled staff are deployed within the home could lead to more direct work with residents. Please contact the provider for advice of actions taken in response to this The Yews DS0000012960.V278122.R01.S.doc Version 5.1 Page 7 inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The Yews DS0000012960.V278122.R01.S.doc Version 5.1 Page 8 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 Yews DS0000012960.V278122.R01.S.doc Version 5.1 Page 9 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): 3 A robust admission process ensures resident’s needs are met. EVIDENCE: Prior to admission residents are seen within their own home or hospital as part of gathering information to establish whether the home can meet an individuals needs. Residents or their representatives are invited to visit the home and meet other residents and staff before any decision to move in is made. During the trial period staff spend time in getting to know the new resident to ensure that all needs are met. The information sort is used to inform the ongoing care plan. The Yews DS0000012960.V278122.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Care plans are holistic and establish how individual resident’s health, social and personal care needs will be met EVIDENCE: During the inspection the inspector was able to meet with service users and their relatives who confirmed that they had been fully involved in the development of the care plans and that reviews are undertaken on a regular basis. All care plans had been signed by the resident or their representative. Care plans demonstrated ongoing involvement of the local primary health team with staff being proactive to involve them as health care needs arose. All residents felt that they were supported in a manner that maintained their dignity and enabled choice. Residents were very happy with the support they received and said they staff were always available to meet there needs. All files contained medication profiles and staff had received appropriate training at Tresham College.
The Yews DS0000012960.V278122.R01.S.doc Version 5.1 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): 13,14,15 Resident’s lifestyles are enhanced by the regular contact made with families & friends and being involved within the everyday activities within the home. Meals served at the home are balanced, well cooked and appealing in their presentation. EVIDENCE: At the time of the inspection several family members were visiting the home and shared their views with the inspector. They felt that the support their family member received was good and always found them well cared for. Relatives were always welcomed and they were kept informed of events. During the inspection the inspector was able to see the main meal of the day served. The food was attractively presented and portions sizes were good. Residents with special diets could be catered for as required. On viewing the menu it was evident that residents were offered a wide range of dishes to choose from over a four week period. The Yews DS0000012960.V278122.R01.S.doc Version 5.1 Page 12 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): 16,18 Residents can be assured that their views will be heard and their safety protected. EVIDENCE: The home complaints policy and procedures are fully available to residents and relatives. There have been no complaints received at the home since the last inspection. Residents and relatives spoken with were aware of the policy and would have no reservations in speaking with the registered manager who had always been receptive to listen and address concerns raised. In discussion with staff they were aware of the protection of vulnerable adults policy and local reporting procedures. They would always initially report any concern to the registered manager but if not available would seek assistance from CSCI The Yews DS0000012960.V278122.R01.S.doc Version 5.1 Page 13 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): 19,20,21,22,23,24,25,26 The environment ensures residents a safety and provides relaxed and comfortable areas that are maintained to an acceptable standard. EVIDENCE: The homes recent redecoration programme has provided residents with attractive and homely personal space. Residents are encouraged and supported to bring small items from there home that are important to them. The home employs a dedicated member of staff to undertake the cleaning and laundry within the home. These are maintained to a good standard. The Yews DS0000012960.V278122.R01.S.doc Version 5.1 Page 14 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): 27,29,30 Needs are met by a trained staff team that work to enhance the quality of life for resident’s. EVIDENCE: Although additional hours have been arranged in a morning and afternoon by extending the role of the domestic to support care staff in the home at busy times it will only go some way in meeting the shortfall identified at the last inspection. The use of senior member of care staff to cook is not an effective use of their skills and the registered manager should continue to develop staff in taking on more person centred activities with residents. The home recruitment policies and procedures ensure that residents are protected. Staff files viewed contained all relevant documents required under schedule 3 of the Care Home Regulations. Staff training is high on the agenda at the home with staff continuing to extend their skills. A dementia course is arranged to start at the end of February one day each week for eight weeks. The registered manager has recently gained his Registered Managers Award. The Yews DS0000012960.V278122.R01.S.doc Version 5.1 Page 15 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): 31,35 A competent manager manages the home in resident’s best interests. The home policy and procedures on personal finances protect residents. EVIDENCE: The manager demonstrates that they are fully aware of the needs of residents and supports staff to ensure that they deliver a good standard of care. The manager is open to new ideas and continues to develop their skills. In open discussion with the inspector the manager explored different ways in which they could achieve the required number of staff supervisions within the year and make best use of time available. The homes policy is not to act, as appointee for any resident and families are encouraged to manage this activity. Any additional service that is not included within the homes fees i.e. hairdresser, chiropody is billed directly through an invoice. Some individual residents keep any small amount of personal money.
The Yews DS0000012960.V278122.R01.S.doc Version 5.1 Page 16 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 X X N/A 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 X 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 2 28 X 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X 3 X X X The Yews DS0000012960.V278122.R01.S.doc Version 5.1 Page 17 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 OP27 Good Practice Recommendations The registered manager is strongly advised to review the current staffing levels and deployment of staff. The Yews DS0000012960.V278122.R01.S.doc Version 5.1 Page 18 Commission for Social Care Inspection Northampton Office Newlands House Campbell Square Northampton NN1 3EB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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