Inspection on 02/11/05 for Troydale Farm

This inspection was carried out on 2nd November 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Troydale Farm 27/11/07

Troydale Farm 04/12/06

Troydale Farm 20/02/06

Troydale Farm 09/12/04

Troydale Farm 03/08/04

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 Troydale Farm Troydale Lane Pudsey Leeds West Yorkshire LS28 9JT Lead Inspector Barbara Grell Unannounced Inspection 2nd November 2005 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 Troydale Farm DS0000001517.V258763.R01.S.doc Version 5.0 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. Troydale Farm DS0000001517.V258763.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Troydale Farm Address Troydale Lane Pudsey Leeds West Yorkshire LS28 9JT 0113 255 5984 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 Edna Gilbank Mrs Edna Gilbank Care Home 13 Category(ies) of Old age, not falling within any other category registration, with number (13) of places Troydale Farm DS0000001517.V258763.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 09/12/04 Brief Description of the Service: Troydale care home was built as a farmhouse in 1706 and was first registered as a care home in July 1989. It has been converted over time to provide residential accommodation to elderly service users with a moderate level of disability. The house is situated within pleasant gardens with car parking. Troydale is set in farmland in the Tong-Cockersdale conservation area with extensive views over Troydale valley onto the Post Hill. The house has been converted retaining many original features. The house provides 9 single and two double rooms on two levels, alongside two communal rooms. The home is accessible via public transport from Leeds and Bradford. There is level access into the home and a stair lift is fitted within. Troydale Farm DS0000001517.V258763.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was undertaken by one inspector unannounced on 2 November 2005. There are no requirements made during the previous inspection. In line with CSCI procedure a number of core standards were inspected. Janet Riley the deputy manager was on duty and Mrs. Gilbank the provider was at Troydale for a short period to say hello to service users and have discussion with the inspector. Reports and information relating to this and other social care services can be found on the CSCI Internet site on www.csci.org.uk. The following methods were used. The inspector had conversations with five service users. Staff and managers were observed in their interactions with service users during lunch and at other times during the morning. Staff on duty were able to make comment about the care and services as well as training provided at Troydale. Two service users were case tracked. Both case records were inspected including assessments and the service user plan. The staff personnel records, supervision and training records were inspected and practices discussed with staff on duty. The management provided CSCI with a self-assessment against the minimum standards and the completed pre-inspection questionnaire. What the service does well: The management ensures excellent staff training and opportunities for skill development within an appraisal and supervision system. A well thought out and practicable quality assurance and management system has resulted in standards being exceeded. The service users benefit from the ethos at the home that is service user centred. Service users felt that they were allowed and enabled to make choices and follow their own routines and interests. The service users opinion informs practice and individual care plans. The atmosphere at the home is a happy one with service users and staff interacting well in an informal domestic and well maintained environment. The needs assessments value the service users skill level and abilities and enable independence and choice. The staff understand the collective and individual needs and wishes of the service users in the home. Troydale Farm DS0000001517.V258763.R01.S.doc Version 5.0 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. Troydale Farm DS0000001517.V258763.R01.S.doc Version 5.0 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 Troydale Farm DS0000001517.V258763.R01.S.doc Version 5.0 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): 3, 5 & 6 The home follows appropriate pre-admission practices that ensure the input of service users and their representatives. Service users and their family are invited to visit the home prior to admission and many take advantage. Assessments seen showed a good level of input from service users. Service users benefit from a person centred approach. EVIDENCE: The registered person or deputy managers undertake an assessment prior to admission. When a core assessment is available this is obtained and the content noted. Most of the service users are privately funded and often have not been subject to care management assessment hence staff from Troydale are vigilant in obtaining appropriate information in respect of the service users care needs. There was good evidence that service users families and friends are involved in finding the home. Service users are involved in the assessment process and many visited prior to admission. Pre-admission visits to the home are encouraged by staff. The person undertaking the original assessment either at Troydale Farm DS0000001517.V258763.R01.S.doc Version 5.0 Page 9 Troydale or the service users current situation would be on duty during the admission and this is good practice. Assessments are recorded, reviewed over time and amended when changes occur. The assessments include good evidence that other professional are involved during the admission process and thereafter. There was much evidence that the service users opinions are ascertained and recorded including their expectations of the service and care to be provided. Any risks to the service users are assessed and minimised. The home at times provides for short stays but intermediate care is not provided. Short stay service users are assessed in the same manner as a long term service user. Troydale Farm DS0000001517.V258763.R01.S.doc Version 5.0 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 & 10 The care plans are based on the service users assessed needs and their individual expectations. Personal and health care needs are included and the same importance given to social, emotional and environmental and safety needs. The service users wishes and feelings are ascertained and form the basis of the care and services provided. EVIDENCE: The care plans are based on the assessments undertaken. In each case seen appropriate tools were used to assess the service users needs in respect of falls, skin viability, manual handling and nutrition. The care plans include details of the actions taken to minimise any assessed risks. Appropriate areas are included in the care plan. Any identified nursing needs are attended to by NHS nurses. The service users personal care needs are assessed and service users are clearly involved in this process. The care plans were seen to take account of the service users skill level and service users are assisted to increase this or maintain the level of current independence. Service users were seen to be assisted disceetly by staff. Interaction were appropriate and professional. The Troydale Farm DS0000001517.V258763.R01.S.doc Version 5.0 Page 11 service users preferred and stated wishes were recorded and made a part of the care plan. The service users medical diagnosis are recorded if any. Additionally staff monitor and observed for any indicators that are known to trigger poor health. Staff at the home have good relationships with the NHS nurses covering the area. Staff said that they can ring for advice and assistance and were able to discuss how they deal with medical emergencies or noted deterioration. Staff clearly had good contacts and pathways to involve medical professional and specialists in the care of the service users at the home. One of the local GP’s visits the home weekly to hold a surgery and staff said that they can ring for advice and a home visit at any other time. This is an excellent level of support and provision. Service users have a choice of local GP. The staff undertake and record a monthly review of the service users well being and the services and care provided. Any changes over time are monitored and the care plan altered when needed. A key worker system is shortly commencing at the home. This will further formalise the responsibilities with regard to record keeping and will link in with the staff supervision system. Managers oversee and monitor the quality of care and recording. Service users and staff had good interactions. Staff spoke to service users respectfully. Personal conversations and care giving was undertaken in private. The cook has daily contact with individual service users who clearly monitors and discusses the meals with service users. Service users said that the staff are professional and attentive. Troydale Farm DS0000001517.V258763.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 14 & 15 Service users benefit from stimulating activities and good interactions with staff. Service users fell in control of their lives and have a choice of their own routine supported by staff when needed. The food including any special diets is varied and freshly prepared and enjoyed by the service users. EVIDENCE: The care plans are person centred and include assessments of the service users religious, social and emotional needs. Activities provided are based on the interests that service users have. There is much one to one conversation with staff as well as discussions in lounges stimulated by staff. Service users enjoy these conversations and discussions. The managers hold service user meetings in order to ascertain what individuals and the group would like to do. The menu’s are similarly discussed. Many of these meetings are informal but actions taken are clearly informed by the service users wishes. Service users used their own rooms and communal areas as they wished. All had their meals in one of the two communal rooms. There was much talk and banter during the meal. Service users were enjoying the food and company. Service users said that the food is very good, varied, fresh and home made. The service user plans take account of individual wishes and are personalised. Service users spoken to clearly felt in control of their routines and lifestyle and stated that they could make choices, go out, have visitors, be alone or with Troydale Farm DS0000001517.V258763.R01.S.doc Version 5.0 Page 13 company and refuse or choose to take part in any arranged activities. Special occasions are celebrated with special meals, seasonal celebration and service users friends and relatives are welcome to join in on many occasions. The staff are planning and practicing the annual Panomime that is shown during the annual Christmas party. Service users spoken to felt that life at the home is only boring ‘if you want it to be’. The meal of the day was well prepared and presented. Service users were enjoying the food and company. There was a relaxed atmosphere during the meal. The menu plans are changed periodically and changes made on special days to provide for a special menu. The menus are varied and fresh, good quality produce is used in the meal preparation. Fresh baked pastries, cakes and biscuits are prepared in the homes kitchen and enjoyed by service users during morning or afternoon tea’s. Service users said that they could ask for food and drinks at any time and said that they would be provided with an alternative choice at meal times. The service users dietary needs are ascertained and recorded in the care plan. Special diets are catered for when needed. Troydale Farm DS0000001517.V258763.R01.S.doc Version 5.0 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 There are appropriate policies and training provided to staff in respect of complaint and protection. There have been no complaints or adult protection issues in the home. EVIDENCE: The home has a complaints policy that is part of the service user guide. There have been no complaints made to the home or CSCI. Janet Riley said that she would investigate any complaint and respond in writing about findings and any actions taken. Mrs. Gilbank and Mrs. Riley give service users and their visitors regular opportunity for discussing the quality of care and services. Most of the staff at the home have attended training in respect of recognising and reporting abuse and providing protection to vulnerable adults. Policies are available including policies for whistleblowing. Troydale Farm DS0000001517.V258763.R01.S.doc Version 5.0 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standards not assessed on this occasion. EVIDENCE: Troydale Farm DS0000001517.V258763.R01.S.doc Version 5.0 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): 29 & 30 Service users benefit form a staff team that is well trained and experienced. Gaps in knowledge are ascertained and appropriate training provided. The level of staff qualified to level 2 or above have also been exceeded. EVIDENCE: 75 of staff are qualified to NVQ level 2 or 3. standard. This exceeds the required The individuals training needs are assessed and training plans implemented based on the assessed needs. Staff are encouraged and enabled to attend NVQ and other training. All new recruits undertake induction. The level of induction training needed is based on required skill level and core skills and the individuals previous experienced and training. All staff undertake core training and refresher courses periodically. This includes recent training with the following topics: Medication, moving and handling, dementia care, infection control, health and safety and basic food hygiene. There is a high level of commitment toward the training needs of the staff and the standard is exceeded. Domestic staff have been provided with training specific to their task as well as training in philosophy of care. Staff spoken to stated that they benefited from good levels of training and support from managers. Troydale Farm DS0000001517.V258763.R01.S.doc Version 5.0 Page 17 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): 32, 33, 35 & 36 The practices and ethos communicated to staff ensures that the outcome for service users is of a high standard of services and care. The managers ensure a good system of quality assurance and cycle of review and improvement. There are excellent systems of staff supervision and development that benefit the service users by ensuring consistency and expectations of high standards are well communicated and achieved. EVIDENCE: Mrs. Gilbank is the registered provider and manager. There are plans to change the registration and make application for Mrs. Riley to become the registered manager. In anticipation of her application a new deputy manager has been appointed and individual roles and responsibilities reviewed. A new key worker system is about to commence. Staff supervision arrangements have been split in line with the key worker system. The two deputy managers currently ensure that the care and service provided are of a high standard and continue a high level of contact with service users Troydale Farm DS0000001517.V258763.R01.S.doc Version 5.0 Page 18 relatives and hand on care with service users. This benefits the service users and enables the managers to stay closely involved with all aspects of the care and services provided at Troydale. The managers act as role models to all other staff and follow good practice principles. Staff on duty said that they receive a high level of good quality training and support is always available. Mrs. Gilbank continues to be involved in the running of the home and provides for some on duty presence. Examples of good quality monitoring and management was apparent within documentation seen. Service users and staff have regular and planned opportunity to make comment and be involved in the decision making. Practices are service user centred and based on good practice. Service user surveys are undertaken and outcomes recorded. A self-assessment against the minimum standards has been completed and included all areas. The homes manager noted no shortfalls. The inspector judged several standards to be exceeded. Good quality management that aims at a high quality of service and care has lead to high standards being achieved. The service users deal with their own financial arrangements and the home’s staff do not hold any valuables or money for safe keeping. Lockable facilities are provided in service users rooms to keep their own valuables. Extra services provided such as hairdressing for example are included in any invoice sent to service users or their named representatives. Individual arrangements are made with service users and their families in respect of the payment of fees. The managers have regular, planned, one to one supervision meetings with staff. These continue the appraisal and goal setting process throughout the year. Training plans are made in line with supervision and appraisals and records kept showing how development has been achieved. A new key worker system is being implemented to further increase the development of the staff. This area is well managed and ongoing planning is ensured in developing a competed staff team. This very good system of supervision benefits service users as it ensures a consistency of approach and stable staff team of committed individuals. Staff meetings and handovers ensure ongoing discussion and good communications. Troydale Farm DS0000001517.V258763.R01.S.doc Version 5.0 Page 19 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 3 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 X X X X X X X X STAFFING Standard No Score 27 X 28 X 29 4 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X 4 4 X 3 4 X X Troydale Farm DS0000001517.V258763.R01.S.doc Version 5.0 Page 20 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. Refer to Standard Good Practice Recommendations Troydale Farm DS0000001517.V258763.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Aire House Town Street Rodley Leeds LS13 1HP 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 Troydale Farm DS0000001517.V258763.R01.S.doc Version 5.0 Page 22 - 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!