Inspection on 05/01/07 for Yockleton Grange

This inspection was carried out on 5th January 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

Yockleton Grange 09/12/05

Yockleton Grange 23/08/05

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Maple Lodge

Polesworth Group 32 Station Road

Heathlands

Aston Court Nursing Home

Polesworth Group 70 Long Street

Breme

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

CARE HOMES FOR OLDER PEOPLE Yockleton Grange Yockleton Shrewsbury Shropshire SY5 9PQ Lead Inspector Rebecca Harrison Key Unannounced Inspection 5th January 2007 09:15 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 Yockleton Grange DS0000064028.V326205.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. Yockleton Grange DS0000064028.V326205.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Yockleton Grange Address Yockleton Shrewsbury Shropshire SY5 9PQ 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) 01743821284 01743821319 Springcare (Yockleton) Limited Ms Susan Elizabeth Garner Care Home 30 Category(ies) of Learning disability (6), Learning disability over registration, with number 65 years of age (6), Old age, not falling within of places any other category (20) Yockleton Grange DS0000064028.V326205.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home may accommodate a maximum of 30 service users. No person whose needs fall into the category of learning disability may be admitted under the age of 55. Places registered for people with a learning disability between the ages of 55 and 65 (LD) may be used flexibly to provide accommodation for older people (OP) when required. 9th December 2005 Date of last inspection Brief Description of the Service: Yockleton Grange is registered with the Commission for Social Care Inspection (CSCI) to provide accommodation and personal care for up to 30 Older people to include seven people with a learning disability over the age of 55. The Registered Provider is Springcare Limited and the Registered Manager is Ms Susan Garner. The home is located in Yockleton and is easily approached from Shrewsbury and surrounding villages and Welshpool. The original house was a former rectory, which has been extended to provide additional accommodation with en-suite facilities. The home stands in three acres of landscaped gardens. The home seeks to provide a positive homely environment for service users affording the appropriate levels of support required to meet their individual needs. The aims of the home is ‘To provide all service users a life that is as normal as possible, given their individual health and needs in homely surroundings. To provide all service users with care which will enable them to live as independently as possible with privacy, dignity and with the opportunity to make their own choices.’ Potential service users and their representatives are able to gain information about this home from the Statement of Purpose and Service User Guide available from the home. CSCI reports for this service can be obtained direct from the provider or are available on CSCI’s website at www.csci.org.uk The current fees charged range from £325.00 to £400.00 per person per week. Yockleton Grange DS0000064028.V326205.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection started at 09.15 a.m. and was carried out over a period of 6.5 hours. It included talking with a number of service users, three staff on duty, the manager, visiting relatives, looking in detail at all aspects of care for two people most recently admitted to the home, observing work practices, reviewing a number of records and a full tour of the home. 21 key National Minimum Standards for older People were assessed in addition to Standards 1,32 and 36 and a quality rating provided based on each outcome area for service users. These ratings are described as excellent/good/adequate or poor based on findings of the inspection. The purpose of the inspection was to assess ‘Key’ National Minimum Standards and to review progress made by the home since the last inspection undertaken on 9th December 2005. No requirements or recommendations were previously made. What the service does well: What has improved since the last inspection? A number of environmental improvements have taken place to include new floor coverings in the original house and a number of rooms have been redecorated to include external paintwork. Some new beds and curtains have been purchased and a new sink fitted in kitchen. Yockleton Grange DS0000064028.V326205.R01.S.doc Version 5.2 Page 6 New care planning formats have been developed and implemented and the staff and manager reported that these formats are much improved and easier to complete and review. Staff and the manager have undertaken mandatory and service specific training to develop their knowledge and skill base. Medication procedures have improved to safeguard service users and seven staff have received accredited training in medication procedures through the local college. 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. Yockleton Grange DS0000064028.V326205.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 Yockleton Grange DS0000064028.V326205.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): 1 and 3 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Prospective service users and their relatives are provided with information to make an informed choice about what the service offers and an appropriate admissions procedure is in place. EVIDENCE: The care documentation for two people most recently admitted to the home was examined. A Community Care Assessment had been obtained for one individual however there was no evidence of a formal needs assessment being undertaken for the other person admitted, in line with the homes admissions procedure. This shortfall was fully acknowledged by the manager at the time of inspection. The manager stated that intermediate care is not provided therefore it was not possible to assess key Standard 6 on this occasion. Yockleton Grange DS0000064028.V326205.R01.S.doc Version 5.2 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care planning systems have improved to provide staff with the information they need for the delivery of care. Service users are safeguarded by improved medication procedures. Personal support is offered in such a way to promote and protect service users’ privacy, dignity and independence. EVIDENCE: Care planning documentation was examined for the two people most recently admitted to the home. Since the last inspection the care planning format has changed and discussions held with staff and the manager indicated that the new format is more detailed and user friendly. Both care plans reviewed were comprehensive with evidence of review at the required frequency. Staff spoken with considered that they have sufficient information to support the Yockleton Grange DS0000064028.V326205.R01.S.doc Version 5.2 Page 10 individual needs of the people accommodated. There was evidence of formal reviews being held on one file examined involving significant others. Visiting relatives of another service user reported that they had been involved in their relatives care planning and review. The manager was advised to detail care plans further to include specific levels of assistance required in relation to personal care and moving and handling tasks. Service users health needs were clearly documented on the files reviewed with all appointments documented. The manager reported that healthcare professionals regularly see individuals and positive working relationships are maintained. The manager stated that all of the service users accommodated with a learning disability have recently had Health Action Plans developed with the local team. Since the last inspection the home has changed over to the monitored dosage system (MDS) for medication. The staff and manager welcome the introduction of this system and considered it provides greater protection to service users. It was reported that following assessment one individual self administers his own medication. An agreement for administration of medication was not available for the remainder of people on prescribed medication and the manager committed to reviewing this. The lunchtime administration of medication was observed and found satisfactory. The manager stated that seven staff have received accredited medication training. Service users spoken with confirmed that they are treated with dignity and respect. Staff were observed knocking on service users doors prior to entry and staff were seen to interact positively with service users throughout the inspection. Yockleton Grange DS0000064028.V326205.R01.S.doc Version 5.2 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides activities for the service users to participate in. Family and community links are maintained and individuals are enabled to exercise choice and control over their lives wherever possible and are provided with a varied diet in accordance with their personal preferences. EVIDENCE: On arrival to the home a small number of people were out attending day services provided by the local authority. A schedule of planned activities for January was displayed in the reception. The Activity Organiser left employment in October and a nominated staff member is due to take on this role very shortly providing more structured activities four afternoons per week. Training has been sourced in addition to obtaining a file specifically for activities in care homes. An external person visits the home once a week to provide movement and music and service users are supported to attend church, hairdressing services, flower arranging and a number of people attended Christmas events in the community. During the inspection a group of people were supported to take part in an in-house activity, which they appeared to enjoy. The manager Yockleton Grange DS0000064028.V326205.R01.S.doc Version 5.2 Page 12 reported that the home intends to provide a greater choice of structured activities shortly. Contact with friends and family is well promoted and the visitors book evidenced that people receive regular visitors and any contact is recorded in service users daily records. Visiting relatives spoken with were very complimentary in relation to the care provided and staff and managers and stated that they are always made welcome. Residents meetings have recently been implemented and a member of staff reported that the meeting held was very positive with those attending playing an active role in contributing to the meeting. Observations made and discussions held evidenced that individuals are enabled to exercise choice and control wherever possible. A charter of client’s rights was seen displayed in the reception area and also included in the Statement of Purpose and Guide. No independent advocates are currently used therefore relatives and key workers act in the best interests of service users. People living at the home are entitled to bring in personal possessions with them on admission if desired. Following discussions held with service users and a review of the menus it appears that people are provided with a varied balanced diet taking into account personal preferences and choice. The meals provided on the day of the inspection were well presented and individuals requiring assistance were offered this in a discreet and sensitive manner. Special dietary needs are well catered for. Yockleton Grange DS0000064028.V326205.R01.S.doc Version 5.2 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users and their representatives have access to a complaints procedure that enables their views to be listened to and acted upon. Procedures to safeguard service users from potential abuse are in place. EVIDENCE: The home has a complaints procedure and this was seen displayed in the reception area of the home. All service users spoken with had a clear understanding of whom to approach if they were unhappy with the service received. Records seen indicate no complaints have been received since the last inspection which was confirmed by the manager. No complaints or concerns have been referred to CSCI since the last inspection. The home currently uses a loose-leaf complaint log to record any complaints therefore the manager was advised to obtain a bound book for future purposes. The manager reported that the home has a copy of the local adult protection policy and procedure and that no referrals to adult protection have been made since the last inspection however the manager has a clear understanding of the procedure as it has been used previously. Records indicate three staff plus the manager have attended training in the local adult protection policy and procedure. The manager will endeavour to Yockleton Grange DS0000064028.V326205.R01.S.doc Version 5.2 Page 14 ensure other members of staff are put forward to attend training. Staff spoken with had an understanding of the homes whistle blowing procedure. Yockleton Grange DS0000064028.V326205.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home continues to provide a high quality, comfortable, clean and safe environment for those in residence. EVIDENCE: Yockleton Grange is set in an attractive location within extensive and wellmaintained grounds, providing easy and safe access to service users. Rooms seen during an environmental tour were found clean and individually personalised. Service users spoken with reported that they are happy with their room and the communal areas provided. Since the last inspection a number of improvements have been made to enhance the environment to include new floor coverings in the old part of the house and some internal and external redecoration. It was reported a number of new beds and curtains have also been purchased. The manager committed to developing a planned programme of renewal and refurbishment as required. Yockleton Grange DS0000064028.V326205.R01.S.doc Version 5.2 Page 16 It was reported that the Fire Officer has not visited since the last inspection and no requirements remain outstanding. A food safety and health and safety inspection was recently undertaken by the Environmental Health Officer and it was evident that the manager is currently working towards meeting the requirements and recommendations made. A Housekeeper is employed and the home was found well presented and free from offensive odours during this unannounced inspection. Staff confirmed that they have received training on infection control and personal protective equipment was seen to be readily available. Products hazardous to health are appropriately stored and data sheets and assessments available. The home provides a well- equipped laundry. Yockleton Grange DS0000064028.V326205.R01.S.doc Version 5.2 Page 17 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): 27,28,29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are supported by a committed, trained and enthusiastic staff team and are safeguarded by the homes recruitment procedures. EVIDENCE: Discussions held with three staff on duty evidenced they were knowledgeable and had a good understanding of the individuals whom they support. Staff were observed to be accessible, good communicators and interacted appropriately with service users present and spoke positively about their roles and responsibilities. The home currently employs twelve care staff of which five have obtained NVQ qualifications. Staff spoken with stated that teamwork is effective and staff are employed in sufficient numbers to meet the individual needs of the people accommodated. This was confirmed by visiting relatives spoken with during the inspection who were very complimentary regarding the staff and manager. Personnel files for the two most recently recruited staff were examined and contained the relevant information required by the Care Homes Regulations. It is evident that service users are supported by a stable staff team with minimal turnover. Staff receive a copy of the General Social Care Council Code of Practice and a statement of their terms and conditions of employment. Yockleton Grange DS0000064028.V326205.R01.S.doc Version 5.2 Page 18 Staff spoken with reported that they are provided with good training opportunities to include mandatory and service specific courses and a training matrix and certificates of attendance were readily available. Staff are in receipt of formal supervision at the required frequency and individual training needs are discussed during these meetings and as part of their annual appraisal. Files examined of the two staff most recently employed evidenced that they have received in-house induction training however this induction does not currently meet Skills for Care specification as required to equip them to meet the assessed needs of the people accommodated. Yockleton Grange DS0000064028.V326205.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): 31,32,33,35,36 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is managed by a competent manager who is approachable and supportive, having a positive impact on service users and staff. Quality assurance systems are available and the premises are maintained in a safe manner safeguarding service users and staff. EVIDENCE: Ms Susan Garner is the registered manager of the home and has worked at the home for twenty years with the last ten years being in the manager role. She has obtained the Registered Managers Award and NVQ 4 in Care. Since the last inspection she has undertaken numerous training courses appropriate to her role to update her skills and knowledge. All service users, staff and visiting Yockleton Grange DS0000064028.V326205.R01.S.doc Version 5.2 Page 20 relatives spoken with were very complimentary in relation to the registered manager and her leadership skills. Views about the service are actively sought through questionnaires, which are distributed annually to service users and visitors. Feedback seen was very positive with comments to include ‘Excellent care, no complaints’ ‘Staff are always helpful’. The manager committed to ensuring questionnaires are also distributed to stakeholders in addition to developing an annual development plan for the home as required. A Quality Assurance assessment was undertaken by the organisation on 21.03.06 and the home achieved an overall score of 96 with very minimal shortfalls identified. One service user spoken with stated ‘It’s home from home living here and I am very happy and well cared for’. Another service user spoken with stated ‘All of the staff must have been chosen as they are wonderful’. Equality and diversity is promoted throughout the home and it was evident that people from both clients groups accommodated are provided with equal opportunities across all aspects of service provision. The manager holds small amounts of money on behalf of five service users in agreement with relatives for expenditures such as hairdressing, chiropody etc. Although written records of transactions are maintained and receipts given to relatives no formal financial agreements were seen to be in place. Lockable storage facilities were seen available in service users own rooms. Matters relating to Health and Safety appeared satisfactory at the time of the inspection and no potential hazards were identified however the manager was advised to detail individual moving and handling assessments further. All records required are maintained and staff are in receipt of mandatory Health and Safety training. As previously stated the manager is working towards meeting the requirements made by the Environmental Health Department in relation to health and safety matters made during a recent visit made to the home. Yockleton Grange DS0000064028.V326205.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 3 x 2 x x 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 4 x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 4 3 x 3 3 x 3 Yockleton Grange DS0000064028.V326205.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? N/A 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. 1. Standard OP3 Regulation 14 (1) Requirement A needs assessment must be obtained/ undertaken prior to a new service user being admitted to the home. New staff must receive induction training to Skills for Care specification. Timescale for action 08/01/07 2. OP30 18 (1) 28/02/07 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 OP7 OP9 OP35 Good Practice Recommendations It is recommended that care plans be further detailed to include specific levels of assistance required in relation to personal care and moving and handling tasks. Service users consent to the administration of medication should be obtained and recorded in the individual plan. It is recommended that financial agreements be developed for safekeeping of service users finances. Yockleton Grange DS0000064028.V326205.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Shrewsbury Local Office 1st Floor, Chapter House South Abbey Lawn Abbey Foregate SHREWSBURY SY2 5DE National Enquiry Line: 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 © 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 Yockleton Grange DS0000064028.V326205.R01.S.doc Version 5.2 Page 24 - 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!