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Inspection on 04/07/05 for Yolanta House Care Home

Also see our care home review for Yolanta House Care Home for more information

This inspection was carried out on 4th July 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home provides good personalised care for older people from a range of ethnic backgrounds particularly polish. The majority of the staff speak both English and Polish, and Polish newspapers and TV are available. This is clearly helpful for some of the residents seen who are not able or prefer to speak in Polish. In addition many signs and documents in the home are available in both languages. As the home is fairly small and the staff are very familiar with each individuals plan of care, care is provided in a personal and individual manner. This together with the relatively small size of communal rooms leads to a homely and friendly atmosphere. Meals are nutritious and home cooked and service users are given a choice that includes both Polish and English dishes. Some service users commented favourably about the food and it was observed that others clearly enjoyed their meals.

What has improved since the last inspection?

At the last inspection the home was required to introduce an assessment document that could be completed if any new resident moves to the home without one. This has been done and will ensure that staff can provide appropriate care to all new service users immediately.

CARE HOMES FOR OLDER PEOPLE Yolanta House 1-3 Herbert Road Sherwood Nottingham NG5 1BS Lead Inspector Chrisandra Harris Unannounced 4/7/05 9.30 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 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. Yolanta House C03 C53 S2226 Yolanta House V236316 040705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Yolanta house Address 1-3 Herbert Road Sherwood Rise Nottingham NG5 1BS 0115 9626316 0115 9693122 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr J Sekowski Mrs J Sekowski Care Home 19 Category(ies) of Dementia 19 registration, with number Older People 19 of places Yolanta House C03 C53 S2226 Yolanta House V236316 040705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 10th March 2005 Brief Description of the Service: Yolanta House is a care home for 19 older people and older people with dementia. A majority of the residents and a large number of the staff are of Polish origin, although there are residents from a range of ethnic backgrounds. The home is owned and run by Mr and Mrs Sekowski, and their adult son also works in the home as a senior care assistant. Mrs Sekowski is the manager. The home is located within a residential area of Nottingham close to shops, health centres and other amenities. The local Polish community centre and Catholic church are within walking distance. The home is converted from three large houses and the residents accommodation is on two floors. On the ground floor there are 2 shared lounges and 2 dining rooms, 1 bathroom, 1 shower room and 2 toilets. There are 7 single rooms on this floor, one of which is ensuite, and 2 double rooms. The remaining bedrooms are on the first floor, all these are single rooms. Also on the first floor are a further 3 bathrooms and 3 toilets. There is no passenger or stair lift installed. There is ramped access to the home and garden. Yolanta House is well decorated and furnished with a homely atmosphere. Yolanta House C03 C53 S2226 Yolanta House V236316 040705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over 3 hours and was unannounced. The inspector looked around some parts of the building and the garden, observed the midday meal and looked at a number of records. In addition four service users, four members of staff and Mr and Mrs Sekowski were spoken to. As some service users were not able to discuss their opinions observations were made as to their reactions to care and meals. There were no visitors to the home during the inspection. What the service does well: What has improved since the last inspection? Yolanta House C03 C53 S2226 Yolanta House V236316 040705 Stage 4.doc Version 1.40 Page 6 At the last inspection the home was required to introduce an assessment document that could be completed if any new resident moves to the home without one. This has been done and will ensure that staff can provide appropriate care to all new service users immediately. 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. Yolanta House C03 C53 S2226 Yolanta House V236316 040705 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Yolanta House C03 C53 S2226 Yolanta House V236316 040705 Stage 4.doc Version 1.40 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 standard(s) 3 A requirement was made at the last inspection to introduce a system for assessing self-funding service users. An appropriate assessment form is now in place. This will ensure that all service users are able to receive appropriate and safe care as soon as they are admitted. EVIDENCE: Since the last inspection the home has devised an assessment form for new residents that move to the home without one. This was seen to include all the necessary areas to ensure that staff can provide appropriate care immediately. Although there have not been any new admissions since the assessment form was put in place, an assessment was seen for the last self-funding person that moved to the home. Care staff were aware of the new form and expected that it would be completed for future admissions. Yolanta House C03 C53 S2226 Yolanta House V236316 040705 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, and 9. Individual’s health and personal care needs are recorded and advice and assistance from relevant health professionals sought in order to ensure that appropriate care is provided. Some adjustment of care plans need to be made in order to reflect the particular method of monitoring weight for each individual. EVIDENCE: Three individual plans of care were inspected and it was seen that these were reviewed monthly. Staff described how they were given responsibility for maintaining and reviewing care plans with their key service users at regular intervals. The care plans were well-written and easy read, and included information about health, personal and social care needs. Plans included a risk assessment. Care staff were familiar with the contents of the plan and the specific needs of each service user. This enables them to provide personalised care. Care plans had evidence of pressure sore risk assessment, monitoring and referral to the district nurse when risks were identified that needed specialist equipment or attention. There were details of positional changes and routines for relieving pressure and information about the specialist equipment to be used. This was also observed in use within the home. Yolanta House C03 C53 S2226 Yolanta House V236316 040705 Stage 4.doc Version 1.40 Page 10 Weight records were observed in care plans and it was noted that one person had been admitted with a very low weight and that their weight had significantly improved. However the home does not have the equipment needed to weigh individuals who are not weight bearing and should discuss this with the district nurse and closely monitor by observation. This should be reflected in the care plan. Service users are helped to attend hospital appointments and to access local health services; one person was accompanied to a dental appointment during the inspection. Each service user is assessed as to their ability to self medicate and either they or their representative signs documentation regarding this. Medicines (including controlled drugs) are stored, recorded and administered appropriately. Yolanta House C03 C53 S2226 Yolanta House V236316 040705 Stage 4.doc Version 1.40 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 standard(s) 12 and 15. Efforts have been made to provide suitable reading material and TV for service users, but in order to fully meet their meet their social and recreational needs, a programme of suitable activities, (both inside and outside the home) needs to be developed. This should be done in conjunction with service users and relevant to their needs and interests. There is a choice at meal times that includes both English and Polish dishes. Meals are home cooked, nutritious and varied providing a good diet for service users. EVIDENCE: There are TVs in both lounges that can receive Polish language programmes as well as the usual channels and both English and Polish newspapers are provided. In addition there is a small library of books available to service users. Some service users are assisted to attend the Polish day centre and the local church both of which are nearby. A priest also visits the home monthly. Care plans detail service users interests. However at present the home does not offer a programme of activities although staff have many ideas for activities and trips that could be offered. The inactivity of service users was clear at the inspection and individuals spoken to were unable to describe any activities within the home. Yolanta House C03 C53 S2226 Yolanta House V236316 040705 Stage 4.doc Version 1.40 Page 12 Records are kept of meal choices offered and some service users commented favourably on the food offered. There is a choice of English and Polish dishes at each main meal. The meal observed was home cooked and nutritious. Several people need to have their food liquidised and the staff try to make this food as attractive and appealing as possible. All service users were observed to be eating their meal with enjoyment. Yolanta House C03 C53 S2226 Yolanta House V236316 040705 Stage 4.doc Version 1.40 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 The complaints book needs to be kept in the home. Although complaints appear to be taken seriously and acted upon, they have not been recorded. In future all complaints must be recorded fully in order to ensure that service users views are listened to and appropriate action taken. Information in the complaints documentation regarding contacting the Commission for Social Care Inspection needs to be updated in order for service users to be able to easily contact the Commission if they wish. EVIDENCE: The home has a complaints procedure in place and copies are available within the service users guide and were seen in individual’s bedrooms. The information regarding contacting the Commission for Social Care Inspection on this documentation was out of date and incorrect and needs to be updated. The manager was unable to locate the complaints book at the inspection and later recalled that it had been taken home. Therefore it could not be examined at the inspection. The manager could not recall any complaints since the last inspection, however during discussion it appeared that a complaint had been made via a social worker and that relevant action to resolve the complaint had been taken. This had not been viewed as a complaint at the time but the manager agreed in retrospect that it should have been recorded. Yolanta House C03 C53 S2226 Yolanta House V236316 040705 Stage 4.doc Version 1.40 Page 14 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 standard(s) 19 and 20. The home provides a safe and homely environment with a choice of communal areas for service users. It is well maintained, clean and decorated to a good standard. EVIDENCE: The home was observed to be comfortable and homely. It is in a residential area and close to local amenities including the Polish day centre and church. There is a programme of maintenance with records of work undertaken. Decoration is done on a rolling programme and when a bedroom becomes vacant. The grounds were seen to be clean and tidy and accessible via ramps. Signs within the home were in both English and Polish. There are two shared lounges and two dining rooms. In all rooms the furnishings were of good quality with a range of seating to meet individuals needs. Both lounges had large windows allowing natural light and domestic type lighting. Gardens are enclosed to ensure safety. Yolanta House C03 C53 S2226 Yolanta House V236316 040705 Stage 4.doc Version 1.40 Page 15 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 and 29. The numbers and skills of the staff employed are appropriate for the home. It is clearly an advantage for the Polish-speaking service users that the majority of staff is able to speak both English and Polish. There are satisfactory procedures for the recruitment of new staff that will contribute to protecting service users. EVIDENCE: The staff rota was seen and indicated that sufficient staff are on duty at a time. Systems are in place to cover for sudden staff absence, as happened on the day of the inspection. Rotas overlap in order to allow for appropriate communication and handover of events, this was also seen recorded in the handover book. There are sufficient domestic staff. Communication between service users and staff in Polish was observed. This was clearly valued by the Polish-speaking service users. A new member of staff had recently started work at the home. The staff file contained an application form, evidence of identity and satisfactory checks and two references. Staff spoken to were able to confirm that they had received contracts stating their terms and conditions. Yolanta House C03 C53 S2226 Yolanta House V236316 040705 Stage 4.doc Version 1.40 Page 16 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 35 In general service users financial interests are safeguarded, however records are not directly kept of the service users bank account. Therefore it is difficult to be clear how much of the money in this account belongs to each service user. In order to safeguard the finances of service users, there needs to be clear documentation to show money deposited and withdrawn in the service user bank account EVIDENCE: The manager/owner does not act as an appointee for any service users. Small cash floats and valuables can be left with the manager and appropriate records and receipts are kept. A few service users receive regular lump sums from their solicitor for personal spending. This money is kept in one separate account and withdrawn as cash as the service users need the money. Although clear records are kept of the cash spending, records are not kept directly in relation to the bank account. Yolanta House C03 C53 S2226 Yolanta House V236316 040705 Stage 4.doc Version 1.40 Page 17 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 x 14 x 15 3 COMPLAINTS AND PROTECTION 3 3 x x x x x x STAFFING Standard No Score 27 3 28 x 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 x x x x x x 2 x x x Yolanta House C03 C53 S2226 Yolanta House V236316 040705 Stage 4.doc Version 1.40 Page 18 No Are there any outstanding requirements from the last inspection? 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 8 Regulation 17(1) Requirement Where it is not possible to regularly weigh service users, devise alternative plans for monitoring weight loss or gain and record these in the care plan. Taking into account the needs and wishes of service users, establish a programme of recreational and social activities. Ensure that a record of all complaints is kept at the home. Adjust the information regarding the Commission so that it is up to date. Ensure a record of finances deposited and withdrawn in the servcie usrs bank account is kept in relation to each servcie user. Timescale for action 5th August 2005 2. 12 16(2) 5th August 2005 5th August 2005 29th August 2005 5th August 2005 3. 4. 5. 16 16 35 17(2) 22(7) 17(2) 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. Yolanta House C03 C53 S2226 Yolanta House V236316 040705 Stage 4.doc Version 1.40 Page 19 Refer to Standard Good Practice Recommendations Commission for Social Care Inspection Edgeley House Tottle Road Nottingham NG2 1RT 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. 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