Inspection on 01/12/08 for York House

This inspection was carried out on 1st December 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 8 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

York House 02/03/10

York House 20/01/10

York House 21/08/07

York House 14/11/06

York House 31/01/06

York House 04/07/05

York House 01/02/05

York House 26/08/04

York House 30/03/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 13/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: York House 8-10 Cauldon Avenue Swanage Dorset BH19 1PQ     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: John Clarke     Date: 0 1 1 2 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: · · · · Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: York House 8-10 Cauldon Avenue Swanage Dorset BH19 1PQ 01929425588 01929425588 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mrs Maxine Valerie Toni Jacqueline Wylie,Mr Richard Graham Wylie Name of registered manager (if applicable) Mrs Margaret Street Type of registration: Number of places registered: care home 34 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home York House is a large, older style, detached property that overlooks a recreational/garden area and is close to the seafront. The home is approximately a mile from Swanage town centre, which has a G.P surgery, community hospital, shop, banks, a post office and places of worship. Accommodation is provided over three floors, all are serviced by a passenger lift. All communal lounges and dining areas are on the ground floor, also the kitchen and managers office. There are 30 bedrooms in the home; 20 have en suite toilet facilities. Two rooms are registered for use as shared rooms. A maximum of 34 service users can be accommodated in the category OP (older persons). Mr and Mrs Wylie are the registered providers and have owned York House since 1988. The registered manager is Mrs Street, who is supported by a Deputy Manager and a team of care and household staff. The gardens and grounds are Care Homes for Older People Page 4 of 28 Over 65 34 0 Brief description of the care home well tended with garden furniture available so that residents can sit outside in good weather. There is car parking space at the front of the house for use by visitors. Laundering of clothing and household linen is carried out at the home and arrangements are made for chiropodists, opticians and other health and social care professionals to visit individual residents. The fee range quoted in the service user guide at the time of inspection was #455 to #515 per person per week. Up to date fee information may be obtained from the service. Information regarding the subjects Value for Money and Fair Terms in Contracts can be obtained from the web link: www.oft.gov.uk Care Homes for Older People Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This was an unannounced visit to the home as part of our inspection. We looked at a number of records including those relating to pre-admissions, care plans, administering and management of medication, staff recruitment and training. We also looked at practice around health and safety and documents relating to this area. We also had an opportunity to talk with individuals who live in the home about their views of the quality of the service they receive. We also spoke with a number of staff about working in the home and the service they provide. We received a Annual Quality Assurance Assessment which told us about the changes and improvements that have been made since our last inspection in July 2007. Fees 485-545 pounds all inclusive other then community services such as chiropody. Care Homes for Older People Page 6 of 28 Care Homes for Older People Page 7 of 28 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. Care Homes for Older People Page 8 of 28 The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 28 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home undertakes full and comprehensive assessment of prospective residents so that they are able to make an informed decision about the capacity of the home to meet health and social care needs. Evidence: We looked at a number of pre-admission assessments where the manager or her representative had visited the individuals. They provided good information about the health and social care needs of the individual. Where individuals are known to the local authority a copy of the social services assessment is obtained by the home. Care Homes for Older People Page 11 of 28 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care Planning and arrangements for meeting health care are adequate providing staff with the necessary information so that the health and social care needs of residents are met. However individuals and staff are potentially placed at risk because of lack of moving and handling assessments and also nutritional needs of individuals are not being assessed to make sure dietary needs are being met. Arrangements for managing residents medication fail to make sure that residents health needs are fully protected.Controlled drugs are not recorded or stored as legally required. Guidance is not available to staff where variable dose is prescribed so that individuals welfare is fully protected against misuse of medication and medication is given to individuals in appropriate circumstances. The practice of staff and policies of the home help to make sure that residents are treated with respect and their dignity is upheld. Evidence: We looked at a number of care plans(5). They showed good details about the physical health, needs and abilities, mental health, daily living. They also provided life history, Care Homes for Older People Page 12 of 28 Evidence: likes and dislikes, personal values. Good details about specific tasks. All reviewed regularly. Risk assessments complete specifically for falls. In two instances no moving and handling assessments completed or nutritional. In one instance where individual was of particular faith this was not reflected in care plan in relation to her spiritual needs. Not all had evidence of individuals involvement. Medication administering records were looked at for period of 3 weeks they had been completed as required with no gaps in administering. Creams and ointments not recorded on administering sheets. No photos of individuals as part of medication record. Allergies recorded. One individual had variable dose but on 10 occasion no record of dose given or guidance as to change of dose if needed. Record of medication administer showed that one individual is prescribed Tempazpam this is a controlled drug and was not being in a Controlled Drug cupboard or being recorded in a Controlled Drug Register when it was administer to the individual. No separate fridge for storage medication requiring refrigeration. Returns book with signature of pharmacist representative. Individuals who live in the home are able to selfadminister, one individual had risk assessment in place for managing their medication. Records showed that individuals have full access to range of community health services including chiropody, dental and community nurses. Individuals are able to retain their doctor if possible. The home has access and makes referrals to other services where these are required such as physiotherapy and community psychiatric nurses. We spoke to a community nurse who visits the home regularly she said that the home was in her view well run and always acts on advice given and that the home will contact the service when required and that residents always seem happy and content. We spoke to a number of individuals about the approach of staff specifically whether they felt they were treated with respect. Individuals told us that staff always respect my wishes, always respect what I do and say and that they listen to us. Staff were observed throughout our visit talking and supporting individuals with respect and in a sensitive and supportive manner. Care Homes for Older People Page 13 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The arrangements for meeting the social and recreational needs of residents are good and there are opportunities for residents to maintain links with family, friends and the local community. The homes practice and routines are flexible and enable residents to exercise choice and have control over their lives. The home provides meals, which are balanced and meet the dietary needs of individuals in the home. Evidence: We spoke with a number of individuals who live in the home about the activities provided they said how there was quite abit going on. Activities arranged include bingo, quizzes, sing-a-long. One individual said how much they enjoyed a trip out during the summer. Staff said they felt there could be more activities but at times it was difficult to get a group together. The home has also tried to organize events and activities with another local home in the community. We spoke to a relative who visits the home who said that they were able to visit at any time and when they visited was made to feel welcome they described staff as very Care Homes for Older People Page 14 of 28 Evidence: good, excellent care, staff very caring. Importantly they felt they were always kept informed about how their relative was and certainly when she was poorly they let me know. The inspector joined some individuals for lunch. They were all very positive about the meals provided in the home: always very good good choice enjoy the food here. The meal on the day was well presented and looked appetizing. Menus were looked at and showed a good variety of meals being provided in the home. Care Homes for Older People Page 15 of 28 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has procedures in place enabling individuals to make a complaint and voice their views about the service they receive and to know that they will be listened to and actions taken where necessary. The home makes sure that as far as possible residents are protected from harm by having a policy and procedure about the Protection of Vulnerable Adults however the knowledge and competence of staff would be improved by all staff undertaking Safeguarding training. Evidence: We spoke to a number of individuals who live in the home about what they would do if they had any worries or were unhappy about the service they were receiving. They spoke of speaking to a member of staff would talk to the manager. One individual said they had cause to make a complaint and spoke to the manager who had been very responsive and dealt with it to our satisfaction. The home has not received any complaints since the last inspection. A copy of the homes complaints procedure was displayed in the home and is given to all those who come to live in the home. The home has Safeguarding policies and procedures in place. We spoke to a group of staff about their understanding of abuse and they were able to give some good examples of what may constitute abuse in a care setting: rough handling, talking down to people, not giving choice. They all said they would immediately report any concerns Care Homes for Older People Page 16 of 28 Evidence: to the manager. Training records showed that not all staff had completed Safeguarding training. Care Homes for Older People Page 17 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a safe and hygienic environment for the residents and staff. People who live and work in the home benefit from a warm, welcoming and well-maintained environment. Evidence: In looking around the home it was evident that there was a good standard of maintenance and decoration. Rooms were all pleasantly decorated and furnished. A major improvement in the past year has been the landscaping of the rear garden with summer house making this an attractive areas for individuals to use during the summer months. Individuals we spoke with all said how clean and tidy the home was and one individual said hygienically the home is tip top. Staff have undertaken infection control training and there are procedures in place in the event an infection occurs in the home with staff being provided with protective clothing at all times if this is necessary. Care Homes for Older People Page 18 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staffing arrangements in the home are generally satisfactory so that the needs of residents can be met in an efficient way. Recruitment of staff needs to be more robust in undertaking the required checks so that the health and welfare of individuals who live in the home is as far as possible protected. Training of staff needs to improve so that all staff have the required level of knowledge and skills. Evidence: Recruitments records were looked at for 3 members of staff. They showed full details of previous employment, two references and Criminal Record Bureau checks had been obtained. There was no record of POVA first checks prior to employment for two individuals. There are Training logs for staff though for 2 staff there was no record of training available. Training log showed that 7 members of staff had not completed Moving and Handling training. There was no record of Safeguarding training for all staff. Three staff we spoke with said they had undertaken Moving and handling, health and hygiene, first aid, fire training. Distance learning is undertaken by staff this includes moving and handling. Staffing levels are set relating to needs of individuals who live in the home. There are Care Homes for Older People Page 19 of 28 Evidence: generally 3 staff on duty am and 3 pm with deputy or manager. There is a waking night with sleep-in being the deputy or manager. Over 50 of staff have completed NVQ 2/3 professional qualification. Care Homes for Older People Page 20 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Health and Safety practice in the home is generally satisfactory however there is potential for individuals who live and work in the home to be placed at risk because of required standard of fire safety and training particularly drills not being provided. Individuals who live in the home have an opportunity to comment on the quality of the service they receive. The manager fails to make sure that records are maintained as required so that there is evidence of staff recruitment and training meeting the required standard. Evidence: The manager has extensive experience of working in a care home. Whilst she has not completed managers training she has undertaken training around Safeguarding, Mental Capacity Act, NVQ 2 and other areas associated with care of older people. Individuals we spoke with were all very positive about her approach and described her Care Homes for Older People Page 21 of 28 Evidence: as someone we can talk too she will listen to what we have to say. It was noted that she has a very hands on approach and illustrated a real understanding of the needs of individuals living in the home. A quality assurance system is now in place with questionnaires being sent to individuals who live in the home. A Food Questionnaire was also distributed to individuals and there was positive comments about the quality of meals provided in the home. As a result of the quality questionnaire and comments made by individuals additional stair rails have been fitted. Health and Safety records evidenced maintenance of equipment in the home such as hoists, lift and electrical installation. Risk assessments have been completed for the environment. A Fire Risk Assessment was completed in June 2008 not all measures have been taken as required by the report. It was noted a number of rooms were wedged open despite fitting of door closures. Staff have received fire safety awareness training and drills held as part of this training, no evidence of further fire drills taking place. Weekly fire alarm tests. Inspection and servicing of fire system and emergency lighting. Food Hygiene Inspection October 2008 found all satisfactory. Recruitment records are not as required through lack of POVA 1st checks. Training records not available for all members of staff and no evidence of training undertaken. Care Homes for Older People Page 22 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 23 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action 1 28 19 The registered manager to 31/01/2009 make sure that all necessary checks are carried out before commencement of employment by any staff member. This refers to a POVA 1ST check being obtained if individual starts work before CRB has been obtained. This can be applied for at same time as CRB and can be provided before full CRB check is received. 2 38 23 The registered manager shall 31/01/2009 make adequate arrangements for the detecting, containing of fire. This refers to the need to look at ways whereby fire doors and doors to individual accommodation close in the event of a fire and do not remain open. Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 7 13 The manager to make sure there are suitable arrangements to provide a safe system for moving and handling individuals. 01/03/2009 Care Homes for Older People Page 24 of 28 This refers to the need to undertake moving and handling assessments for all individuals in the home. 2 7 15 The manager to make sure care plans are completed in consultation with the individual or their representative. This refers to evidencing the involvement of individuals in the completion of their care plan. 3 9 13 The manager to make sure there are arrangements for the recording, handling, safekeeping, safe administration of medicines received in the home. This refers to the use of controlled drugs in the home and the need to store in seperate secure storage and recorded in controlled drug register. 4 9 17 The registered manager to make sure there are records relating to the individuals in the home. This refers to the need to have photos of all individuals in the home which should be in care plans or on medication sheets for that individual. 5 9 13 The registered manager to make sure there are arrangements for the recording, safe 31/01/2009 01/03/2009 01/02/2009 01/03/2009 Care Homes for Older People Page 25 of 28 administration of medicines received in the home. This refers to the need to have written guidance as to the use of variable dosage of medication and the accurate recording of variable dosages. 6 30 18 The registered manager to 31/03/2009 make sure that persons employed to work at the care home receive training appropriate to the work they are to perform. This refers to all staff having moving and handling and Safeguarding training. 7 37 17 The registered manager to 31/01/2009 make sure records are available and kept up to date as specified in Schedule 4. This refers to having full recruitment records available (POVA 1st checks) and those relating to training of staff. 8 38 12 The registered manager shall make sure that the care home is conducted so as to promote and make proper provision for the health and welfare of individuals who live and work in the home. This refers to staff undertaking fire drills at a frequency recommended by the Fire and Rescue Service. 30/01/2009 Care Homes for Older People Page 26 of 28 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 27 of 28 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 28 of 28 - 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!