Inspection on 09/11/06 for York House Residential Care Home

This inspection was carried out on 9th November 2006.

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

York House Residential Care Home 17/02/06

York House Residential Care Home 21/11/05

York House Residential Care Home 24/03/05

York House Residential Care Home 10/01/05

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE York House Residential Care Home Waterside Billinghay Lincoln LN4 4BU Lead Inspector Moya Dennis Key Unannounced Inspection 9th November 2006 09:20 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 York House Residential Care Home DS0000061879.V318720.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. York House Residential Care Home DS0000061879.V318720.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service York House Residential Care Home Address Waterside Billinghay Lincoln LN4 4BU 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) 01526 860378 01526 860378 Mrs Linda Petruzziello Care Home 13 Category(ies) of Dementia - over 65 years of age (3), Mental registration, with number disorder, excluding learning disability or of places dementia (2), Old age, not falling within any other category (9) York House Residential Care Home DS0000061879.V318720.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 17th February 2006 Brief Description of the Service: York House is a detached property, situated in the Fenland village of Billinghay, ten miles north east of the town of Sleaford and sixteen miles from both Boston and Lincoln. The village community incorporates shops, a doctor’s surgery, a church and a library. The home is a family-run business; the proprietor lives on the premises and is actively involved in the day-to-day management of the home. Accommodation consists of nine single and two shared rooms, on the first and ground floor. None have en suite facilities. Access to the first floor is via a stair lift. There is a lounge, sun lounge and main dining room on the ground floor and further seating in the lobby. The home provides personal care for thirteen people over the age of 65. There was one vacancy on the day of inspection. The house stands in large, mature gardens with river frontage and is set well back from the main road. Access to the property is shared with another business but this does not present any difficulties to visitors. A small car parking area is available at the front of the property. The homes philosophy is to provide and maintain high standards of care for all residents, to ensure the environment is comfortable, friendly and therapeutic and to encourage the residents to develop their full potential within a safe, homely environment”. Fees are from£336 to £416 per week. Hairdressing, newspapers, toiletries and chiropody are not included in the fees. The home does not advertise; referrals come from local Social Service departments and by personal recommendations. York House Residential Care Home DS0000061879.V318720.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced visit to the home was undertaken by one inspector and took place over 4 hours in November 2006. It formed part of a key inspection and focussed on standards in the key areas that most affect the quality of life for residents. All key standards were inspected an additional standards were inspected to check issues raised at previous inspections. The site visit included a thematic enquiry. A number of standardised questions were asked of a sample of residents as part of a national pilot scheme. We informed the registered person and sought the agreement of residents in advance of asking the questions about the care they received. Information already held, such as the service history and incidents since the last report, was used to plan the visit. The inspection method used was to case track the care received by a sample of residents by looking at their records and discussing their experiences of care with them. Samples of residents’ and staff files were inspected and a number of staff and residents were spoken to. No visitors were present during the inspection. General care practices were observed throughout the visit. Residents’ survey replies were not available before inspection but responses to the home’s own quality assurance process were seen and used to form part of this report. The atmosphere in the home was relaxed and pleasant. Residents’ comments included, “It’s a happy home” and, “I feel part of a big family”. The acting manager was present throughout the inspection and was given general feedback at the end of the visit. What the service does well: York House is a domestic style property; homely, clean and well maintained. Residents’ rooms are comfortable and spacious. Residents and relatives are happy with the high standard of care provided. The staff team is stable; many have worked at the home for several years. The small nature of the home provides opportunities for residents to maintain as much independence as possible. One relative wrote to complement the staff; “ You make everyone you care for feel loved”. Residents maintain contact with the local community; enjoy coach trips and other outings. Activities are offered each day. York House Residential Care Home DS0000061879.V318720.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. York House Residential Care Home DS0000061879.V318720.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 York House Residential Care Home DS0000061879.V318720.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): 1,2,3,4,5,6. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefited from pre-admission assessment and support. They could be assured that the home could meet their needs. EVIDENCE: Residents’ files contained pre-admission details of leisure and religious needs. Evidence showed that assessments were carried out with residents, relatives and involved professionals, where appropriate. Files evidenced that residents and/or their families had received terms and conditions and contracts. York House Residential Care Home DS0000061879.V318720.R01.S.doc Version 5.2 Page 9 Residents said they had been given the opportunity to visit the home before moving there. All stays were on a trial basis. The home did not provide Intermediate Care. York House Residential Care Home DS0000061879.V318720.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10,11. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Care plans were clear and residents were protected by sound risk assessments. Residents could be assured that end of life arrangements would meet their needs. EVIDENCE: Four residents’ files were inspected. Care plans contained clear direction regarding needs such as pressure area care, dementia, pain management and sleep. Risk assessments related to needs such as moving and handling, falls and challenging behaviour. York House Residential Care Home DS0000061879.V318720.R01.S.doc Version 5.2 Page 11 All areas of personal care were recorded in detail, along with the way in which residents preferred to have those needs met and what actions staff needed to take to meet those needs. Each file contained care plans signed by the resident or their relatives and there was evidence of monthly reviews. Relatives were always informed when reviews happened and of any changes. Families were involved as much as they wanted to be. All files contained a social history, including former employment, significant event and family structure. A member of staff was employed to take residents out each day. More able residents were able to walk; others were taken in wheelchairs. Residents were further able to remain fit by taking part in musical exercise sessions. The home’s medication policy, records and storage were satisfactory. Medication profiles detailed what medication was take and possible side affects. All but one member of staff had received training on administration of medication No resident self medicated. Residents’ files included the name they wished to be known by. Staff confirmed that respect for residents was stressed during induction and was central to all their work. End of life wishes were discussed and recorded. The home has a detailed policy, procedure and practice guidance to help staff with terminal care. Letters were seen from families, confirming that they had been able to stay with residents during their end of life stage. “I will always remember the loving care and consideration at this very emotional time” … “You have restored my faith in human nature”. All staff received training and practical advice in palliative care and managing end of life arrangements in a respectful and supportive way. Staff had continuous support and opportunities to discuss their own anxieties, concerns and feelings. York House Residential Care Home DS0000061879.V318720.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents were supported to maintain as much choice and control in their lives as possible and had access to a good range of activities and entertainments. EVIDENCE: The home employed a worker to take residents into the village and surrounding areas. Care staff undertook other activities. There was evidence in records and conversation with residents that a wide range of activities and entertainment were provided, such as parties, outings, entertainers and groups who visited the home, needlecraft, cards, bingo, reminiscence sessions, arts and crafts, quizzes and baking. Some residents preferred more personal pastimes, such as crosswords, jigsaws, conversation or reading and this was recorded in their care plans. Activities were planned around residents’ various interests and different levels of ability and offered every morning and afternoon. Socialisation and activities York House Residential Care Home DS0000061879.V318720.R01.S.doc Version 5.2 Page 13 were seen as part of residents’ care, rather than a separate duty. Staff were employed in sufficient numbers to spend social time with residents, giving manicures, helping with crosswords or just talking. Residents said, ”The entertainments are very good”, “I don’t have many visitors but I’m never lonely. The best part of living here is the staff and the company”. Routines with in the home were flexible. Residents were able choose when to get up and go to bed, to have the food offered on the menu, or an alternative; whether to join in activities and to go out of the home, with the support of staff. Residents said they liked the food and meal times were seen as a social occasion. Sherry was available at lunch times for those who wished. The cook was very experienced and well aware of residents’ likes and dislikes, dietary and cultural needs. Residents were involved in menu planning and meals were varied, balanced and imaginative. York House Residential Care Home DS0000061879.V318720.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and relatives benefited from a clear complaints procedure and they were assured that any concerns would be listened to. EVIDENCE: Copies of the home’s complaints procedure were included in the Statement of Purpose and Service User Guide. Further details were displayed on the relatives’ notice board in the lobby. There had been no complaints since the last inspection. Records showed that all staff had received training in adult protection and staff demonstrated their awareness and understanding of issues relating to abuse. All had received training on ‘whistle blowing’ and said they would feel confident to raise any concerns with senior carers or the acting manager. Allegations of abuse would be followed up promptly and action taken recorded. The homes ’policy reflected Lincolnshire Adult Protection Committee (LAPC) guidelines. Relatives managed residents’ personal allowances; the home invoiced them for any extras required. Residents were able to vote in elections if they wished, either by postal vote or by visiting the polling station. York House Residential Care Home DS0000061879.V318720.R01.S.doc Version 5.2 Page 15 Residents and relatives demonstrated that they were very satisfied with the care and felt safe and well supported. Five letters of thanks had been received from relatives since the last inspection. York House Residential Care Home DS0000061879.V318720.R01.S.doc Version 5.2 Page 16 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): 19,24,25,26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents lived in comfortable surroundings and rooms that enabled them to retain as much independence as possible EVIDENCE: The home was well furnished with good quality domestic type furniture and fittings. The dining room was welcoming, set up restaurant style. It was clean but in need of redecoration. The acting manager said this was next on the maintenance programme. Residents were able to use the garden in fine weather and had the use of the sun lounge all year round. Guardrails had been York House Residential Care Home DS0000061879.V318720.R01.S.doc Version 5.2 Page 17 placed at the large window in the sun lounge to protect residents in case of falls. Residents were able to bring their own furniture and personal possessions to the home. Some had brought complete bedroom suites. There was an inventory of all personal possessions on residents’ files. The majority of rooms were carpeted but new flooring was laid in 2 rooms. This had the appearance of carpet but was non-slip vinyl, to accommodate the special needs of some residents. Screens were provided in the shared room to ensure that personal care was given in privacy. Bathrooms were warm, clean and met residents’ needs. No rooms had en-suite facilities. All parts of the home were clean, light, and warm and smelled pleasant. Standards of cleanliness throughout the home were very high. Residents confirmed that the home was always clean and tidy. Some commented that their rooms were very well maintained and the beds were made promptly. All beds were made by the start of inspection and the housekeeper was busy throughout the visit. The home had written policies on cross infection and infection control and staff had recent training on these issues. York House Residential Care Home DS0000061879.V318720.R01.S.doc Version 5.2 Page 18 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): 27,28,29,30. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents benefited from a well trained staff team, able to meet their needs. Polices for safe recruitment, training and supporting staff safeguarded the residents at all times. EVIDENCE: The acting manager was a National Vocational Qualification (NVQ) assessor; all but one member of staff had achieved NVQ awards. Staff said the acting manager had been very supportive with her NVQ assignments and other training she had undertaken. Three staff files were seen. All contained the information required by Schedule 2 of the Care Homes Regulations. Staff said they had access to good induction training that included fire safety, policies and procedures, adult protection, introductions to residents and confidentiality. New recruits shadowed more experienced staff for a week, until they felt confident and competent to work alone. All said that team spirit was very good, “We all pull together to cover York House Residential Care Home DS0000061879.V318720.R01.S.doc Version 5.2 Page 19 shifts if someone’s ill”. All staff thought there were sufficient numbers to meet the needs of residents at all times. They said they Residents confirmed they never have to wait, “ If I need something they come right away.” This was true of the night shift. One resident said she often had nightmares and rang for staff on waking. They stayed and talked to her until she felt better, … “no matter how long it takes”. Staff agreed there were plenty of training opportunities. One member of staff remarked that they had done more training since the acting manager had been in post than they had previously. Training records confirmed that all staff had regular training and updates in both mandatory and more specialist areas. Staff were knowledgeable about equality and diversity issues and were able to discuss which groups of people could be vulnerable to discrimination. York House Residential Care Home DS0000061879.V318720.R01.S.doc Version 5.2 Page 20 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): 31,33,35,36,37,38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefited from an open and supportive management approach and a well supported staff team. EVIDENCE: The acting manager had 22 years experience in care giving and was highly competent to manage the home. She had recently applied to the commission to be registered. She had extensive knowledge of age related conditions and how they could affect residents, equality and diversity issues, good York House Residential Care Home DS0000061879.V318720.R01.S.doc Version 5.2 Page 21 interpersonal and leadership skills. She had kept her learning up to date; was an NVQ assessor and was about to start a health and safety trainers’ course. Staff confirmed that she ensured policies and procedures were understood and followed by discussions during supervision, training, staff meetings and annual appraisals. Records were clear, concise and current. Residents’ and relatives’ views were sought by questionnaires and the responses used to monitor and improve the service. Staff said she was very supportive but professional. “She’s flexible, easy going but there is a line you don’t cross”. She encouraged staff to achieve awards and further training. ”She values us as people, as well as workers”. Staff said they were encouraged to make suggestions and their opinions were respected”. Staff, including the cook, said they had supervision six times a year with the acting manager. Rotas confirmed this. Supervision sessions were recorded and signed and dated by both parties. Staff meetings were held every 6 to 8 weeks. Agendas and minutes were posted on the notice board. Separate meetings were held for night staff, day staff and senior carers. Residents, relatives and staff were able to discuss any concerns with the acting manager at any time. Letters from relatives mentioned instances of her professionalism, insight and efficiency. A resident remarked, “You can never fault good people”. Fire safety and training records were satisfactory, as were water temperature and general maintenance records. York House Residential Care Home DS0000061879.V318720.R01.S.doc Version 5.2 Page 22 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 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 4 11 4 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X 4 3 3 STAFFING Standard No Score 27 3 28 4 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 4 X 3 3 4 3 York House Residential Care Home DS0000061879.V318720.R01.S.doc Version 5.2 Page 23 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. 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 York House Residential Care Home DS0000061879.V318720.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN 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 York House Residential Care Home DS0000061879.V318720.R01.S.doc Version 5.2 Page 25 - 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. 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