Inspection on 31/07/06 for York Lodge

This inspection was carried out on 31st July 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 found no outstanding requirements from the previous inspection report, but made 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

York Lodge 24/10/05

York Lodge 09/06/05

York Lodge 30/09/04

York Lodge 22/04/04

Similar services:

1 Marten Road

Daubeney House

Three Gables

Aldwick House

49 Glendale

The Springs Community

Crossways Community

Belle Vue Country House

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

CARE HOME ADULTS 18-65 York Lodge 1-5 York Road Worthing West Sussex BN11 3EN Lead Inspector Mr E McLeod Unannounced Inspection 31st July 2006 09:00 York Lodge DS0000014865.V299207.R01.S.doc Version 5.2 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 Lodge DS0000014865.V299207.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 Adults 18-65. 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 Lodge DS0000014865.V299207.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service York Lodge Address 1-5 York Road Worthing West Sussex BN11 3EN 01903 212187 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) Yorklodge1988@yahoo.co.uk Mrs Marie Anne Harrity Mr Austin Harrity Anthony McKernan Care Home 24 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (24), Mental Disorder, excluding of places learning disability or dementia - over 65 years of age (12) York Lodge DS0000014865.V299207.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The total number of persons accommodated should not exceed 24. 12 Service Users will be over the age of 65 years. Date of last inspection 24th October 2005 Brief Description of the Service: York Lodge is registered for the accommodation of up to 24 residents in the category of mental disorder, 12 of whom may be over the age of 65. The property is situated close to the seafront in central Worthing with access to local bus and train services. The registered provider is Mrs M. Harrity, and the registered manager is Mr Tony McKernan. York Lodge DS0000014865.V299207.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspector was on the premises for 4.5 hours on the day of inspection, and returned to provide feedback to registered manager Mr McKernan on the 2nd August 2006. The inspection was arranged to follow up requirements made at the previous inspection. The inspector spoke with five residents, two members of care staff, and the registered manager. Five sets of care plans and three sets of staff recruitment records were sampled. Policies and procedures were sampled, and a partial tour of the premises was made. The inspector would like to thank everyone who contributed to the inspection. What the service does well: There is a stable, experienced and trained staff team. Residents are encouraged to contribute to the running of the home, and become involved in projects and activities in the home. There is a good atmosphere, and residents find staff approachable and sympathetic. The service has a good record of addressing concerns identified at inspection. Arrangements, including staff training, are in place to ensure health and safety is promoted in the home. The service is well managed, with residents being encouraged to contribute to their environment. Residents can also contribute to a household tasks rota, for which rewards are earned. Residents are receiving the health care services which they need. A good system for ensuring the views of residents, relatives, and involved professionals is in place to seek views on how the service can be improved. York Lodge DS0000014865.V299207.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Care plans could be made more comprehensive by ensuring that all risks identified are addressed in the plan, and the individual support to be undertaken by the key worker is included. Residents who administer their own medication should have a lockable space in which to store their medicines. The provider should ensure that risk assessments on self-medication are updated at appropriate intervals. The provider needs to assess which items of furniture, including beds, are in need of replacement and take action accordingly. The provider must ensure that necessary replacement of carpets, flooring and beds, and re-decoration, are being carried out. Residents need to have a lockable space in their bedroom. Please contact the provider for advice of actions taken in response to this York Lodge DS0000014865.V299207.R01.S.doc Version 5.2 Page 7 inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. York Lodge DS0000014865.V299207.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection York Lodge DS0000014865.V299207.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 5 Arrangements are in place to ensure residents are assessed and the service can meet the individual’s needs. Information provided in the statement of purpose and terms and conditions of residence has been updated. The outcomes for residents in this section were seen as good. EVIDENCE: The current scale of charges is £303 to £750 per week. Records for the admission of a new resident were sampled, and these indicated that a proper admission procedure including assessments and pre-admission visits had taken place to ensure the service could meet the resident’s needs. Information in the Statement of Purpose, which advises residents and prospective residents on the service provided, has been updated. York Lodge DS0000014865.V299207.R01.S.doc Version 5.2 Page 10 The terms and conditions of residence have been updated to include information on the room to be occupied, the fee payable and who pays what part of the fee. York Lodge DS0000014865.V299207.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9 Residents are being assisted to develop skills and independence, and are being consulted on aspects of life in the home. Care plans could be made more comprehensive by ensuring that all risks identified are addressed in the plan, and the individual support to be undertaken by the key worker is included. The outcomes for residents were seen as good. EVIDENCE: Five sets of individual care plans were sampled by the inspector, which provided evidence that residents’ care plans are being reviewed with them, and that medication and mental health service reviews are also taking place. Copies of service user plans seen had been signed by the resident. York Lodge DS0000014865.V299207.R01.S.doc Version 5.2 Page 12 Risk assessments are also being carried out to ensure the service has a plan in place to minimise risks for residents and staff. Care plan information could be made more comprehensive by ensuring that risk assessments are updated and plans to address risks are recorded, and that individual support to be provided, including hygiene, personal care and social support, are routinely included in the care plan. Residents are involved in decision making in the home through the residents’ meetings. Residents contribute to projects in the home. The most recent project has been the improvement of the patio area, for which residents assisted in buying the materials and plants and contributing to the planning, painting, and planting. Care plans seen and discussion with residents indicated that residents are being supported to make decisions about their lives. Examples of individual work with residents to assist them to become more independent and to develop confidence and coping strategies were provided by staff and in the care records seen. One resident is self-catering with access to a separate kitchen as part of his preparation for independence. Residents can also contribute to a household tasks rota, for which rewards are earned. York Lodge DS0000014865.V299207.R01.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16, 17 Residents are being supported to make use of the local community, and to participate in life in the home. Residents’ choices are being respected. Residents enjoy the meals provided. The outcomes for residents were seen as good. EVIDENCE: Residents are taken on an annual holiday with all expenses, including outings, paid by York Lodge, this year having been a caravan holiday in Hastings which residents spoken to said they enjoyed. There is a weekly outing to tea rooms in the country for residents, and residents said they looked forward to this. Activities arranged by the home include bingo, arts and crafts, cooking, theme nights, country walks, and video York Lodge DS0000014865.V299207.R01.S.doc Version 5.2 Page 14 mornings. Activities accessed in the community include cinema, theatre, bowling, outings, and adult education. Menus seen indicate that a choice of lunches is provided. On the day of the inspection the main choice for lunch was mince, potatoes, and vegetables, and the main dessert was jam roly poly. Residents interviewed said the meals were very good. There is a sociable and friendly atmosphere in the home. Residents who spoke to the inspector talked of social clubs, voluntary work, and churches which they attended. Residents’ choices are respected, and records seen indicate that, for example, residents had the choice to go on the annual holiday or not, and to attend their care plan review or not. York Lodge DS0000014865.V299207.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 Residents are receiving the health care services which they need. Residents receive support in the ways they prefer. Residents who administer their own medication should have a lockable space in which to store their medicines. The provider should ensure that risk assessments on self-medication are updated at appropriate intervals. The outcomes for residents were seen as good. EVIDENCE: Records and care plans seen indicate that a wide range of health care and specialist health care services are being accessed by residents. Residents’ consent to medication is obtained on the service user plan form, which residents sign. Two residents administer their own medication, but do York Lodge DS0000014865.V299207.R01.S.doc Version 5.2 Page 16 not have a lockable space in which they can store their medicines. Mr McKernan said that residents who manage their own medication receive a risk assessment before this is agreed – it was unclear if these assessments are being updated at appropriate intervals. Discussion with residents indicated that personal care, such as assistance with bathing where needed, are done at times and in ways preferred by the resident. York Lodge DS0000014865.V299207.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 Residents are being protected by the home’s adult protection policy and procedure. Good arrangements for residents and others to make a complaint are in place. Outcomes for residents were seen as good. EVIDENCE: The manager/owner acts as appointee for handling the financial affairs of three residents. Savings are invested for service users in building society accounts in their own names. One set of financial records held for a resident were sampled. Cash held tallied with the balance on the record, and receipts are provided where payments have been made. It was recommended that deposits and withdrawals by the resident be signed for on all occasions. The adult protection procedures were updated in November 2005, and a copy of these were seen. The procedures now better reflect local guidelines in West Sussex for adult protection. The previous recommendation made in respect of these is now seen as met. There is a whistle blowing policy for staff in place. York Lodge DS0000014865.V299207.R01.S.doc Version 5.2 Page 18 A policy and procedure is in place to ensure residents and others are being enabled to make a complaint, and that a response to the complaint will be made within a given timescale (which will be no longer than 28 days). Mr McKernan advised that there have been no complaints recorded since the previous inspection. York Lodge DS0000014865.V299207.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 26, 27, 28, 30 Some improvements to the premises have been made, which are making the house look more homely. Photographs of residents having fun in the home which are framed and on the walls also make the dining room look more cheerful. The provider needs to assess which items of furniture, including beds, are in need of replacement and take action accordingly. The provider must ensure that necessary replacement of carpets, flooring and beds, and re-decoration, are being carried out. Residents would benefit from having a lockable space in their bedroom. The outcomes for residents were seen as good. EVIDENCE: A partial tour of the premises was made. All communal areas and nine bedrooms were visited. York Lodge DS0000014865.V299207.R01.S.doc Version 5.2 Page 20 All areas of the home visited were clean and hygienic. A handyman is employed to carry out repair work and redecorating. Improvements to the premises since the previous inspection include the upgrading of the residents’ facilities in the patio area, and the redecoration of a bedroom. Communal areas have many colourful photographs of residents framed and on the walls, which probably helps residents feel more at home and makes the premises look more bright and cheerful. Some of the photographs show residents in fancy dress on theme nights held in the home. It was noted that the dining room carpet and some bedroom carpets were not in good condition. A lot of the furnishings in the home were in good condition, but some individual items of furniture were not. The main bathroom is in need of redecoration. Mr McKernan said it was planned for the sitting room carpets to be replaced and the bathroom redecorated in the autumn. One bed seen was noted to have a very sagging mattress. Mr McKernan said beds and mattresses were replaced when staff brought this to his attention. Not all residents have a lockable space in their bedroom. York Lodge DS0000014865.V299207.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35, 36 The experience and stability of the staff team contributes to the quality of care provided. Residents are benefiting for a well supported and supervised staff team. The outcomes for residents were seen as good. EVIDENCE: There are 11 care staff, and 2 ancillary staff. York Lodge has one first level registered nurse, and 5 care staff who have achieved NVQ2 or above in care. 2 staff have recently completed NVQ3. 2 staff hold a current first aid certificate. All staff are trained in the safe administration of medicines. Training provided this year has included The Care and Administration of Medicines, Understanding Psychosis, The Administration of Medicines, and the protection of vulnerable adults. Further training is planned in Food Hygiene, Core Values, Communication Skills, Health and Safety, and Fire Training. Staff interviewed said the training provided was helpful, and increased their confidence in the work they do. York Lodge DS0000014865.V299207.R01.S.doc Version 5.2 Page 22 Staff records seen indicate that recorded staff supervision and annual appraisals are taking place. Staff meetings are also taking place once per two months, and staff say they feel listened to, and have the opportunity to discuss issues that arise. Staff interviewed said they felt they worked in a good home. Interactions between residents and staff observed by the inspector indicated there is a good atmosphere in the home, and that residents find staff approachable. The inspector noted that during their breaks the staff sit down with residents. One member of staff has left, and their hours are now covered by other members of the team. The experience and stability of the staff team contributes to the quality of care provided. Staff recruitment records were sampled, and it was noted that arrangements are in place to ensure that staff employed receive proper references and checks. York Lodge DS0000014865.V299207.R01.S.doc Version 5.2 Page 23 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42 Arrangements, including staff training, are in place to ensure health and safety is promoted in the home. The service is well managed, with residents being encouraged to contribute to their environment. A good system for ensuring the views of residents, relatives, and involved professionals is in place to seek views on how the service can be improved. EVIDENCE: Mr McKernan has been undertaking the Registered Manager Award in Management at NVQ level 4. Mr McKernan continues to develop a service which encourages residents to take a part in things (such as the upgrading of the patio garden area) and encourages them to be sociable and feel good about themselves. York Lodge DS0000014865.V299207.R01.S.doc Version 5.2 Page 24 An environmental health department visit was carried out on 29.3.06, and Mr Mckernan advised that requirements made have been complied with. The provider has advised CSCI of the most recent equipment and fire, health and safety checks and drills carried out in the home. Records of environmental risk assessments carried out by the home in May 2006 were sampled. Mr McKernan advised that fire alarms tests and drills are being carried out. The accident book was seen, and it was noted that no accidents have been recorded since the previous inspection. Staff training records indicated that staff are receiving training in health and safety topics. The views of residents on the performance of the service were gathered in October 2005, and residents have been encouraged to contribute their ideas to the running of the home and the planning of events and changes. The views of relatives and involved professionals were also gathered. The outcomes of this quality review have been published, and an action plan for improvements identified is in place. York Lodge DS0000014865.V299207.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 3 2 3 3 X 4 X 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 2 27 2 28 2 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 3 3 X X 3 x York Lodge DS0000014865.V299207.R01.S.doc Version 5.2 Page 26 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 YA6 Regulation 15 Requirement Care plans should be made more comprehensive by ensuring that all risks identified are addressed in the plan, and the individual support to be undertaken by the key worker is included. The provider needs to assess which items of furniture, including beds, are in need of replacement and take action accordingly. The provider must ensure that necessary replacement of carpets, flooring and beds, and re-decoration, are being carried out. Residents should be provided with a lockable space in their bedroom. Residents who administer their own medication should have a lockable space in which to store their medicines. The provider should ensure that risk assessments on selfmedication are updated at appropriate intervals. DS0000014865.V299207.R01.S.doc Timescale for action 27/10/06 2. YA24 23.2 27/10/06 3. YA24 23.2 27/10/06 4. 5. YA26 YA20 23.2 23.2 27/10/06 15/09/06 6. YA20 13.2 27/10/06 York Lodge Version 5.2 Page 27 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 Lodge DS0000014865.V299207.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Worthing LO 2nd Floor, Ridgeworth House Liverpool Gardens Worthing West Sussex BN11 1RY 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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