Care Home: Bury Metro - Killelea

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What the care home does well The home specialises in providing an Intermediate Care service and is doing so in a way that seeks to maximise the potential of the individual people who uses the service. Comments made by some of the people who use the intermediate care service included `they have given me much more confidence to walk and this will really help me when I go home`, `I am starting to do things I thought I would never do again with the help of all the staff here`. They also meet the care and support needs of other people who use the service for respite or long term care. Care and support for all people who use the service is provided by staff who are well trained and able to meet peoples needs. The home is well managed and organised. What has improved since the last inspection? The way care records and medicines are managed has improved and the requirements made at the last inspection have been addressed. What the care home could do better: We are of the view that because of the fluctuating dependency levels of people who use this service staffing provision for the evening and night shifts should be reviewed. This is because staffing numbers are based on dependency levels and needs of people who use the service (and the layout of the building) and not their absolute numbers. However at the time of inspection people who were using the service were being well cared for and supported by the manager and her staff. CARE HOMES FOR OLDER PEOPLE Bury Metro - Killelea Killelea Residential Care Home Brandlesholme Road Bury Lancs BL8 1JJ Lead Inspector Mike Murphy Unannounced Inspection 9th January 2008 09:00 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 Bury Metro - Killelea DS0000008465.V337472.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. Bury Metro - Killelea DS0000008465.V337472.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Bury Metro - Killelea Address Killelea Residential Care Home Brandlesholme Road Bury Lancs BL8 1JJ 0161 253 6550 0161 764 3075 m.j.glynn@bury.gov.uk 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) Bury M.B.C. Mrs Marie Josephine Glynn Care Home 36 Category(ies) of Old age, not falling within any other category registration, with number (35), Physical disability (1) of places Bury Metro - Killelea DS0000008465.V337472.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 36 service users, to include: up to 35 service users in the category of OP (Older People) up to 1 named service user in the category of PD (Physical Disabilities under 65 years of age) may be accommodated within the overall number of registered places. The service should employ a suitably qualified and experienced Manager who is registered with the Commission for Social Care Inspection. The service must at all times employ suitably qualified and experienced staff to meet the assessed needs of service users. Within the maximum of 36 places registered, there is provision for up to 18 places for intermediate care. 7th September 2006 2. 3. 4. Date of last inspection Brief Description of the Service: Killelea House is situated one mile from the centre of Bury and is on a main bus route. The home has undergone major refurbishment to create a purpose built facility. There is plenty of parking to the front of the home for the use of staff and visitors. The front door of the home allows a level access for wheelchair users and people who have problems climbing steps. The first floor is reached either by stairs or a passenger lift. Accommodation throughout the home is provided in single bedrooms that have an en-suite facility of toilet and shower. The toilets and bathrooms have aids to assist any resident with a disability or mobility problem. There is a therapy room on the ground floor plus a hairdressing salon, medical and chiropodist room. Details of the services at Killelea are described in a Statement of Purpose which is available on request. Killelea House provides a range of services to older people in the Bury area. These include Intermediate Care, the aim of which is to promote recovery, independence and daily living skills for people who may then be able to return to live at home following an illness or accident. The remaining places provide Short Stay Care, Interim Care, and a limited number of permanent residential care places. Bury Metro - Killelea DS0000008465.V337472.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This key inspection which included a site visit that the home did not know was going to happen took place over a period of seven hours. The inspection included discussion with some people who use the service, relatives, and consideration of responses in the pre-inspection comment survey sent to people who use the service and their relatives, a tour of the premises, inspection of care and other records maintained by the service and discussion with the registered manager and staff. Before the inspection, we also asked the manager of the home to complete a form called an Annual Quality Assurance Assessment (AQAA) to tell us what they felt they did well, and what they needed to do better. This helps us to determine if the management of the home see the service they provide the same way that we see the service. We felt this form was completed adequately and that a lot of time and effort had been given to filling it in great detail. What the service does well: What has improved since the last inspection? The way care records and medicines are managed has improved and the requirements made at the last inspection have been addressed. Bury Metro - Killelea DS0000008465.V337472.R01.S.doc Version 5.2 Page 6 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. Bury Metro - Killelea DS0000008465.V337472.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 Bury Metro - Killelea DS0000008465.V337472.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): 3 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Potential users of this service are appropriately assessed prior to admission and are provided with a rehabilitation programme or period of respite care. EVIDENCE: The assessment documents of 2 people using the Intermediate Care program were inspected. Both these detailed assessments had been undertaken by the hospital social workers. They were kept within the residents’ care records and provided a clear indication of the residents’ needs and capabilities. On the day of inspection the home was providing intermediate care for 12 people. There is a specialist team of workers available for this service including medical staff support, physiotherapists and occupational therapists. The district nursing service provides nursing support. Specialised equipment, facilities and dedicated space was available within the home for the provision of rehabilitation services and the promotion of daily living activities. Bury Metro - Killelea DS0000008465.V337472.R01.S.doc Version 5.2 Page 9 Comments made by some of the people who use the intermediate care service included ‘they have given me much more confidence to walk and this will really help me when I go home’, ‘I am starting to do things I thought I would never do again with the help of all the staff here’. Bury Metro - Killelea DS0000008465.V337472.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 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The assessed health and personal care needs of people who use the service are fully met., ensuring they are well cared for. EVIDENCE: Killelea provides (on the 1st floor of the home) Intermediate Care that has been commissioned by the local Primary Care Trust and Social Services Department. These arrangements can be used to facilitate earlier discharge from hospital following an acute episode of illness; alternatively, it can provide care to prevent admission to hospital for people who have a short term episode of ill health, which does not require specialist medical intervention. All admissions have a time-limited stay, the maximum being around six weeks. The home also (on the ground floor of the home) provides Short Stay Care, Interim Care, and a there are a limited number of permanent residential care places. Bury Metro - Killelea DS0000008465.V337472.R01.S.doc Version 5.2 Page 11 The care records of 2 people who receive intermediate care, 2 people-receiving short stay care and 1 person who were receiving long-term care were inspected. Care records were organised in a standard format throughout the home. All contained detailed pre and post admission assessments that clearly identified the care needs of people who use the services provided. Care plans clearly identified how needs were to be met by identifying exactly what actions and support needs to be provided to support them appropriately. Care plans were formally reviewed on a regular basis. Care plans were person centred and recognised the diverse needs of the people using the service. Particular areas of risk are formally ‘risk assessed’ regularly to protect people’s health and safety. Examples of such risk assessments included those completed in relation to mobility, moving and handling and nutrition (including regular weight monitoring). Medical care is provided by a designated responsible medical officer who visits the home frequently for those receiving intermediate care and it was evident that all users of the service were enabled to access GP’s, chiropodists, district nurses and other specialist services that individual people required. Relatives spoken to indicated they were kept informed of progress and were actively involved in the planning of their relatives discharge – preparation for discharge begins as early as possible in the rehabilitation process to ensure that people return home at the appropriate time with an appropriate support package in place. The procedures for the receipt, recording, storage, handling, administration and disposal of medicines were appropriate and safe. Service users who are able to take responsibility for their own medicines are appropriately assessed and provided with a secure space in their rooms to keep their medication safely. Medicine records had been completed properly. Discussion with people using the service revealed that they are treated with respect and that their right to privacy is upheld. Comments made included; ‘ all the staff are pleasant, encourage me to do things for myself as much as possible but support me to do so’, ‘they are getting me back walking since I came in here and have been very kind to me and my family’, ‘ I am kept fully informed and my opinions are regarded as important in all areas of my care’, ’the staff speak to you decently and treat me kindly’. During the inspection staff treated service users with respect, kindly, protected their dignity and assisted them properly. Bury Metro - Killelea DS0000008465.V337472.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): 11,12,13,14 and 15 Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. People using the service are actively encouraged to pursue their interests and maintain their family and social contacts during their stay at the home. EVIDENCE: The person who is employed at the home to organise social and leisure activities actively engages with all people who use the services of Killelea. A wide range of individual and group activities is provided both within and outside the home. People spoken to said there was a good variety and they could always find something they could join in. A project is also underway to raise funds to make a suitable garden to the rear of the home for the benefit of people who use the service. People are encouraged to maintain contact with their family and friends as well as accessing facilities in the local community if able to. They are also able to receive visitors and meet with them in private. There are no unreasonable restrictions on visiting. People using the service expressed satisfaction with care provided and organisation of life at the home. Observation of care practice and information Bury Metro - Killelea DS0000008465.V337472.R01.S.doc Version 5.2 Page 13 in care plans indicated residents are encouraged to make choices. For example what time they like to get up/go to bed. While some residents chose to sit in the lounge a number were observed to spend their time in their own rooms. Menus revealed that people are provided with a varied and balanced diet. Meals are taken in the main dining rooms. The general view was that the food was good and provided reasonable choice. Lunch was observed on the day of inspection. This was a hot and substantial meal and people were served and assisted appropriately. Bury Metro - Killelea DS0000008465.V337472.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 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People spoken to felt comfortable enough to and knew how to make a complaint if they felt it necessary. Written guidance and training arrangements ensure that staff members have a good knowledge of abuse. Protection arrangements and safeguards are in place to protect the welfare of people who use the service. EVIDENCE: The complaints procedure was prominently displayed in the home and included details of how to contact the CSCI. People spoken to (and in responses in preinspection questionnaires) say concerns or worries brought to the manager’s attention are responded to quickly and in the main don’t become formal complaints. A record of complaints made is kept at the home which reflects that complaints are taken seriously, investigated appropriately and that the outcome of the investigation is communicated to the complainant. Policies and practices aimed at protecting residents from abuse are in place. Also Bury’s inter agency safeguarding procedure is held on site. Staff spoken to confirmed that they had received adult protection training (this was also reflected in training records maintained by the home) and were aware of the whistleblowing policy operated by the home. Bury Metro - Killelea DS0000008465.V337472.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,22,24 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides a comfortable and appropriate environment to accommodate, care for and support people who use the service. EVIDENCE: A tour of the premises revealed that the home was very clean and free of malodour. Discussion with people who use the service, visiting relatives and responses to pre-inspection survey questions revealed that the home is regularly cleaned to a high standard. Killilea was in a good state of repair and adequately decorated throughout. Communal lounge and dining areas were clean, suitably heated, comfortably and appropriately furnished and provided a suitable environment for people who use the service to be cared for and supported properly. Appropriate provision of televisions, music centres and other leisure equipment has been made. Bury Metro - Killelea DS0000008465.V337472.R01.S.doc Version 5.2 Page 16 People are also able – when the weather is suitable - to access the pleasant garden/patio area and the grounds of the home. Appropriately adapted bathing/shower areas are provided. The home has been suitably adapted to meet the needs of people in relation to specialist equipment. Individual specialist needs are met following referral of the individual to the relevant health care professional for assessment. Bedrooms that were inspected were very clean, suitably furnished and equipped. All bedrooms are provided with en-suite WC, shower and washbasin. The home was very clean and free of malodour. Suitable arrangements and equipment were in place to manage the laundry requirements of people at the home. And appropriate measures were being taken to minimise the potential spread of infection within the home. Bury Metro - Killelea DS0000008465.V337472.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People’s needs were being met although the staffing levels at certain times of the day need to be reviewed. Also people were being cared for by staff who were suitably experienced and trained. EVIDENCE: Inspection of staff rosters and discussion with the manager indicated that the number of carers on duty in the evening vary according to the day of the week – namely 5 are on duty Monday to Wednesday but this changes to 4 for the evening shift for the rest of the week. It is also noted that 2 care staff are on duty overnight. In view of the fluctuating dependency levels of people who use this service staffing provision for the evening and night shifts should be reviewed as staffing numbers are based on dependency levels and needs of people who use the service (and the layout of the building) and not their absolute numbers. However at the time of inspection people who were using the service were being well cared for and supported by the manager and her staff. There is a commitment to NVQ training, moving and handling, fire safety, first aid, protection of vulnerable adults and other training provision for all staff at the home. The registered manager works in conjunction with Bury adult training partnership to ensure that the induction and ongoing training provided Bury Metro - Killelea DS0000008465.V337472.R01.S.doc Version 5.2 Page 18 by the home meets the common foundation standards and other requirements of ‘Skills for Care’ (part of the Sector Skills Council). Staff spoken to stated they were enabled and supported to access appropriate training on a regular basis. In September 2007, the CSCI carried out an inspection of Bury Adult Care Files at the Human Resources section at Castle Buildings. We looked at a random sample of the recruitment files for eight recently appointed employees working in registered care homes. Files examined were found to be organised, contained proof of identity, an application form that included a full employment history and an explanation for any gaps in employment, a criminal record check and two written references. There was also a signed declaration in respect of the Rehabilitation of Offenders Act’ a health declaration form, copies of agreed terms and conditions, a job description, person specification and documentary proof of qualifications. We also checked all the CRB checks carried out for employees working in registered services that had been appointed in the last six months. No concerns were raised and all the required action from the last inspection had been addressed. Bury Metro - Killelea DS0000008465.V337472.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home was being appropriately managed in a way that enables people who use the service, their relatives and staff to feel that they are being supported properly. EVIDENCE: The registered manager is highly experienced and has obtained the Registered Managers Award and also holds a social work qualification. Discussion with people who use the service, their relatives and staff indicate that the manager operates a management style that is open and accessible. The home was well organised with a clear management structure. Senior carers and a team of care staff support the manager. A quality assurance system to measure service users and their relative’s satisfaction, with the level Bury Metro - Killelea DS0000008465.V337472.R01.S.doc Version 5.2 Page 20 of care and accommodation provided is in place. This is essential as such information will enable a quality improvement plan to be fully developed and implemented to further improve the quality of life for service users. The manager informed the inspector that it is intended to further develop the quality assurance system to incorporate the views of visiting doctors, nurses, social workers and others who regularly come to the home. Measures were in place to ensure that residents’ financial interests are safeguarded. Residents are encouraged to control their own money. However where they are unable (or choose not to) personal allowances are managed by the home. The arrangements for this were secure and appropriately documented. The health, safety and welfare of residents and others is promoted and protected. For example staff are provided with regular training and appropriate equipment to ensure resident’s moving and handling needs are met. An example of this would be for a resident who needs to be safely moved with the aid of a hoist. Fire safety training is regularly provided. Information provided by the home indicates that electrical/gas/other equipment safety inspections/servicing has been carried out. Bury Metro - Killelea DS0000008465.V337472.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 X 3 X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Bury Metro - Killelea DS0000008465.V337472.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No 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 OP27 Regulation 18(1)(a) Timescale for action Staffing provision for the evening 29/02/08 and night shifts should be reviewed as staffing numbers are based on dependency levels and needs of people who use the service (and the layout of the building) and not their absolute numbers. The outcome of that review is to be communicated in writing to the CSCI Requirement 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 Bury Metro - Killelea DS0000008465.V337472.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Manchester Local office 11th Floor West Point 501 Chester Road Manchester M16 9HU 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 Bury Metro - Killelea DS0000008465.V337472.R01.S.doc Version 5.2 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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