Care Home: Emily Court

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What the care home does well The home is well managed and run in the best interests of the people who live there. The people who live at the home said they are very happy. They enjoy their meals and the activities and said the staff do what people want in the way people prefer. One person said `The staff are very friendly and helpful going out of their way to provide a service. Often in their own time`. Another person said `I am very happy with the support I get...`. One member of staff told us that the home cares well for people `Providing personal care but at the same time keeping their dignity and helping them to have their independence as far as they are able`. The pre-admission assessments are thorough and make sure the home can meet people`s needs. The staff understand the needs and preferences of all the people who live at the home. People`s health is looked after and the staff have the skills and experience they need to do this. Everyone said that staff listen to them, and act on what they say. Visitors said they are always welcomed. The medicines administration procedures are safe and accurate. There is good and friendly interaction between the people who live at the home and the staff. There seemed to be enough staff on duty to make sure they have time to spend with people in conversation as well as supporting people to take part in individual and group activities. All the staff said they enjoy working at Emily Court and felt they were well supported by their manager. They all said the training is good and helps them to do their job well. People said the meals are good and there is a choice of dishes. People are offered drinks throughout the day. The cook is aware of people`s dietary needs and preferences. The kitchen and the rest of the house is clean, safe and well maintained. The complaints and adult protection systems work well and people said they know and understand what to do if they have a concern. What has improved since the last inspection? A new care planning system has been introduced since our last visit and the manager is gradually getting all the support staff involved in developing the plans and writing the daily records. There are now sufficient staff on duty to meet the needs of everyone who lives at Emily Court.Improvements have been made to the decor and the building, including completing the conservatory, and further changes are planned. What the care home could do better: The care and support plans need to include better developed risk assessments and management plans where someone may, for example, be at risk of falling or any other area the staff feel may put the individual at any risk. An improved range of activities and outings would be beneficial and make people`s daily lives more interesting and fulfilling. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Emily Court Oakwell Close Bradford West Yorkshire BD7 3PU     The quality rating for this care home is:   two star good 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: Liz Cuddington     Date: 3 0 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 27 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 27 Information about the care home Name of care home: Address: Emily Court Oakwell Close Bradford West Yorkshire BD7 3PU 01274521733 01274522607 ruth.smith@yorkshirehousing.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Ruth Smith Type of registration: Number of places registered: Brunel and Family Housing care home 38 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category physical disability Additional conditions: Date of last inspection Brief description of the care home Emily Court is registered as a home for older people. It is situated off the main road leading into Bradford City centre and is well served by public transport. There are shops, banks and other amenities close by. The home has a car park to the front and other parking is available close by. The home provides accommodation for 38 older people aged over 65. There is provision for people who have a diagnosis of dementia or have a physical disability. Accommodation is provided over two floors with disabled access into the home and a shaft lift to access the first floor. All the bedrooms have en-suite facilities and there are specialised bathrooms around the home. People are encouraged to bring small items of their own furniture and other personal belongings, Care Homes for Older People Page 4 of 27 Over 65 12 38 11 0 0 0 Brief description of the care home when they move into the home. The home has a large open plan lounge and dining area on the ground floor and there is an additional lounge on the first floor. Care Homes for Older People Page 5 of 27 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: two star good 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: The quality rating for this service is two stars. This means the people who use this service experience good quality outcomes. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations, but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. The purpose of this inspection was to assess the quality of the care and support received by the people who live at Emily Court. The visit to the home was carried out Care Homes for Older People Page 6 of 27 over one day by one inspector. The last key inspection was in January 2007 and an Annual Service Review was completed in May 2008. The methods used to gather information included conversations with the people living at the home, their relatives and the staff, as well as looking at care plans and examining other records. We received the homes self-assessment questionnaire before the inspection visit. We also received surveys from people who live at the home, their relatives and the staff. These gave us a lot of useful information about the home and helped us plan the visit. We would like to thank the people who live at the home, their relatives and the staff, for their welcome and hospitality and for taking the time to talk and share their views during the visit. What the care home does well: What has improved since the last inspection? A new care planning system has been introduced since our last visit and the manager is gradually getting all the support staff involved in developing the plans and writing the daily records. There are now sufficient staff on duty to meet the needs of everyone who lives at Emily Court. Care Homes for Older People Page 8 of 27 Improvements have been made to the decor and the building, including completing the conservatory, and further changes are planned. 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. 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 27 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 27 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. People are assessed before they are admitted to the home, to make sure their needs can be met. Evidence: People said that they were given enough information about the home before deciding to move in, and they had also received a contract. Where possible the home encourages people and their families to visit the home and talk to the people who already live at the home, their relatives and the staff. The home invites them to come and spend time at the home, including an overnight stay if they wish, share a meal and maybe take part in the days activities. This means that the home can get to know the persons needs and the individual has the information he or she needs to make a decision. Care Homes for Older People Page 11 of 27 Evidence: Before moving into Emily Court, peoples needs are assessed to make sure that the home is able to meet their needs. This assessment, as well as Social Services needs assessments when available, forms the basis for the individual plan of care and support. Care Homes for Older People Page 12 of 27 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples personal and healthcare needs are met. People are protected by the medication administration systems. Staff treat people with respect, care and consideration at all times. Evidence: From observation and discussions with staff and people living at the home, it was clear that the staff are aware of each persons needs and preferences. The staff make sure they provide the help people need in the way they prefer. A new care planning system has been introduced since our last visit. The manager is gradually getting all the support staff involved in developing the plans and writing the daily records. The managers aim for the coming year is to get all the staff fully involved in this and to make sure they understand the value of good person centred planning. Care Homes for Older People Page 13 of 27 Evidence: Three care and support plans were looked at, to make sure that peoples health and personal care needs are being met in the way the person prefers. The plans cover each area of the individuals care needs. They all contain enough information to guide staff in how to care for and support each person. The plans need to include better developed risk assessments and management plans where someone is at risk of falling, developing a pressure sore, becoming malnourished or any other area the staff feel may put the individual at any risk. Health care visits and treatments are recorded in detail and everyone who commented said they always receive the healthcare they need. One person said he or she is Happy with all the care I receive. The care plans are reviewed regularly and showed that, where possible, the individuals and their families are involved in developing and reviewing their plans. The daily records are kept up to date and include brief information on significant occurrences. One staff member said that there are Very good handovers given to staff in any changes to care plans and service users needs. One member of staff confirmed other peoples comments that the home will Always keep families up to date with any doctors visits and treatment, any falls....and action taken to minimise risk re-occurring. The medicines are kept safe and secure and the Medicines Administration Record (MAR) charts are securely stored. Most of the medicines are supplied by the pharmacy in a monitored dosage system, but some remain in the original packaging. The MAR charts, which must show clearly the quantities of medicines received and in stock for each person, were examined. The medicines supplied in the monitored dosage system appeared to be recorded accurately. The medicine trolley was locked when it was unattended and the member of staff who was administering the medication signed the MAR chart after offering each dose. Each persons tablets were offered with a glass of water and people were given all the time and assistance they needed to take their medicine. We checked some of the medicines that are supplied in their original packaging, to make sure the quantities that have been signed as administered tallied with the amounts received and the numbers remaining. All the medicines we checked were accurate and staff had signed the MAR charts on every occasion. Care Homes for Older People Page 14 of 27 Evidence: During the visit, all the staff were seen to treat people with respect and maintain their dignity. The people who commented said that they receive the care they need and are supported to maintain their independence for as long as they are able. Peoples relatives confirmed this. Everyone said the staff listen and act on what they say. Care Homes for Older People Page 15 of 27 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. People are supported to take part in a range of activities. People are offered a good choice of meals to make sure their dietary needs and preferences are met. Evidence: The organisation has a number of activities co-ordinators who work across all of the services. They work with the staff to provide a range of activities for people to take part in, if they wish. Notes are kept of the activities people have taken part in and enjoyed. Peoples care plans include life histories, which help staff get to know people better and plan activities that they will enjoy. One person said I have enjoyed some nice trips to Ilkley and to Blackpool illuminations. Some people said there are sufficient activities and others said there are not enough. This is an area that the manager and staff could develop further, in order to improve the daily life of the people who live at Emily Court. Care Homes for Older People Page 16 of 27 Evidence: People said they like the meals. The home offers a choice of two main courses and two desserts at lunchtime, as well as a choice at other mealtimes. The cook is very knowledgeable about peoples particular likes and dislikes and makes every effort to give people the foods they will enjoy. People who eat a soft diet are offered their meals in an appetising way and staff were seen to assist people who needed help in a calm and discreet manner, following the persons own pace. The cook plans the menus, to include the wishes of the people who live at the home and to meet any special dietary needs. There are always alternatives available if people do not want the choices on the menu. A record is kept of the foods that are served each day, as this can vary from the planned menu. People are offered hot and cold drinks throughout the day. Care Homes for Older People Page 17 of 27 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. People are aware of how to raise a concern or make a complaint if they are dissatisfied with the service. Staff have received suitable training and understand the adult protection policies and procedures, which makes sure that people at the home are safe. Evidence: Any complaints or concerns are recorded in a complaints file. The actions taken and the outcomes are recorded. Staff said they know what to do if anyone has concerns. The relatives said the home responds appropriately to any concerns. People said they know what to do if they have a concern or complaint. Newly employed staff are made aware of the homes whistle blowing policies and procedures, to be used if they suspect abuse or see examples of poor practice. Most of the care staff have had adult protection training, and further refresher training is planned. All the appropriate policies and procedures are in place to guide staff. Care Homes for Older People Page 18 of 27 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, comfortable, attractive and generally well-maintained environment. Evidence: The home is clean and generally well maintained and everyone we spoke to said the home is always kept fresh and clean. The rooms are comfortably furnished and have a welcoming feel. There are sufficient, accessible toilets and bathrooms on both floors of the house. Staff are employed to help look after the maintenance of the house and grounds as well as keeping the gardens tidy. The conservatory has been completed and some people like to sit there to socialise and watch television. There is also a small dining area in this room. The gardens are attractive and there is seating for people to use in the better weather. New fencing is going to be erected around the perimeter of the grounds, to make them safer for people. The nurse call system is also to be updated in the near future. The bedrooms are gradually having their en suites updated and new dining room Care Homes for Older People Page 19 of 27 Evidence: furniture has been ordered, as part of the homes ongoing refurbishment programme. Protective gloves and aprons are available for staff to use when necessary. The home uses red bags for soiled linen, as part of their infection control measures. Care Homes for Older People Page 20 of 27 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Sufficient staff are employed to meet peoples needs. People are protected by thorough recruitment procedures, which ensure that staff are suitable to work with people who live at the home. Suitable training is provided to make sure staff have the skills and knowledge they require to be able to meet peoples needs. Evidence: The staff rotas, and peoples comments, confirmed our observations that there are enough staff on duty to meet peoples care, social and leisure needs. There are six care staff on duty during the day and six during the evening. There are two waking staff on duty during the night, although this is soon to increase to three. The staff confirmed that staffing levels are adjusted to meet peoples needs. People said there are always or usually plenty of staff around and our observations confirmed this. All new staff complete an application form and provide two written references. Criminal Records Bureau (CRB) and Protection of Vulnerable Adults (POVA) register checks are obtained and no new staff begin work until these checks have been completed satisfactorily. The members of staff we spoke to confirmed that the procedures are Care Homes for Older People Page 21 of 27 Evidence: thorough and one staff member confirmed that CRB checks are renewed every year.. There is plenty of training available for staff. All the staff said the training is good and keeps them up to date. The home keeps good records of staff training, which also shows when updates are needed. All new support staff complete induction training which meets the Skills for Care criteria. This gives them good basic training to help them do their job effectively, and provides a sound basis for taking a National Vocational Qualification (NVQ) course. In addition staff attend training courses covering all areas of the general principles of care. All the staff said they felt the induction training was good. One member of staff said I had a very in depth induction which helped me a lot in my job. The support staff have regular training updates and one of the staff co-ordinates the moving and handling training. The manager plans to go through all the mandatory training taken by new staff, to make sure it is fully relevant and to see if it can be improved. Equality and diversity training had been planned for the staff in January 2009 and team leaders are taking the more in depth dementia care training offered by Bradford University. All of the support staff have achieved an NVQ in care. The team leaders all have an NVQ at level 3 and are encouraged to take the level 4 award if they wish. Care Homes for Older People Page 22 of 27 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is safe and well managed, in the best interests of the people who live there. Evidence: The manager has the necessary experience and qualifications to manage the home, in the best interests of the people who live there. The manager attends training to keep up her professional development. The records and the staff confirmed that all staff have regular one to one supervision meetings with their line manager. This supports staff to plan their personal and professional development and gives them the opportunity to discuss any areas of concern in a confidential setting. The staff also said that they ...can speak to the manager any other time and another said that Our managers door is always open to us if we have a problem. Care Homes for Older People Page 23 of 27 Evidence: Peoples personal information is stored securely when it is not being used. Where the home helps people to manage their personal finances, accurate records are kept of all transactions and all monies are securely stored. The homes policies and procedures are kept up to date, to make sure they provide relevant information to guide staff on how to act in every situation. All the regular health and safety checks for the home are carried out in a timely manner. These measures make sure that the health, safety and welfare of the people at the home is promoted and safeguarded. The laundry is well organised and peoples personal clothing, as well as their bedding and towels, are properly cared for. The most recent Environmental Health Officers report awarded the kitchen 4 stars out of a possible 5 for cleanliness and safe working practices. The home has a range of quality assurance systems in place, to help determine the quality of service the home offers. These include surveys for the people who live at the home and their relatives, meetings for people who live at Emily Court, staff meetings and regular audit checks. Care Homes for Older People Page 24 of 27 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 25 of 27 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 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 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 26 of 27 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. 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