Care Home: Ghyll Court

What the care home does well The home is well managed and effective quality assurance monitoring systems are in place, which allow people to air their views and opinions of the service provided. The home provides a safe and comfortable environment for people and all concerns/complaints are taken seriously, and action is taken to resolve matters. The manager and staff are approachable, have a caring attitude and create a homely atmosphere. There is a commitment to staff training, which is reflected in the number of staff who have achieved or who are studying for a National Vocational Qualification (NVQ) at level two or above.The admission procedure is thorough and the manager will not admit people unless she feels that the staff can provide the level of care and assistance they require. What has improved since the last inspection? A new care planning system has been implemented and care plans now give clear guidance to staff on how to meet people`s health, personal and social care needs. There is also evidence that people living at the home and their relatives are now involved in the care planning process. Improvements have been made in the way medication is stored. However, senior staff need to be more vigilant when recording medication on the Medication Administration Record (MAR) sheet. This is necessary to reduce the risk of errors occurring. What the care home could do better: More care needs to be taken when medication is administered and an accurate stock control system maintained for medication administered on a PRN (as and when required) basis, so that people can be confident that medication is being given as prescribed. More could be done to provide people with a range of recreational and leisure activities both within the home and the wider community. The emergency call system must be extended to cover all en-suite facilities so that people can summon assistance easily if they need to do so. Appropriate locks must be fitted to all bedroom doors and screening provided in the double bedroom so that people`s right to privacy is not compromised. CARE HOMES FOR OLDER PEOPLE Ghyll Court The Wells Walk Ilkley West Yorkshire LS29 9LH Lead Inspector Steve Marsh Key Unannounced Inspection 19th March 2008 09:30 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 Ghyll Court DS0000001279.V361056.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. Ghyll Court DS0000001279.V361056.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ghyll Court Address The Wells Walk Ilkley West Yorkshire LS29 9LH 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) 01943 607059 F/P 01943 607059 Mrs Jane Mary Verfuerth Mrs Jane Mary Verfuerth Care Home 14 Category(ies) of Dementia - over 65 years of age (4), Old age, registration, with number not falling within any other category (14) of places Ghyll Court DS0000001279.V361056.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 8th March 2007 Brief Description of the Service: Ghyll Court is a converted, extended property situated close to Ilkley town centre. It was first registered in November 1989 and bought by the present owner in 2001. The owner, Mrs Verfuerth, also manages the home. The home provides personal care and support for 14 older people who do not require nursing care. There are twelve single bedrooms and one twin bedroom, most rooms have en-suite facilities. The home stands in attractive gardens and is within easy reach of Ilkley Moor, the railway station and public transport links to Leeds, Bradford and Skipton. The fees are between £450 and £600 per week. Hairdressing, chiropody and personal items are extra. Ghyll Court DS0000001279.V361056.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 Two Star. This means the people that use the service experience good quality outcomes. The inspection process included looking at the information we have received about the home since the last key inspection, as well as an unannounced visit to the home, which was carried out between 09:30 and 16:00hrs. The purpose of this inspection was to assess what progress the service had made in meeting the requirements made in the last inspection report and the impact of any changes in the quality of life experienced by people living at the home. The methods we used included looking at records, watching staff at work, talking to people living at the home, talking with staff and looking around the property. The manager had also completed an annual quality assurance assessment form and the information provided has also been used as evidence in the report. Feedback was given to the manager at the end of the visit. What the service does well: The home is well managed and effective quality assurance monitoring systems are in place, which allow people to air their views and opinions of the service provided. The home provides a safe and comfortable environment for people and all concerns/complaints are taken seriously, and action is taken to resolve matters. The manager and staff are approachable, have a caring attitude and create a homely atmosphere. There is a commitment to staff training, which is reflected in the number of staff who have achieved or who are studying for a National Vocational Qualification (NVQ) at level two or above. Ghyll Court DS0000001279.V361056.R01.S.doc Version 5.2 Page 6 The admission procedure is thorough and the manager will not admit people unless she feels that the staff can provide the level of care and assistance they require. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Ghyll Court DS0000001279.V361056.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 Ghyll Court DS0000001279.V361056.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 5 – Standard 6 does is not applicable to this service. People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People’s needs are assessed before they are admitted and they can visit or stay for a trial period to make sure that the home is right for them. EVIDENCE: Records show that pre-admission assessment visits are carried out to see people before they are admitted to the home. The needs identified during this visit form the basis for the initial care plan. The manager confirmed that people are always invited to visit before admission so they can look round, meet the staff and people already living there and stay for a meal. This helps them decide if they want to move in and gives them the opportunity to experience at first hand the standard of care and Ghyll Court DS0000001279.V361056.R01.S.doc Version 5.2 Page 9 facilities provided. People are also able to move into the home for a trial period, the length of which can be negotiated with the manager. People offered a place at the home are always supported throughout the admission process and care is taken to make sure they settle into their new environment. Comments included “the initial visit to the home was helpful and informative” and “all the staff are kind and friendly and made me feel so welcome.” One person said she had not seen the home before moving in because she was unwell however a relative had visited on her behalf. The manager had also visited her before she moved in, and reassured her that the staff at Ghyll Court could meet her needs. She said, “I found that reassuring, as I was at first reluctant to move into a care home.” Ghyll Court DS0000001279.V361056.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 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People’s healthcare and personal needs are met in a way that maintains their dignity and independence. EVIDENCE: New care plans have recently been introduced at the home, which cover all aspects of people’s social and healthcare needs. Records show that wherever possible people are involved in the care planning process, which means that they are consulted about, how they want their care and support to be provided. The four care plans reviewed were completed to a good standard and show that people are encouraged to maintain their independence and do what they can for themselves. All people living at the home are registered with a general practitioner and are supported in having access to the full range of NHS services. The input of other Ghyll Court DS0000001279.V361056.R01.S.doc Version 5.2 Page 11 healthcare professionals is clearly recorded in the documentation available, which shows that staff are seeking advice if they have concerns about an individual’s health. Moving and handling and nutritional assessments are routinely completed for all new admissions and risk assessments are completed, where areas of potential risk to people’s general health or welfare are identified. People said that they were generally pleased with the care and attention they received. Comments included “the staff are kind and caring and look after us very well.” On reviewing the medication system we noted that for one person the stock control figure for PRN (as and when required) medication was wrong. In three other instances medication had not been signed for correctly on the Medication Administration Record (MAR) sheet. Staff must therefore be more vigilant when administering medication so that people can be confident it is being given as prescribed. Ghyll Court DS0000001279.V361056.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People living at the home are encouraged and supported to participate in activities within the home. However, more could be done to provide people with a more extensive range of recreational and leisure activities both within the home and the wider community. Meals are nourishing and take into account people’s likes and dislikes. EVIDENCE: The manager confirmed that the daily routines are flexible and people are encouraged to make choices about how they will spend their time whilst living at the home. The home does not employ an activities co-ordinator and therefore it is the responsibility of the care staff to organise activities, outings, and entertainment for people. A weekly programme of activities is on display, although the manager confirmed that this is subject to change depending on what is happening within the home. Ghyll Court DS0000001279.V361056.R01.S.doc Version 5.2 Page 13 Communion is held at the home on a monthly basis and the manager said people are encouraged to attend their place of worship if they wish to do so. The home has established links with local church and school groups who visit the home throughout the year to celebrate special occasions. Chair exercises take place on a weekly basis and the home has recently started a horticultural group. People spoken to on the day of the visit were generally happy with the level of activities offered. Two people felt that more organised activities and trips out could be arranged for them. Comments included “what activities take place depends on how busy the staff are but generally we do something on a daily basis” and “It would be nice to go out more during the better weather.” The self-assessment form completed by the home showed that they have plans in place to improve this aspect of the service. People said that they are able to see visitors in their own room if they wish to do so and confirmed that visitors were always made to feel welcome and offered light refreshment. Mealtimes are relaxed and sociable occasions and each person takes all the time they need to eat their meal. There is a good choice of dishes on the menu, and alternatives are offered if people prefer something different. Staff are aware of people’s needs and preferences and assistance is offered discreetly to people who are not able to manage to eat independently. Hot and cold drinks are freely available to people both day and night. Ghyll Court DS0000001279.V361056.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 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Robust complaint and adult protection policies and procedures ensure that people are listened to, and protected from any form of abuse. EVIDENCE: There is a clear complaints procedure available and people said that they would have no problems approaching the manager if they had any concerns about the standard of care being provided. The self-assessment form shows that no complaints have been received since the last inspection visit. Adult protection policies and procedures are in place and with the exception of staff recently employed all staff have attended a training course on the recognition and reporting of abuse. Staff confirmed that they were aware of the home’s policy on “whistle blowing” and their responsibility to safeguard people living in the home from any form of abuse. Policies and procedures are in place to protect people from financial abuse, which precludes staff from being involved in the making of, or benefiting from people’s wills. Ghyll Court DS0000001279.V361056.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, 22, 24 and 26 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. The home provides people with a pleasant and comfortable environment in which to live. EVIDENCE: All the communal areas including the lounge and dining room are situated on the ground floor of the home, conveniently close to toilet facilities. The standard of décor and furnishing is good and they are pleasant areas for people to take their meals and relax. Bedrooms are located on both floors of the home and consist of twelve single and one double room most of which have en-suite facilities. There is a stair lift available to the accommodation on the first floor to assist people with mobility problems. All bedrooms are comfortably furnished and the majority are light Ghyll Court DS0000001279.V361056.R01.S.doc Version 5.2 Page 16 and spacious. People are encouraged to bring personal possessions into the home, which makes each room look individual and homely. However, some of the bedrooms do not have door locks and there is no screening in the double room. This could compromise people’s right to privacy. Some en-suite facilities do not have emergency call leads, these are needed to make sure people can easily summon help if they need to. People said that they were very happy with the standard of accommodation, and the fact that they had been able to furnish their rooms with personal possessions had made the move into residential care easier for them. On the day of the visit the home was clean and tidy and free from offensive odours. Externally the building and grounds are well maintained. Ghyll Court DS0000001279.V361056.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 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. People are protected by the recruitment and selection procedures. There is a commitment to staff training and to ensuring that people receive the standard of care and support they require. EVIDENCE: The home has a small but stable care staff team with a good skill mix, which makes sure that people’s needs are met in line with their care plan. However, the staff rota shows that the home is currently run on the minimum staffing levels with little cover available for staff sickness or annual leave. The manager is aware of this and is considering recruiting an additional care assistant to work during peak periods of activity. Recruitment and selection procedures are in place, which include checking the Protection Of Vulnerable Adult (POVA) register and obtaining at least two written references and a Criminal Record Bureau (CRB) report before new staff are permanently employed. All new staff receive induction training and the manager is currently in the process of introducing the Skills for Care Common Induction standards. Ghyll Court DS0000001279.V361056.R01.S.doc Version 5.2 Page 18 Following induction training there is an expectation that staff will study for a National Vocational Qualification (NVQ) at either level two or three depending on the post they hold. Information provided by the manager shows that currently five staff have achieved the award and a further three are studying for the qualification. Staff said that the manager also encourages them to take up other training opportunities either specific to the needs of people living at the home or for their own personal development. This shows that the home is committed to ensuring that people who use the service are cared for and supported by a trained and skilled workforce. Training certificates are kept in individual staff files however it was recommended to the manager that she carry out a full training audit so that any gaps in training can be more easily identified. Staff said that the level and quality of training provided is good and confirmed that the manager is committed to ensuring that people benefit from having a trained, skilled and experienced workforce caring for them. Ghyll Court DS0000001279.V361056.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, 32, 33, 35, 36 and 38 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. The home is well managed and the manager makes sure that people’s rights are protected and their needs are met in line with their care plan. EVIDENCE: Mrs Jane Verfuerth is both the registered manager provider and manager of Ghyll Court. Mrs Verfuerth is a qualified nurse with many years experience in the caring profession and therefore has the skills and experience to manage the home effectively. Mrs Verfuerth communicates a clear sense of direction and leadership to the staff team, and staff confirmed that she has an open and approachable management style. Ghyll Court DS0000001279.V361056.R01.S.doc Version 5.2 Page 20 The manager works within the home on a daily basis and therefore is on hand to deal with any queries/concerns raised by either the staff or people living there. There is evidence to show that staff have one-to-one supervision with the manager on a regular basis and an annual appraisal of their work. There is a range of quality assurance monitoring measures in place including sending out regular survey questionnaires to people living at the home, relatives and visiting healthcare professionals. The survey gives people the opportunity to express their views of the service and is an important part of the quality assurance monitoring process. The home holds money in safekeeping for a number of people and transaction sheets are in place showing income, expenditure and a balance. Only senior staff deal with financial transactions and regular audits are carried out to make sure the records are accurate and in good order. Receipts are obtained for any items purchased by staff on behalf of people. Information provided in the self–assessment form showed that all equipment in use at the home such as the stair lift and bath hoist are serviced in line with the manufacturer’s guidelines. People can therefore be confident that all the equipment in use is in good working order. Ghyll Court DS0000001279.V361056.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 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 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 X 2 X 2 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 3 3 X 3 3 X 3 Ghyll Court DS0000001279.V361056.R01.S.doc Version 5.2 Page 22 YES 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 OP9 Regulation 13(2) Requirement An accurate stock control system must be maintained for medication administered on a PRN (as and when required) basis so that people can be confident that medication is being given as prescribed. The Medication Administration Record sheet must be correctly completed so that people can be confident that medication is being given as prescribed. The emergency call system must be extended to cover all en-suite facilities so that people can summon assistance easily if they need to do so. Appropriate screening must be provided in the double bedroom so that people’s right to privacy is not compromised. Appropriate locks must be fitted to all bedroom doors so that people’s right to privacy is not compromised. Timescale for action 30/04/08 2. OP9 13(2) 30/04/08 3. OP22 23 30/09/08 4. OP24 16(c) 31/05/08 5. OP24 23 30/09/08 Ghyll Court DS0000001279.V361056.R01.S.doc Version 5.2 Page 23 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 Ghyll Court DS0000001279.V361056.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB 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. 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