Care Home: Hall The

What the care home does well Care is offered in a well-kept and attractive setting. All people living a the home, visitors and staff spoke very highly of the manager and felt she managed the home well whilst being approachable and understanding. They also said how she had kept them up to date with information about refurbishment plans. The home is tastefully decorated and more improvements to decor are planned. The grounds are very pleasant. Visitors are made welcome at any time. The home writes down what care is required for each person and what needs to be done to avoid unnecessary risks. Staff also write down when doctors or other health care professionals call and make notes on any advice given. The staff are friendly and thoughtful and all have time to spend chatting or to help people on a one to one basis. The meals are of a particularly high standard, with variety and choice. Staff are aware of each person`s likes and dislikes. The staff enjoy working at the home and there is a low turnover. Any complaints are listened to, acted upon and taken seriously. People are kept safe by good health and safety procedures and thorough staff training. What has improved since the last inspection? The manager has completed her Registered Manager Award. there are ongoing improvements to the internal decoration and lay out of the building. What the care home could do better: The home could consider the specific recreational and social needs of those people suffering with memory difficulties and write how these are to be met in the care plans. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Hall The Chestnut Ave Thornton Le Dale Pickering North Yorkshire YO18 7RR     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: Karen Ritson     Date: 0 4 1 1 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. that people have said are important to them: They reflect the things 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 23 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 23 Information about the care home Name of care home: Address: Hall The Chestnut Ave Thornton Le Dale Pickering North Yorkshire YO18 7RR 01751474789 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): York Heritage (The Hall Thornton Le Dale) Limited Name of registered manager (if applicable) Mrs Joanna Eva Mary Morris Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 38 The registered person may provide the following category of service only: Care home only - Code PC to service users of the following gender: Either who primary care needs on admission to the home are within the following category: Old age, not falling within any other category - Code OP, maximum number of places: 38 Date of last inspection Brief description of the care home The Hall is a care home providing personal care and accommodation for 35 older people. It is owned by York Heritage Limited. Mrs. Johanna Morris is the registered manager of the home. The home is centrally located in the village of Thornton-le- Dale Care Homes for Older People Page 4 of 23 care home 38 Over 65 35 38 0 0 Brief description of the care home close to shops, public transport and other amenities. The building is a former hotel and stands in extensive grounds overlooking the countryside. 3 single en-suite bedrooms have been created from existing communal space. The Hall has good provision of communal space for the number of people accommodated. The three new bedrooms are located on the ground floor and have patio door that lead to the garden and they are decorated and furnished to a high standard. The new en-suites have a shower, toilet and sink. There is a passenger lift and a stair lift as well as aids and adaptations to assist people. A public house is separately located within the building and people living at the home can use this facility. The home has a statement of purpose and service user guide, which provide information about the scope and nature of the care and facilities on offer. These, with CSCI reports, are available on request at the home. Chiropody, hairdressing, toiletries and newspapers are not included in this fee and these are charged at cost. This home is undergoing refurbishment and has been purchased by York Heritage Limited since the last Key Inspection. Care Homes for Older People Page 5 of 23 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: This service provides good (two star) quality outcomes for the people who live there. The inspection for this service took 23 hours. This includes time spent gathering information and examining documentation before and after a site visit and in writing the report. The site visit took place on 4th November 2008 between 9.30 and 15.30. Information for this inspection was gathered from the following: 1. A tour of the premises 2. Observations of care throughout the day of the site visit. 3. Speaking with people who live at the home. 4. Speaking with staff. 5. Case tracking people on the day of the site visit. 6. Looking at information provided by the manager in a pre inspection questionnaire. 6. Notifications sent to the commission from the home since the last inspection. 7. Examining policies, procedures and records kept at the home, Care Homes for Older People Page 6 of 23 including staff files. 8. Examining information regarding the home on the file kept by CSCI. All key standards were looked at during this inspection. The manager was present throughout the day of the site visit. 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. What the care home does well: What has improved since the last inspection? 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 8 of 23 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 9 of 23 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. Prospective residents and their representatives have the information needed to choose a home. Needs are assessed and a care plan is drawn up from this. This ensures needs will be met. Evidence: People receive a thorough assessment of care needs before admission. This includes risk assessments where relevant.The home completes a personal history for each person and a description of each persons likes, dislikes, interests, hopes and goals for the future are included. One person said: The care here is very good indeed. They know what help I need and the staff are all first class. Observations of care showed that the needs of people were well known to staff. The manager and staff said that people and their relatives are encouraged to look around the home before admission so they can make an informed decision about whether the Care Homes for Older People Page 10 of 23 Evidence: home will be suitable for them. This ensure that people have the information they need to make an informed decision. Care Homes for Older People Page 11 of 23 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. The health and personal care is based on individual needs. The principles of respect,dignity and privacy are put into practice. Evidence: Care plans are detailed and often reviewed. Risk assessments are included when necessary. All accidents are recorded with action. Visits from health care professionals are recorded also. New care plans are being implemented which cover each area of care required in detail, and a new key worker role has begun. This is to ensure that people get individual and personalised care. The home is good at monitoring the dayto-day health of each person and daily notes contain appropriate and useful information. One person said: They have it all written down and each member of staff understands what I need. They are always quick to contact my doctor if theres a problem. Observations of care showed that people are treated kindly with their privacy and dignity respected. It is the policy in the home that staff knock and wait at the door of Care Homes for Older People Page 12 of 23 Evidence: each persons room until they are invited in. People said they liked this. Medication is kept, given and recorded appropriately, with policies in place. Staff who handle medication have had training. The home intends to purchase a new medication trolley which will make administration easier to manage. Care Homes for Older People Page 13 of 23 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 able to choose their life style, social activity and keep in contact with family and friends. Social, cultural and recreational activities meet individual expectations. People receive a healthy, varied diet they enjoy. Evidence: Many of the people living at The Hall are reasonably independent and pursue their own social and leisure activities. Some of the people enjoy gardening and several have cultivated individual plots within the grounds and attend to cuttings etc in the greenhouse. Several people have window boxes and tubs. Darts and dominoes are available in the bar, which adjoins the home. Entertainers visit the home regularly, and a company visits who provide activities for those who wish to be involved. Activities on offer include bingo, quizzes, exercises and sing -alongs. The home has a library and books are also available through the visiting library van. A minibus is hired in the summer months for outings. People said they felt there was some uncertainly over the future of outings which they hoped the new owners would clarify. There was also some concern about a resident who had brought caged birds with her to the home but it was felt the new owners were not encouraging of this. People said they had plenty to do and were able to choose activities, which reflected their preferred lifestyle. Care Homes for Older People Page 14 of 23 Evidence: As the home has a small number of people who have a dementia, special consideration of their needs in terms of activities and stimulation should be considered. The meals are excellent. The statement of purpose outlines the way meals are offered. Breakfast is served in the room, with a choice of cereal, fruit juice, fruit, cooked breakfast, toast and marmalade. The home will also cater for any special preferences. Lunch is a three course meal where alternatives and salads are always available. People may also choose to eat from the bar menu at an extra cost. Afternoon tea is provided around three and an evening meal with a main course and dessert later. Drinks and snacks are available 24 hours a day. The staff pay great attention to the likes and dislikes of people regarding food. Detailed lists are kept of meal preferences. Any details regarding special diets are recorded carefully. All people said the meals were very good. One person said: The meals are splendid. I cant fault them. My friend and I sometimes go into the bar for a drink at lunch time- very civilised. Care Homes for Older People Page 15 of 23 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 have access to an effective complaints procedure; their complaints are listened to and acted on. People are protected from abuse. Evidence: The home has a complaints policy and procedure. People said they could speak with staff if there was a problem or they had a complaint and that they were confident they would be listened to and any concerns acted upon. They said that the manager visited them often in their rooms and encouraged them to tell her if there were any problems or niggles. All complaints are recorded with outcomes. One person said: Mrs Morris comes in often to check if things are going all right. We could always tell her if there was something. Staff have received abuse awareness training and an update was planned in November 2008. The home has an equal opportunities policy and procedure. People said they felt safe and reassured about their care and that the new owners were good at meeting with them to tell them about new developments. Care Homes for Older People Page 16 of 23 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. People live in a safe, well-maintained and comfortable environment. Evidence: The home is in the process of undergoing a major refurbishment since the new owners took over. It is well decorated and furnished. There is ample communal space and most rooms look out over the attractive grounds. The home provides furnishings for rooms, but if people wish to bring their own furniture they are enabled to do so. All rooms are comfortable and well decorated. Many rooms are personalised with pictures, photographs and ornaments. Redecorated bedrooms and new en-suite bath and shower rooms are to an excellent standard and there are plans to refurbish rooms whenever they fall vacant. The kitchen and laundry have been relocated since the last inspection and further building work is to create additional bedrooms on the ground floor. The home complies with fire and building regulations and the environmental health department. This ensures that people live in comfortable, safe and attractive surroundings. Care Homes for Older People Page 17 of 23 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff in the home are trained and in sufficient numbers to fulfil the aims of the home and meet the changing needs of people. Evidence: The home is well staffed with little staff turnover. There are four members of staff on duty during the mornings, three in the afternoons and two at night. Staff have a new training programme which covers induction and all foundation areas. All staff employed at the home receive this training including domestic and maintenance staff. Staff are well recruited. Two references are placed on file and Criminal Records Bureau Checks are carried out on each member of staff prior to commencing employment. This ensures people are kept safe from those who are not suitable to work with vulnerable adults. People said they felt confident staff knew what they were doing and that they understood their particular needs. Staff said that the manager was very supportive regarding their training and that she was always there to offer encouragement. Care Homes for Older People Page 18 of 23 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. People benefit from an open style of management based on respect and from the considerable experience of the manager. Peoples views inform practice. Welfare is protected by good health and safety systems. Evidence: The manager has completed the Registered Managers Award. She already holds the equivalent to NVQ 4 in care, as she is a registered nurse. All staff commented on how supportive and approachable she was and how they now had formal supervision with her in addition to being encouraged to address any issues with her on a day to day basis. People also commented on how the manager had been supportive whilst the home had gone through the recent changes in ownership. Staff commented that they were not yet familiar with the new owners, who visited the home but had not yet got to know individual staff. The home has a quality assurance system, where the views of people living at the home, visitors and health care professionals are taken into consideration and acted upon. Responses to questionnaires are collated, fed back to Care Homes for Older People Page 19 of 23 Evidence: staff in meetings and informally to people living at the home in discussion. The manager also carries out her own annual audit based around the outcome groups of the national minimum standards and incorporates this and survey results into an annual plan for the improvement of the service. This ensures that the views of people using the service influence how it is offered. Personal allowances are kept for some people. Records were examined and these tallied with money held. This means personal allowances are kept safely. All policies and procedures were reviewed last year. All maintenance certificates examined were up to date. This ensures people live in a safe home. Care Homes for Older People Page 20 of 23 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 21 of 23 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 1 12 The home could consider the social and recreational needs of those with a dementia and write how these needs may be met in the care plan. Care Homes for Older People Page 22 of 23 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. 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. Care Homes for Older People Page 23 of 23 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!