Care Home: Ivanhoe Residential Care Home

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What the care home does well The home makes sure that there is enough information provided to people who are thinking about moving in to the home so they can make an informed choice about whether the home can met their needs and it the right place for them. The home make sure that every one who is thinking about moving into the home are properly assessed so that their needs can be met and the staff can look after them properly.The home makes sure that there are enough activities going on for the people who live there to choose from and that they go out on a regular basis. They also make sure that relatives are made welcome and that they can see the people who live at the home in private if they want to. The home makes sure that the pole who live there live in comfortable surroundings and that the home is clean and tidy. The makes sure that any prospective employees are properly checked before they come to work at the home, this ensures the safety of the people who live there. What has improved since the last inspection? The home recently been taken over by new owners and this is the first inspection with the new owners. They regularly send the Commission for Social Care Inspection (CSCI) updates about improvements they are making and they provide time scales and tell who is responsible for these improvements. What the care home could do better: The home need to makes sure there is enough information recorded about peoples special medical needs so the staff can respond properly and meet the needs of the person properly. CARE HOMES FOR OLDER PEOPLE Ivanhoe Residential Care Home 1121 Hessle Road Hull East Yorkshire HU4 6SB Lead Inspector George Skinn Key Unannounced Inspection 11th September 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 Ivanhoe Residential Care Home DS0000071633.V371768.R02.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. Ivanhoe Residential Care Home DS0000071633.V371768.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ivanhoe Residential Care Home Address 1121 Hessle Road Hull East Yorkshire HU4 6SB 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) 01482 566000 01482 575745 Denestar Limited Manager post vacant Care Home 24 Category(ies) of Dementia (24), Old age, not falling within any registration, with number other category (24) of places Ivanhoe Residential Care Home DS0000071633.V371768.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only - Code PC To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP, maximum number of places: 24 2. Dementia - Code DE, maximum number of places: 24 The maximum number of service users who can be accommodated is: 24 Date of last inspection Brief Description of the Service: Ivanhoe is owned Denestar Limited, it is family run business that own a small number of care homes in the Hull and East Riding area. The home is registered to provide care and accommodation for up to 24 residents of either gender, over the age of 65, some of who may suffer from dementia. The home is on Hessle High Road on the outskirts of Kingston upon Hull, to the west of the city. There is a small car park to the rear and some parking available to the front and on the street. The home is on a major bus route between Hessle and Hull. There are fourteen single and five double bedrooms spread over three floors, accessible by a passenger lift. The communal areas include two lounges (one with a conservatory) and a dining room with a conservatory. These are situated on the ground floor along with the homes kitchen and laundry. The home operates a no smoking policy throughout. To the rear is an attractive garden, patio with seating, flowerpots and a lawn. Most of the ground-floor bedrooms have French windows opening onto the garden area. The grounds are well maintained and the home is well furnished and decorated. The current scale of charges (Fees) range from £420.00 for a single en-suite Ivanhoe Residential Care Home DS0000071633.V371768.R02.S.doc Version 5.2 Page 5 room to £389.00 for a shared room per week. Top up charges range from £63.50 to £37.50 per week. The owner told us that this negotiable. The fees include: • Meals and all snacks • Beverages • Local telephone calls • Insurance up to £100 for any personal items • Day trips The fees do not include: • Clothing • Cosmetic treatments/items • Or items personal use for example magazines, daily papers, books Ivanhoe Residential Care Home DS0000071633.V371768.R02.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means that the people who use this service experience good quality outcomes. The key inspection has used information from different sources to provide evidence. These sources include: • • • • Reviewing information that has been received about the home since the last inspection. Information provided by the registered person on an Annual Quality Assurance Assessment (AQAA) Comment cards returned from people who live at the home, relatives and staff A visit to the home carried out by one inspector. A site visit was carried out which lasted 5 hours. We spoke with the people who live at the home, their relatives and staff. Records relating to the people who live at the home, staff and the management activities of the home were inspected. During the visit care practices were observed, where appropriate, and time was also spent watching the general activity within the home. 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 owner was available to assist throughout the day. What the service does well: The home makes sure that there is enough information provided to people who are thinking about moving in to the home so they can make an informed choice about whether the home can met their needs and it the right place for them. The home make sure that every one who is thinking about moving into the home are properly assessed so that their needs can be met and the staff can look after them properly. Ivanhoe Residential Care Home DS0000071633.V371768.R02.S.doc Version 5.2 Page 7 The home makes sure that there are enough activities going on for the people who live there to choose from and that they go out on a regular basis. They also make sure that relatives are made welcome and that they can see the people who live at the home in private if they want to. The home makes sure that the pole who live there live in comfortable surroundings and that the home is clean and tidy. The makes sure that any prospective employees are properly checked before they come to work at the home, this ensures the safety of the people who live there. 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. Ivanhoe Residential Care Home DS0000071633.V371768.R02.S.doc Version 5.2 Page 8 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 Ivanhoe Residential Care Home DS0000071633.V371768.R02.S.doc Version 5.2 Page 9 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&6 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 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, what they hope for and want to achieve, and the support they need. EVIDENCE: The home has recently changed ownership and we saw that the new owners had updated the Statement of Purpose and the Service user guide. A full information pack is given to people who are thinking about coming to live at the home. This includes the Service user guide, Statement of Purpose, a copy of the contract (in large print if required), financial policy, complaint information, menu sample and a scale of charges informing people of what’s included in the price. Ivanhoe Residential Care Home DS0000071633.V371768.R02.S.doc Version 5.2 Page 10 We looked at sample of file which belonged to the people who live at the home ands we saw that these contained copies of assessments undertaken by the placing authority and the home. This assessment information is then used to write a care or support plan describing what staff need to do to look after each person. The home does not provide intermediate care, which is a specialist service aimed at maximising people’s independence and return home after a hospital admission. Ivanhoe Residential Care Home DS0000071633.V371768.R02.S.doc Version 5.2 Page 11 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 & 10 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 receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people 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. EVIDENCE: We looked at four care plans, which belonged to the people who live at the home. We saw that personal support is provided in accordance with the care plan; these contained risk assessments around the area of falls, tissue viability, nutrition and diet. The new owners have put in place new care plans for all the people who live at the home. We saw that some vital information was missing from two of the plans we looked at. A man at the home suffers from epilepsy but we could find no information which instructed the staff on how to identify when he was having seizure or when to ring for the emergency services. We saw that one person’s mobility needs had changed quite significantly. Following a fall and a stay in hospital she now needed two Ivanhoe Residential Care Home DS0000071633.V371768.R02.S.doc Version 5.2 Page 12 members of staff to help her; her care plan had not been updated and indicated that she could still be helped by one member of staff. We saw that the people who live at the home can access healthcare professionals like doctors and nurses when needed, some people also have input from specialist nurses like community psychiatric nurses (CPN). Some people have involvement with psychiatrists, specialist social workers, physiotherapist and dieticians. When we spoke with the staff they were clear about how to maintain someone’s dignity and uphold their rights. We saw that the staff were sensitive to peoples needs when undertaking any personal tasks and were sensitive and patient when dealing with those people who have dementia. At no time did we hear any of the staff using any derogatory language or belittling any one in any way. We looked at the way the home handles and stores medication. We saw that the way this was done ensures the safety of the people who live at the home. The medication was stored in the proper cabinets and secured in a separate storage area. The staff make sure that correct medication has been supplied by the pharmacist when it is delivered and any mistakes are quickly rectified. The staff make sure that the recording of the medication is up to date and gives a clear indication that the medication has been administered. The recording also indicates when the medication has not been given and why. All of the staff who give out medication have had the proper accredited training and we saw certificates which confirmed this. Ivanhoe Residential Care Home DS0000071633.V371768.R02.S.doc Version 5.2 Page 13 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 & 15 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. Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender including gender identity and sexual orientation. They can take part in activities that are appropriate to their age and culture and 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 and the home supports them to have appropriate personal, family and sexual relationships. EVIDENCE: When we spoke with the people who live at the home they said they could make choices about activities, food, how to spend their time and when to get up and go to bed. The home encourages contact with relatives and friends and the home were busy organising an open day for the weekend. We saw that visitors were made welcome to the home and had good relationships with the staff. Ivanhoe Residential Care Home DS0000071633.V371768.R02.S.doc Version 5.2 Page 14 We saw that a selection of activities are arranged for the people who live at the home to take part in if they wish; these included reminiscence, one to one discussions, bingo, quizzes, table games, dominoes, crosswords, nail care and carpet bowls. Advertisements around the home told us that that entertainers visit regularly and during the summer months trips out are booked, weather permitting. When we spoke with the people who live at the home about the food they told us it was very good. One person said “there is always plenty of it and there is always a choice”. The cook visits all the people who live at the home every day to establish what they would like for lunch and tea, as choice is available for both. Lunch on the day of the inspection was nicely presented and looked wholesome and nutritious. Staff helped those people who required assistance when eating in a relaxed unhurried manner. When we spoke with the cook she was knowledgeable about peoples diets and received the appropriate training. Ivanhoe Residential Care Home DS0000071633.V371768.R02.S.doc Version 5.2 Page 15 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 & 18 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. If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and would take action to follow up any allegations because there are procedures in place for staff to follow. EVIDENCE: We saw that 2 complaints have been received by the home since the last inspection. We saw that these had been fully recorded, investigated and appropriate action taken. The CSCI have received no complaints about the home since the new owners have taken over, or since the last inspection. The home has not been subject to any safeguarding referrals or investigations. In discussion with the people who live at the home they were aware that they had the right to make complaints and told us that they would talk to their key worker or the manager. The home has a policy and procedure for safeguarding adults and the staff interviewed were aware of this, all had received training about Protection Of Vulnerable Adults (POVA). This is to be updated. Ivanhoe Residential Care Home DS0000071633.V371768.R02.S.doc Version 5.2 Page 16 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 & 26 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 stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. EVIDENCE: We saw that there is a good standard of hygiene around the home. Currently building work is being undertaken to extend the home and reduce the number of double rooms and improve access to the laundry to avoid carrying dirty laundry through the dining room. The laundry room will also be increased in size creating a better drying area. The building work is reaching completion. The home provides the required amount of bathrooms and toilets to meet the needs of the people who live there. Ivanhoe Residential Care Home DS0000071633.V371768.R02.S.doc Version 5.2 Page 17 There was good infection control practice to stop people picking up infections. Any laundry that needs to be carried through the dining room is safely bagged up and only carried outside of mealtimes. The home now have mobile hoists to help any one who is at risk of falling to move safely. The home was well maintained and safety certificates were available for inspection. Ivanhoe Residential Care Home DS0000071633.V371768.R02.S.doc Version 5.2 Page 18 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 & 30 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 have safe and appropriate support as there are enough competent, qualified 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. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. EVIDENCE: There is a satisfactory staff rota in place that records the role of each member of staff. The staffing levels are based on the needs of the people who live at the home. There is a cook on duty each day as well as a kitchen assistant, and other ancillary staff. This enables care staff to concentrate on assisting people with personal and social care activities. There is a separate rota for night staff. Training records indicated that that more than 50 of the staff are trained to NVQ level 2 which includes training on equality and diversity and an awareness of abuse. The recruitment and selection procedures remain robust and all checks are undertaken prior to staff commencing work at the home. The staff files looked at contained references from previous employer; an application form which identified gaps in employment and a completed Criminal Record Bureau (CRB) check. Ivanhoe Residential Care Home DS0000071633.V371768.R02.S.doc Version 5.2 Page 19 There is a training and development plan in place that shows all staff have undertaken core training and that some staff undertake more specialised training such as Challenging Behaviour, Dementia and Palliative care. We saw that staff records include information about individual training achievements and a copy of training certificates is kept on their file. Staff have refresher training as appropriate to ensure that their skills and knowledge are kept up to date. All staff have received mandatory training in Health and safety, Manual handling, Basic Food Hygiene, First Aid and Fire. Staff receive regular supervision and developmental opportunities are given for the staff to attend further training. When we spoke with staff they said they found the training excellent and where pleased that the new owners encouraged them to attend lots of training. They felt this gave them the skills needed to care for the people who live at the home. Ivanhoe Residential Care Home DS0000071633.V371768.R02.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 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 have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. EVIDENCE: The home has recently been taken over by new owners; as a consequence the new owner has been at the home on a daily basis supporting the manager. Managers from other homes, which the new owner owns, have been at the home to support the manager. The manager of the home is not registered with the CSCI. When we spoke with the people who live at the home they said the Ivanhoe Residential Care Home DS0000071633.V371768.R02.S.doc Version 5.2 Page 21 new owners were approachable and they felt confident that they could go to them if they had any concerns. The staff also said the new owners approachable and they could go to them for advice or guidance. They also said they were making some positive changes. Since taking over the home the new owners have sent the CSCI an action plan of improvements they intent to make to meet the National Minimum Standards and this is updated every month. The home consults with the people who live there on a regular basis. The home also sends regular surveys to relatives and visiting health professionals. A full audit report is made based on the findings of the surveys and this identifies areas of improvement for the coming year. Financial arrangements have been improved since the last inspection and the home now keep a more accurate record of the peoples finances. This ensures that the peoples finances are not put at risk. We saw that the records were accurate and up to date The home continues to be well maintained and all safety certificates were up to date. The staff are trained in health and safety and all of their mandatory training is updated as required Ivanhoe Residential Care Home DS0000071633.V371768.R02.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Ivanhoe Residential Care Home DS0000071633.V371768.R02.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP7 Good Practice Recommendations The home should make sure that there is enough information recorded in the people’s care plans so that staff can care people properly. Ivanhoe Residential Care Home DS0000071633.V371768.R02.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. Extracts may not be used or reproduced without the express permission of CSCI Ivanhoe Residential Care Home DS0000071633.V371768.R02.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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