Care Home: Salroyd Villa

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What the care home does well People or those close to them are encouraged to visit the home before making a decision about moving in. The first four weeks are treated as a trial period so that people can experience the service before making a decision about moving in permanently. The home does not provide nursing care but has developed good working relationships with community based health care staff, such as the district nurses, to make sure that people`s health care needs are met. People told us they are well cared for and happy with the service. They said the staff are kind and caring. People told us they feel comfortable talking to the owners and manager about any concerns they might have and are confident their concerns will be acted on. People told us the food is good and alternatives are available if they want something that is not on the menu. The home is clean and comfortable. We saw that people are able to have personal belongings, such as items of furniture, ornaments and photographs in their bedrooms. What has improved since the last inspection? There were two requirements following the last key inspection and they have been dealt with. There is an ongoing programme of refurbishment and maintenance to make sure the home continues to provide a pleasant, safe and suitably equipped place for people to live. The home has improved the way people`s medicines are managed and they have a new pharmacist who will provide ongoing support and training for staff. This will help to make sure that medicines are managed safely and people get their medicines as prescribed. The home has improved its standard of food hygiene and safety. At the last inspection by the Environmental Health Department their star rating was increased from 3 to 4 stars, (the maximum is 5). The home continues to consult with people using the service and make improvements in response to the feedback they get from people. What the care home could do better: The manager agreed to reintroduce the original format for people`s care plans. This will make sure that staff are given detailed information about how to meet people`s needs and will help to make sure care is given consistently in accordance with people`s wishes. The home should update the Statement of Purpose to include information about the use of CCTV inside the building. This has an impact on people`s right to privacy and some people may find it intrusive therefore it is important that people know about it before making a decision about moving in. They should also make sure also make sure they have the correct policies and procedures in place relating to access, storage and retention of the CCTV tapes. They should ensure they are aware of and comply with all the legislation relating to the use of CCTV cameras which includes the Data Protection Act. The home is aware that it needs to continue to develop and improve the way people`s social care needs are met to make sure that people are given the right support to follow their personal interests and make the most of their abilities. Key inspection report Care homes for older people Name: Address: Salroyd Villa 21 - 23 Salroyd Road Low Moor Bradford West Yorkshire BD12 0JN     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Mary Bentley     Date: 2 3 0 7 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. Care Homes for Older People Page 2 of 26 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Salroyd Villa 21 - 23 Salroyd Road Low Moor Bradford West Yorkshire BD12 0JN 01274603887 01274411294 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mrs Kathleen Ellwood,Mr Ian Patrick Ellwood care home 16 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category physical disability Additional conditions: Date of last inspection Brief description of the care home The home has been converted from two semi-detached buildings and provides personal care for sixteen older people. It is situated in a residential area just off the main Cleckheaton Road at Low Moor. Car parking is permitted on the road in front of the home. The home is close to local bus routes. There is access for disabled people at the rear of the building. There are gardens and a patio area to the front of the house that people can use. 0 0 0 0 Over 65 4 1 11 1 Care Homes for Older People Page 4 of 26 Brief description of the care home The accommodation is on the ground and first floor and there is a stair lift linking both floors. There are two bedrooms and a toilet on the first floor that can only be reached by going up some steps, these rooms are only offered to people who are able to walk up the steps. There are fourteen single bedrooms, one of which has en suite facilities, and one double room. The home has two communal bathrooms and four toilets. There are two communal rooms on the ground floor; one is a large lounge/dining area. The home has a no smoking policy. CCTV is being installed to some external areas for security reasons. The home will also have CCTV inside, in some corridors and stairways. The Statement of Purpose will be updated to include this information so that people are aware of it before they make a decision about moving in. In July 2009 the fees ranged from 379.24 to 417.95 pounds per week. Additional services such as hairdressing and newspapers are not included in the fees. Detailed information about the range of services offered is available from the home. Care Homes for Older People Page 5 of 26 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 last inspection of this service was carried out on 25 July 2007. Since then 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 to 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 enforcement action will be taken. This is what we used to write this report. The annual quality assurance assessment (AQAA) that was sent to us by the service. The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. It also gave us numerical information about the service. Care Homes for Older People Page 6 of 26 The report from the Annual Service Review which we carried out in July 2008. Information we have about how the service has managed any complaints. What the service has told us about things that have happened in the service, these are called notifications and are a legal requirement. Relevant information from other organisations. A site visit carried out by one inspector between the hours of 9:45 and 4:30. During the visit we spoke to people living in the home, visitors, staff and management. We looked at various records including care records and staff files. We observed staff as they carried out their duties and looked at some parts of the building. On this occasion we did not send any surveys to people using the service. Care Homes for Older People Page 7 of 26 What the care home does well: What has improved since the last inspection? What they could do better: The manager agreed to reintroduce the original format for peoples care plans. This will make sure that staff are given detailed information about how to meet peoples needs and will help to make sure care is given consistently in accordance with peoples wishes. The home should update the Statement of Purpose to include information about the use of CCTV inside the building. This has an impact on peoples right to privacy and some people may find it intrusive therefore it is important that people know about it Care Homes for Older People Page 8 of 26 before making a decision about moving in. They should also make sure also make sure they have the correct policies and procedures in place relating to access, storage and retention of the CCTV tapes. They should ensure they are aware of and comply with all the legislation relating to the use of CCTV cameras which includes the Data Protection Act. The home is aware that it needs to continue to develop and improve the way peoples social care needs are met to make sure that people are given the right support to follow their personal interests and make the most of their abilities. 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 on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 9 of 26 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 26 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 given information about the service and their needs are assessed before they move in. This helps people to decide if the home is the right one for them and helps to make sure the home will be able to meet peoples needs when they move in. Evidence: The home carries out an assessment of peoples needs before they move in to make sure they will be able to meet the persons needs. When people move in because of an emergency the home uses information provided by Social Services to decide if they will be able to meet the persons needs. The first four weeks are considered a trial period for all new people. This gives people the opportunity to experience what life is like in the home before making a decision about moving in permanently. We spoke to some visitors who told us they had been involved in choosing the home for their relative. They said they had looked around the home and been given information about the service. They said they have no regrets and feel their relative is Care Homes for Older People Page 11 of 26 Evidence: well cared for. Care Homes for Older People Page 12 of 26 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 health care needs are met in a way that takes account of their wishes and abilities and respects their privacy and dignity. Evidence: There were 16 people living in the home when we visited. We looked at two peoples care records. The home has changed the format of the care records since we last visited. At that time the care plans had detailed information on how peoples personal, health and social care needs would be met. The new format provides good information on peoples assessed needs. However, it does not provide clear information for staff on the actions they should take to meet these needs. We discussed this with the deputy manager and she said would put the original care plans back in place. This will help to make sure that staff have clear and up to date information about how to meet peoples needs. The staff we spoke had a good understanding of peoples needs and we saw they treat people with kindness and respect. People looked well cared for and told us they are. Visitors said their relatives are well cared for and they are kept informed about changes in peoples conditions. Care Homes for Older People Page 13 of 26 Evidence: There are risk assessments in place for falls, nutrition and the risk of developing pressure sores. No one in the home had a pressure sore when we visited. The home does not provide nursing care but works closely with the district nursing teams to make sure peoples health care needs are met. For example, if someone is identified as being at risk of developing pressure sores the home informs the district nurses about this so that measures can be put in place to reduce the risk. Peoples weights are recorded every month. If people are at risk of malnutrition, losing weight or failing to gain weight the home takes action to deal with this. For example on the day we visited one person was seen by their GP because of concerns about weight loss. The home has a chiropodist who visits approximately every six weeks and people have access to eye tests and hearing checks. When we visited the home was in the process of changing to a new chemist who will supply medicines for people living in the home. The new chemist has agreed to provide them with the correct type of cabinet to store controlled medicines, a medicine trolley and will provide more training for staff. The records relating to medicines were correct and showed that people get their medicines as prescribed. Staff are only allowed to help people with their medicines when they have done training on the safe management of medicines. Peoples wishes with regard to end of life care are recorded and staff are trained in palliative care. The home works closely with the palliative care teams to make sure that whenever possible peoples wishes are respected, they are kept comfortable and their families/friends are supported. Care Homes for Older People Page 14 of 26 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. The home has a relaxed and informal atmosphere and people are encouraged to exercise choice and control over their lives. The home is aware that it needs to continue to develop this aspect of the service to make sure that people are supported in following their personal interests and making the most of their abilities. Evidence: Daily routines are flexible and take account of peoples preferences. People are encouraged to socialise but are also able to spend time in their rooms when they want to. The home has a programme of planned activities but does not always follow this plan, it depends on what people want to do. Planned activities include games, exercises and visiting entertainers. The home has engaged the services of an aromatherapist and people can have one to one sessions, for example hand massages. One person told said they would like more opportunities to do exercises. In April this year the home sent questionnaires to people and one person said they would like more organised activities. People are encouraged to be involved in the day to day running of the home, for Care Homes for Older People Page 15 of 26 Evidence: example they are involved in planning the menus. There are no formal meetings for people but one of the people living there holds informal meetings where people can talk about the service. Any comments, concerns and suggestions are then passed to the manager to deal with. One or two people go out to a luncheon club once a week. The home told us they would like to arrange more outings but find this difficult because of funding restraints. Visiting arrangements are flexible and people can receive visitors at times that are convenient to them. Visitors told us they are always welcomed. The home now has a computer with INTERNET access which people in the home can use. There was some initial interest but generally the people currently living in the home have not shown much interest in learning computer skills. Peoples religious needs are identified and people are given whatever support they need to follow the faith of their choice. People said the food is good. The meal service at lunch time was well organised and people had time to enjoy their food. Where necessary people were helped or encouraged discreetly. Alternatives are always available if people do not want the meal on the menu. Care Homes for Older People Page 16 of 26 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 can be confident that any concerns they have will be listened to, taken seriously and acted on. There are suitable systems in place to make sure people are protected. Evidence: The home has a clear complaints procedure. They encourage people to discuss any concerns they have so that issues can be dealt with as they arise. This means that people seldom feel the need to make formal complaints. The home has not had any complaints in the last 12 months and none have been referred to us. Relatives told us they feel comfortable about discussing any concerns they might have. One person told us they had spoken to the manager about their relatives clothes not being ironed properly and this was dealt with immediately. There are procedures in place to make sure people are protected. Staff have attended training on the protection of vulnerable adults (safeguarding). Staff we spoke we able to identify different types of abuse and were able to relate this to their day to day practice. They know how to report any concerns or suspicions of abuse. Care Homes for Older People Page 17 of 26 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 clean, safe, comfortable and pleasant place for people to live. Evidence: In their self assessment the home told us they have an ongoing programme of refurbishment and redecoration. Over the past 12 months they have done work inside and outside the home. This has included refurbishing 3 bedrooms, providing new chairs and soft furnishings and improving the garden area. The home was clean and free of unpleasant odours when we visited. Peoples bedrooms are suitably equipped to meet their needs. People are encouraged to have personal belongings in their bedrooms to make them feel more homely. There are appropriate systems in place to reduce the risk of cross infection and all the staff have had training on infection control. The home has been awarded four stars (the maximum is 5) by Environmental Health for its standards of food hygiene and safety. When we visited the home was in the process of installing CCTV both inside and outside the building. The use of CCTV on the outside of the home to improve security is appropriate. However, we have concerns about the use of CCTV inside the home Care Homes for Older People Page 18 of 26 Evidence: because of the implications for peoples right to privacy. This was discussed during the visit. The owners assured us the CCTV inside the home will only be in public areas such as corridors and stairways. However, this still has an impact on peoples right to privacy. They said they consulted people using the service and their representatives before deciding to go ahead. CCTV cameras collect and process personal information and the Data Protection Act 1998 applies to their use. The owners are aware that they need to update the Statement of Purpose and put policies and procedures in place relating to access, storage and retention of the tapes. Care Homes for Older People Page 19 of 26 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. There are usually enough staff on duty to make sure that peoples needs are met. Staff are well trained and have the knowledge and skills they need to care for and support people properly. Evidence: During the week there are usually 3 care staff on duty between 8:00 am and 4:00 pm, at the weekend there are usually 2 care staff. From 4:00 pm to 10:00 pm there are 2 care staff on duty and overnight there are 2 waking night staff. During the week the home usually has a cleaner and a cook who work in the mornings. The home told us they have had some staffing difficulties over the past couple of months due to absence however these are now being resolved. Relatives said they were aware there had been times recently when the home was short staffed but they also said they felt this has now improved. Staff told us they are given lots of training opportunities. The training records showed that staff have attended training on various subjects including food hygiene, diabetes and dementia. New staff have a detailed induction and when they have completed this they are expected to undertake an NVQ (National Vocational Qualification) at level 2. Nine of the eleven care staff employed have achieved an NVQ at level 2 or above. Care Homes for Older People Page 20 of 26 Evidence: The staff files we looked at showed that all the required checks are completed before new staff start work. Staff told us they feel supported by the management team and said they can always contact a member of the management team if they need to. Care Homes for Older People Page 21 of 26 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 well managed. People are encouraged to share their views and the home responds positively to ideas and suggestions for improving the service. Evidence: The home is owned and managed as a family concern. The registered manager Mrs Elwood is joint owner of the home with her husband. They are both actively involved in the home, for example they deal with the accounts, maintenance, cooking and shopping. The deputy manager is their daughter and is responsible for the day to day running of the home. She has completed the Registered Managers Award and regularly attends training to keep up to date with changes in care practices and legislation. The home has put policies and procedures in place in relation to the Mental Capacity Act and the Deprivation of Liberty. Staff have received training on how this relates to their day to day work. Care Homes for Older People Page 22 of 26 Evidence: The home encourages people to share their views of the service, for example by involving them in care reviews. The home also sends questionnaires to people using the service and visiting health care professionals. The most recent questionnaires for people using the service were sent in April 2009. We looked at a sample of the responses and they showed that overall people are happy with the service. Staff meetings are held approximately every month. Staff have individual supervision and appraisals where they get the opportunity to discuss their work and any training/support needs they have. The home does not get involved in managing peoples finances. They hold small amounts of personal money for some people. Records are kept of all transactions and receipts are available for any money spent on peoples behalf. In the AQAA the home told us that they have suitable systems in place to make sure equipment and installations are maintained and serviced at the required intervals. The records we looked at confirmed this. Care Homes for Older People Page 23 of 26 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 24 of 26 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 19 The appropriate policies and procedures should be put in place in relation to the use of CCTV cameras inside the home. The home should ensure that they comply with all the relevant legislation related to the use of CCTV inside the premises. The Statement of Purpose and Service User Guide should be updated to include information about the use of CCTV. The use of CCTV cameras inside the home should be kept under review. Care Homes for Older People Page 25 of 26 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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