Care Home: Swallow Wood Care Home

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What the care home does well The home provides information for people and their relatives, who are invited to look around the home and spend up to a day there before being admitted. The home provided a welcoming and comfortable environment, with a very relaxed atmosphere. Discussion with both people receiving services and the activities co-ordinator confirmed routines were flexible and people focused. People said they enjoyed the activities available, however if they did not choose to participate in the activities they liked to watch television and spend time in their bedrooms. People also said they were encouraged to keep in contact with family and friends living in the community, they visit local shops, garden centres and meals out to local venues. The home have male and female staff, to ensure people had a choice of who performed their personal care. Throughout this visit staff were seen interacting with people who use the service in a kind manner. They spent time talking to people and were observed to treat people with respect and dignity and encouraging people to make everyday choices, for example what to eat and what to wear. People said that staff listens and acted on what they said and all felt that staff supported them and care was excellent. What has improved since the last inspection? All the issues raised on the last inspection had been addressed for example, the system for recruitment files had been improved. Evidence that management monitor the reregistration of nurses pin numbers was very clear and easy to check information. The number of people attaining NVQ qualifications had improved. They have improved bathing facilities for people,by having various facilities for example walk in shower,baths with hoists and specialist bath. This ensures people have more choice. What the care home could do better: Staff should ensure they document in each persons care plan when personal tasks have been provided,for example when have been nails cleaned or cut or when people have been shaved. For the company to continue to support the manager through the registration process with Care Quality Commission to be the Registered Manager for the home and achieve some constancy with management and staffing. Key inspection report Care homes for older people Name: Address: Swallow Wood Care Home Wath Rd Mexborough South Yorkshire S64 9RQ     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: Janet McBride     Date: 0 3 1 1 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 24 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 24 Information about the care home Name of care home: Address: Swallow Wood Care Home Wath Rd Mexborough South Yorkshire S64 9RQ 01709571477 01709585505 swallowwood@schealthcare.co.uk www.southerncross.co.uk Trinity Care Ltd Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Type of registration: Number of places registered: care home 38 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category physical disability 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 with Nursing, Code N. 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 38 Physical Disability, Code PD, maximum number of places 38 Date of last inspection Brief description of the care home Swallow Wood Care home is registered to provide nursing and residential care and accommodation is registered with thirty-eight beds. The home was purpose built home and is part of the Southern Cross Healthcare group. The home is situated on the main Mexborough road within a residential area to the west of the town centre of Care Homes for Older People Page 4 of 24 Over 65 38 0 0 38 Brief description of the care home Mexborough, shops and amenities are close by. Accommodation is provided on two levels, the upper floor being serviced by a shaft lift, and there are several lounges situated around the home on both floors. Swallow Wood is set in enclosed gardens, comprising of shrubs, mature trees, lawn and patio area which has suitable access for people either on foot or in wheelchairs. Car parking spaces are available at the front of the home. Fees charged depending on residential or nursing care range from £398:72 to £610:00 as of November 2009. Additional charges are made for hairdressing, chiropody, optical, dental services, specialised toiletries, and magazines. For further information contact the home. Information about the service was available for people and their families in the Statement of Purpose and the Service User Guide. The home last published inspection report was on display on the homes notice board. Care Homes for Older People Page 5 of 24 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is Two Stars. This means that the people who use this service experience good quality outcomes. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations, but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. One inspector carried out this Key Unannounced Inspection, which took place on the 3rd November 2009 from 09:30 am to 16:30 pm. Prior to the inspection the home submitted an Annual Quality Assurance Assessment (AQAA) this gives information regarding the home and services provided. This document gives the service the opportunity to tell us what the home did well, what had improved and what they were Care Homes for Older People Page 6 of 24 working on to improve. Other pre-inspection work was carried out on the information received and other relevant documentation, for example analysis of statutory notifications and complaint records. During the inspection various aspects of the service were checked. Care practice were observed, documentation and records were examined, for example medication, complaints, accident records, staff rotas and staff training files. Three care plans were cross-referenced with other relevant documentation relating to those people who use the service, to evaluate how well their care needs were met. Information was gathered from as many different individuals as possible that had contact with people within the home, discussion with the manager and five members of staff. The majority of people living at the home were seen throughout the day and several were chatted to. Three people within the home were individual spoken to. They were asked to comment on the standard of care, staff skills, attitude, and how the needs of people using the service were met. The inspector wishes to thank people living in the home, the staff and the manager for their assistance and co-operation. Care Homes for Older People Page 7 of 24 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 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 8 of 24 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 24 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 within the home had been individually assessed prior to admission and they had been assured that the home could meet their needs. Evidence: The home offers nursing, residential and respite care. The manager confirmed that people and their families were provided with sufficient information before moving into the home. They also had the opportunity to visit before admission to assess the suitability of the home. Records showed that people who use the service were fully assessed prior to moving into the home, with other professionals involved if required. However these records did not record if people had the capacity to make independent choices. The scale of charges was discussed with the manager and any extras that people pay for, these are documented within this report. Care Homes for Older People Page 10 of 24 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. Care plans provided staff with the information they needed to meet the care needs of people that use the service, this ensured that peoples needs were identified and met. Staff ensured that all policies and practices were followed when medicines were administered. Evidence: Three care plans were checked and cross referenced with medication records, accident records and any other relevant information. These set out in detail healthcare, personal and social care needs in an individual plan of care. Lots of information was gathered from professionals and family. Various assessments had been completed for example nutrition and dietary needs were clearly recorded along with weight charts. Records showed that staff document what care was given on a daily basis and weekly progress reports completed, to ensure changing needs were identified. One issue was raised that staff did not always document when people had either nails cleaned and cut or men had been shaved. However on speaking to people and observing people in the home it was obvious that these tasks had been completed. Care Homes for Older People Page 11 of 24 Evidence: Medication policy and procedure were discussed with the manager, examination of records, storage, recording were found to be satisfactory. During this visit staff were seen interacting with people who use the service in a kind manner, they spent time talking to people and were observed knocking on bedroom doors before entering. Staff said all people were encouraged to make everyday choices, for example what to eat and what to wear. This promoted the choices and dignity of people living at the home. People said that staff listens and acted on what they said and all felt that staff supported them and care was excellent. Care Homes for Older People Page 12 of 24 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. Regular opportunities were available for people to participate in a wide range of activities in the home, and in the wider community. Meals offered were healthy and nutritionally balanced. Likes and dislikes were catered for within the menus offered,with a varied selection of food available to meet peoples tastes and choices. Evidence: Discussion with people receiving the services and the activities co-ordinator confirmed they enjoyed the activities available both in the home and trips out. Observation of people taking part in a quiz during the morning ,found the atmosphere very jolly with most people enjoying taking part. Later in the morning a church service took place,most people took part and were singing and enjoying the service. Discussion with one person who said they choose not to participate in most of the activities but enjoyed bingo. The activities organiser said she tries to encourage people to take part but everyone as a choice. She does do some one to one work with those people that dont like to participate in communal activities by either reading to them or just taking. The home have a number of reading books in large print and the library visits every three months. People said they were encouraged to keep in contact with family and friends living in the community, they visit local shops, garden centres and meals out to local venues. People were encouraged to make choices, about many aspects of Care Homes for Older People Page 13 of 24 Evidence: their daily lives, comments received were consistently positive for example, all said they enjoyed life in the home and that staff were always happy and kind to them. Information is provided for people and families on what happening within the home and how to contact various external agents for example, advocates, Age Concern, dementia groups and social services. Food and mealtimes were discussed with the cook who gave examples of food available and confirmed that people had access to food and drinks 24 hours a day. Menus were on display within the home and on tables at mealtimes. Observations during mealtimes, confirmed the food was well presented, lunch was unhurried and assistance was given to people if required. Dining tables were set with tablecloths, cutlery and menus in the middle of the tables. Staff served food from a hot trolley and people were offered seasoning and choice of drinks. Not all people were sat at dining tables, some people said they preferred to sit in lounge chairs with trays on tables in front of them. People made very positive comments about the food on offer at meal times they had enjoyed their meal and liked the food at the home and confirmed they had choices every day. Care Homes for Older People Page 14 of 24 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. The complaints procedure was accessible and displayed within the home. Policies and procedures in place on safeguarding vulnerable adults this promoted and protected the people who use the service. Evidence: The home had a written complaints procedure which was displayed in the reception area of the home. Records showed that five complaints had been received since the last inspection. These records showed that the company had an appropriate system for recording complaints for example detail of complaint,findings of any investigation any action taken and responding information to complainant. Views of people who were residing at the home said if they were unhappy they would talk to the manager. Policies and procedures were in place regarding the protection of vulnerable adults. These were discussed with the operations manager and the home manager and staff that were interviewed. Discussion with staff confirmed they were aware of safeguarding polices and procedures those spoken to were able to verbalize the action they would take on receiving any allegations. Training files confirmed most staff had received safeguarding training. The company are quite proactive in referring concerns to safeguarding at the present they have one outstanding issue regarding a complaint that may go to safeguarding team. Care Homes for Older People Page 15 of 24 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 who use the service live in a comfortable and accessible home which was clean and tidy and provided a well maintained environment. Evidence: A tour of the premises found the reception area of the home displayed the relevant insurance and registration certificate . The information board contained lots of valuable information for people and relatives including the menu for the day and activities that had been organised. a good choice of communal facilities were available both upstairs and downstairs. Since the last inspection the home have made one of the small lounges into a bar and games room for both the people who use the service and their relatives.This gives people a choice of sitting quietly, meeting family and friends in private or being with other people in the larger lounge. All communal areas were found to be clean and tidy and in good decorative order. The home had a selection of bathing facilities for example baths with hoists,one specialist bath and a walk in shower room. All of these are very accessible for people. Bedrooms seen were provided with furniture and furnishings in compliance with peoples needs and preference. Most had been personalised by the person using the service or their families,with their own personal possessions and memorabilia. The home had a number of different beds divans for some people and specialist beds for Care Homes for Older People Page 16 of 24 Evidence: people who need nursing care. Call system were in each bedroom, with cords left in easy reach of people. Laundry facilities remain the same, they had two washers and two dryers, the laundry room was well organised with plenty of clean linen available. Care Homes for Older People Page 17 of 24 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. All staff receive relevant training, which ensures they had the skills and knowledge to fulfill their roles within the home. Recruitment policies are followed this ensured people at the home were supported and protected. Evidence: Staffing was discussed with the companys operation manager and the homes manager and duty rota examined.Which clearly identified staff within the home and their role, including domestic kitchen and laundry staff. Observation on the day, talking to staff and examination of duty rotas demonstrated there were sufficient staff to meet the needs of people who use the service,with more staff being available at peak times of activity. The homes recruitment procedure was discussed with the administrator and records of four members staff files were checked. This established that the homes process for recruitment meets all the requirements of legislation and employment law. Two references, Criminal Record Bureau (CRB) Protection Of Vulnerable Adults (POVA) checks were made prior to being employed. All registered nurses have to re-register their pin numbers with the Nursing and Midwifery Council (NMC). All were found satisfactory. The system for these files were excellent they clearly defined the process to be followed and easy to check information. Care Homes for Older People Page 18 of 24 Evidence: Each member of staff had an individual training file, these were examined and training opportunities were discussed with the manager and five members staff. Staff confirmed they had received induction to the home. Training records showed that a number of staff had received updates and undertaken various training courses since the last inspection. Records indicated that a number of the staff team had achieved National Vocational Qualification level 2 and 3 in care (NVQ) with other members of staff continuing to work towards attaining either NVQ level 2 or 3 in care. Care Homes for Older People Page 19 of 24 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 who use the service were protected by sound management practices. Policies, procedures and training practices ensured that people using the service were safeguarded and protected. Evidence: Since the last inspection the homes has a new acting manager who had only been in post two weeks,the companys operations manager was also present during this visit. Discussion with the manager about her role and her own development, confirmed that she is a registered nurse with twenty years experience in working with the elderly. She confirmed she aware of the role and is responsible for the day to day running of the home and needs to go through the registration process with Care Quality Commission to be the Registered Manager for the home. Quality assurance systems were in place and the manager could evidence they monitor the quality of care and services within the home.The operations manager completes regular monthly visits which are evidenced in regulation 26 visits reports. Care Homes for Older People Page 20 of 24 Evidence: The company have sent out surveys to relatives in September 2009 the results of these surveys showed that most people were happy with the care and support at the home,any issues that had been raised were addressed. Supervision of staff was discussed with the manager, staff on duty and records checked, which confirmed staff received formal supervision on a regular basis. Discussion with the administrator and checking of records confirmed that peoples finances were recorded with receipts kept and audited on a weekly and monthly basis. Some people control their own finances, with the help of their families. There were policies and procedures, which promoted the health, safety and welfare of people within the home. Staff and the providers undertook all necessary health and safety checks. Maintenance and service records were documented in the AQAA, these were discussed with the manager who confirmed they were up to date with current certificates. The required Health and Safety policies and procedures and the relevant notices were displayed throughout the home. Care Homes for Older People Page 21 of 24 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 22 of 24 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 2 3 7 Assessments should record that people have the capacity to make independent choices. Staff should document in each persons care plan when personal tasks have been provided.E.G nails cleaned or cut or when people have been shaved. The manager should to go through the registration process with Care Quality Commission to be the Registered Manager for the home. 3 31 Care Homes for Older People Page 23 of 24 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.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) 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. 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