Care Home: Windsor House - City of York Council

What the care home does well Health and personal care People were observed looking clean and well cared for, this was evident at breakfast time. Staff were interacting with people in a dignified manner. One care plan for a person with dementia was inspected, this contained an assessment from social services and a care plan and some risk assessments which staff in the home had completed. One risk assessment had been completed in February 2008 relating to aggression and violence, this had not be reviewed and no care plan had been formulated though staff confirmed this was an ongoing issue. The moving and handling risk assessment was partly completed in February 2008 but again no review had taken place and it ws unclear as to the equipment the person needed to assist with mobility. This care record had gaps in the general information and the weekly review had not identified the changing needs of this person. Currently no care plan audits take place. This would be beneficial to confirm if effective record keeping is in place and people are receiving the care they need. One issue was discussed regarding an incident that had occurred 8 days ago. No Regulation 37 notification form had been completed and sent to The Commission and the accident book was not detailed enough to give a complete picture of the incident. The medication system was briefly inspected. Medication is stored and administered correctly. Stock balances are in place and three medication charts confirmed this. The controlled drug register showed that staff sign when they administer and witness this type of medication been given. Staff need to ensure they write the dosage of medication (for example Temazepam 10mgs), and ensure all headings are completed. A medicaiton audit should take place to identify any areas for imnprovement and help demonstrate that people are receiving their medication. Complaints and protection The acting manager confirmed that no complaints are been dealt with at present. Training records showed that staff have completed safeguarding training. One member of staff discussed the action they would take if an allegation of abuse was made, this situation described related to a member of staff and a service user. However, it was evident that a safeguarding incident had previously occurred. This was recorded in the individual`s care plan concerned but no safeguarding referral had been made, as teh Regulation 37 notification had also not been completed neither social services or The Commission had beenmade aware of this. Once this member of staff was aware of their responsibilities a referral was made to City of York Council pertaining to this incident. The acting manager was not aware of the necessary action to take regarding safeguarding. Environment People live in a comfortable environment. Some staff have received infection control training and at breakfast time staff were observed wearing protective clothing. It was evident in the corridor area that there was a strong smell of urine. This needs to be dealt with appropraitely. Management and Administration In the past 12 months the home have had an acting manager and the registered manager is now overseeing the home. The acting manager has worked in the care sector for a number of years. However, his experience is not with older people with dementia care needs. Throughout the visit it was evident that his skills and knowledge in this area need to imporve if he is going to continue to manager the home. The quality assurance system was discussed and questionnaires are sent out to people using the service, their relatives and advocates. It would be beneficial if the care aspects of the service were audited on a regular basis. A training plan is in place and some people have recently had dementia care training and infection control and safeguarding training. It was evident that over 20 people have not received moving and handling or fire training since 2007. One person was October 2004, and whilst fire training was planned this person was not included in the next fire training (due shortly). The manager needs to highlight which people have not had training within a twelve month period and this should be in line with the City of York`s policies and procedures. What the care home could do better: As discussed above: Safeguarding Care plans Aspects of mandatory training Inspecting for better lives Random inspection report Care homes for older people Name: Address: Windsor House - City of York Council Windsor House 22 Ascot Way Acomb York North Yorkshire YO24 4QZ two star good service The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed inspection. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Jo Bell Date: Information about the care home Name of care home: Address: Windsor House - City of York Council Windsor House 22 Ascot Way Acomb York North Yorkshire YO24 4QZ 01904798004 01904786459 Mark.Fox@york.gov.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : City of York Council care home 31 Number of places (if applicable): Under 65 Over 65 15 13 dementia old age, not falling within any other category Conditions of registration: 0 0 The maximum number of service users who can be accommodated is 31. To provide personal care and accommodation for up to 5 service users from the age of 55 years and over in the category DE. 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 of the following age range: 65 years and over. Dementia - Code DE Date of last inspection Care Homes for Older People Page 2 of 8 Brief description of the care home Windsor House is a care home run by City of York Council and registered to provide a service for 31 older people of either gender aged over 65 years who may have dementia. The home was purpose-built approximately 35 years ago and is located in Acomb. It is within walking distance of local amenities. There are extensive wellmaintained gardens. The accommodation is provided in single rooms on two floors. The upper floor is accessible via passenger lift. Information regarding the service is available in the statement of purpose and through previous inspection reports. Care Homes for Older People Page 3 of 8 What we found: A random visit took place on Friday 23rd January 2009. This was to confirm whether the service continues to provide good outcomes for people. One inspector spent four hours at the home. During this time aspects of health and personal care, complaints and protection, the environment and management were inspected and discussed. It was evident that aspects of the service in the key areas had deteriorated. Requirements were made in each area. Feedback was given to the acting manager and the senior manager. What the care home does well: Health and personal care People were observed looking clean and well cared for, this was evident at breakfast time. Staff were interacting with people in a dignified manner. One care plan for a person with dementia was inspected, this contained an assessment from social services and a care plan and some risk assessments which staff in the home had completed. One risk assessment had been completed in February 2008 relating to aggression and violence, this had not be reviewed and no care plan had been formulated though staff confirmed this was an ongoing issue. The moving and handling risk assessment was partly completed in February 2008 but again no review had taken place and it ws unclear as to the equipment the person needed to assist with mobility. This care record had gaps in the general information and the weekly review had not identified the changing needs of this person. Currently no care plan audits take place. This would be beneficial to confirm if effective record keeping is in place and people are receiving the care they need. One issue was discussed regarding an incident that had occurred 8 days ago. No Regulation 37 notification form had been completed and sent to The Commission and the accident book was not detailed enough to give a complete picture of the incident. The medication system was briefly inspected. Medication is stored and administered correctly. Stock balances are in place and three medication charts confirmed this. The controlled drug register showed that staff sign when they administer and witness this type of medication been given. Staff need to ensure they write the dosage of medication (for example Temazepam 10mgs), and ensure all headings are completed. A medicaiton audit should take place to identify any areas for imnprovement and help demonstrate that people are receiving their medication. Complaints and protection The acting manager confirmed that no complaints are been dealt with at present. Training records showed that staff have completed safeguarding training. One member of staff discussed the action they would take if an allegation of abuse was made, this situation described related to a member of staff and a service user. However, it was evident that a safeguarding incident had previously occurred. This was recorded in the individuals care plan concerned but no safeguarding referral had been made, as teh Regulation 37 notification had also not been completed neither social services or The Care Homes for Older People Page 4 of 8 Commission had beenmade aware of this. Once this member of staff was aware of their responsibilities a referral was made to City of York Council pertaining to this incident. The acting manager was not aware of the necessary action to take regarding safeguarding. Environment People live in a comfortable environment. Some staff have received infection control training and at breakfast time staff were observed wearing protective clothing. It was evident in the corridor area that there was a strong smell of urine. This needs to be dealt with appropraitely. Management and Administration In the past 12 months the home have had an acting manager and the registered manager is now overseeing the home. The acting manager has worked in the care sector for a number of years. However, his experience is not with older people with dementia care needs. Throughout the visit it was evident that his skills and knowledge in this area need to imporve if he is going to continue to manager the home. The quality assurance system was discussed and questionnaires are sent out to people using the service, their relatives and advocates. It would be beneficial if the care aspects of the service were audited on a regular basis. A training plan is in place and some people have recently had dementia care training and infection control and safeguarding training. It was evident that over 20 people have not received moving and handling or fire training since 2007. One person was October 2004, and whilst fire training was planned this person was not included in the next fire training (due shortly). The manager needs to highlight which people have not had training within a twelve month period and this should be in line with the City of Yorks policies and procedures. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Older People Page 5 of 8 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These requirements were set at the last inspection. They may not have been looked at during this inspection, as a random inspection is short and focussed. The registered person must take the necessary action to comply with these requirements within the timescales set. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 6 of 8 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 1 18 37 Staff must ensure that CSCI 26/01/2009 are informed through Regulation 37 notifications of any allegationsof abuse. A safeguarding referral to the local authority must also be made. This will alert people and ensure the correct procedures are followed to protect people from harm. 2 38 18 Staff must be competent in 23/03/2009 moving and handling people. This will ensure people in the home are moved and handled safely. 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 7 26 Regular care plan auditing should take place. The smell of urine in the corrider should be removed, this will make the home more pleasant for people living there. Care Homes for Older People Page 7 of 8 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report CSCI General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. 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