Care Home: Yanwath Care Home

What the care home does well Yanwath had good arrangements in place for admitting new people to the home. There was a detailed assessment process, which helped staff to know about the persons needs and wishes before they arrived in the home. Staff spent time and effort in helping new people to settle in quickly, and in getting to know their families. People said, "We were shown around and it was explained what would happen if problems occurred", and "We chose this home specially and are very pleased with the home and the care given". The delivery of personal and health care was good, staff had a good knowledge and understanding of people`s individual needs. People were treated as individuals and given dignity and respect. Staff worked closely with external health professionals to get people the advice and support they needed. One person told us, "My relatives progress in Yanwath has been overwhelming, she is very content and feels secure". The service employs three social care staff who provide a good range of activities and occupation, both on an individual and group basis. There were regular acts of worship and visiting entertainers, which people enjoyed. There was a varied menu, which takes account of people`s preferences and accommodates any special dietary needs. People were encouraged to eat and given support in a sensitive way. This is what people we spoke to thought, "There are entertainers every month, singing, crafts and outings". "We know we can visit any time, we are always asked if we need a drink and have had many meals over the years". The staff team hold a good mix of skills and qualifications and worked well together to provide the right level of care and support to each person. There was good training provided for all levels of staff, and care staff were supported to achieve National Vocational Qualifications in care. Recruitment procedures were thorough to ensure any new staff were suitable to work with vulnerable people. Staff felt well supported and told us they enjoyed their work. The home was clean and comfortable and provided a friendly and safe environment for people. The company invested in ongoing decoration and repairs to keep up the standard of accommodation. One person said, "Cleaning appears to be going on at every visit that I have made, so staff do their best to keep the home clean and tidy". The service was well managed, and people felt safe and protected. Families had confidence in the manager and felt he listened to what they said, and addressed any worries or concerns promptly. The manager undertakes a number of regular quality checks to ensure the service is running to the standards expected. What has improved since the last inspection? Since the last inspection staff have continued to work on improving the care plans and risk assessments, to make sure they are up to date and give a true reflection of people`s current care needs. Nurse have been given dedicated time to do this, and the manager has been checking a number of care plans each month to make sure they are up to standard. We found care plans and risk assessments to be detailed, up to date and accurate.Accuracy and safety in managing people`s medicines had also improved, through the use of regular quality checks and audits. Additional medicines guidance materials had been provided for staff, and the medicines policy had been updated. A pain assessment tool for use with people with impaired communication had been introduced. This helps staff to recognise and treat people who are in pain or feeling unwell, but cannot say so. Social care staff were making `life story boards` with people, to help them to celebrate and remember special memories and achievements. Menus had been updated to take people`s wishes into account, and these new menus had been put on display. Redecoration had continued throughout the home. Some new beds, seat covers and a new stair carpet had been purchased. Training records had been improved, so it was easier for the manager to keep a check on what training had taken place and what was due. Staff supervision was taking place more regularly and this was feeding into the training plan. There was a new staff handbook, and monthly `briefings` to keep staff up to date with any changes. The manager had implemented a number of new quality checks and an `action plan` for the service, which have helped to improve the overall quality of the service for people living in the home. What the care home could do better: There were no requirements or recommendations made as a result of this inspection. We judged the manager and staff were providing a good service to people. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Yanwath Care Home Yanwath Care Home Yanwath Penrith Cumbria CA10 2LF     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Jenny Donnelly     Date: 1 0 0 2 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Yanwath Care Home Yanwath Care Home Yanwath Penrith Cumbria CA10 2LF 01768862835 01768899678 a.shewan@virgin.net Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Hemingway Group Limited Name of registered manager (if applicable) Mr Andrew Phillip Shewan Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia Additional conditions: The registered person may provide the following category/ies 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: Dementia - Code DE The maximum number of service users who can be accommodated is: 49 Date of last inspection Brief description of the care home The Hemingway Group Limited own Yanwath Care Home. Mr Andrew Shewan is the registered manager. The home offers nursing care for older people with dementia. The home was purpose built. It had two floors occupied by residents, and there was a passenger lift. The third floor was used for storage and staff rooms. The home had a majority of single bedrooms with en-suite facilities. There were bathrooms with adapted bathing facilities, and several lounges/dining rooms for shared use. There was a large secure garden at the back of the home, with free access out from Care Homes for Older People Page 4 of 27 49 Over 65 0 care home 49 Brief description of the care home one of the lounges. The remainder of the home was secure, with keypad locks on exit doors. The weekly fees at the time of this inspection ranged from £449.00 to £479.00 plus any registered nursing care contribution entitlement from the primary care trust. Information about the home can be gained from the manager along with copies of the latest inspection report. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This was the key inspection of this service for the year. Jenny Donnelly, inspector, made an unannounced visit to the service between the hours of 09.30 and 16.15 on the 10th February 2009. During this visit we (the commission for social care inspection) toured the building, spoke with people who live in the home, staff and the manager. We looked at care, staffing and management records. We saw how people were spending their day and joined them for lunch. Prior to our visit the manager had completed and returned an Annual Quality Assessment Audit (AQAA) that we had requested. The AQAA is a self assessment document that focuses on how well outcomes are being met for people using the service. It also gave us some numerical information. We sent surveys to people living Care Homes for Older People Page 6 of 27 in the home and received a good number of responses from relatives giving us their views of the service. The information received is included in this report. People living at Yanwath suffer from advanced dementia, and are mostly unable to tell us about their experiences. Because of this we spent time watching what went on in the home, seeing how people spent their day and how well staff worked with people. We also spoke with a number of visitors. What the care home does well: What has improved since the last inspection? Since the last inspection staff have continued to work on improving the care plans and risk assessments, to make sure they are up to date and give a true reflection of peoples current care needs. Nurse have been given dedicated time to do this, and the manager has been checking a number of care plans each month to make sure they are up to standard. We found care plans and risk assessments to be detailed, up to date and accurate. Care Homes for Older People Page 8 of 27 Accuracy and safety in managing peoples medicines had also improved, through the use of regular quality checks and audits. Additional medicines guidance materials had been provided for staff, and the medicines policy had been updated. A pain assessment tool for use with people with impaired communication had been introduced. This helps staff to recognise and treat people who are in pain or feeling unwell, but cannot say so. Social care staff were making life story boards with people, to help them to celebrate and remember special memories and achievements. Menus had been updated to take peoples wishes into account, and these new menus had been put on display. Redecoration had continued throughout the home. Some new beds, seat covers and a new stair carpet had been purchased. Training records had been improved, so it was easier for the manager to keep a check on what training had taken place and what was due. Staff supervision was taking place more regularly and this was feeding into the training plan. There was a new staff handbook, and monthly briefings to keep staff up to date with any changes. The manager had implemented a number of new quality checks and an action plan for the service, which have helped to improve the overall quality of the service for people living in the home. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 27 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 27 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. Admission procedures were thorough and enabled staff to be prepared for new people and to help them settle in quickly. Evidence: The admission arrangements for new people to be admitted to the care home were thorough and included a comprehensive assessment of peoples health, personal and social care needs. We looked at the records of a person quite new to the service and saw that an initial enquiry form had been completed as well as a detailed assessment of the persons needs. The assessment had taken into account information from any external professionals involved with the persons care, and their family. This information had been used to develop an initial care plan. This helped staff to know essential information about the person and get the right equipment in place, before they arrived in the home. Care Homes for Older People Page 11 of 27 Evidence: During the inspection we saw the manager showing a prospective residents family around the home, and noted that the manager showed them all areas of the home, including the bathrooms and introduced them to staff and other residents. People we spoke with, and the surveys we received, told us, We were shown around and it was explained what would happen if problems occurred, and We chose this home specially and are very pleased with the home and the care given. The service does not provide intermediate care. Care Homes for Older People Page 12 of 27 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. People received good quality personal and health care in a way that was acceptable to them and benefited their well being. Evidence: Further to previous inspection requirements, the manager and staff had continued to work to improve the quality of care plans, risk assessments and health care records. Nursing staff had been given dedicated office time for working on care plans, which had helped improve standards in this area. We looked in detail at the records of four people, based on different floors of the home and with very different care needs. We found the care plans were detailed, up to date and written in a person centred way to address the needs of each individual. The care plans included good detail on peoples social history, including their interests and achievements in life. There was clear information on what level of personal, health and behavioural support people needed, and guidance for staff on how this support was to be offered. Where people were resistant to care, there were specific plans as to Care Homes for Older People Page 13 of 27 Evidence: what would help to calm the person and the best approach for staff to take to engage with them. Likewise there was information for staff on how not to approach a person, if there were known actions or words that would upset people. We saw that staff treated people with respect and dignity. We saw evidence that people had good access to general and specialist health care services including the doctor, dentist, optician, psychiatrist and the community mental health team. There were good arrangements for staff to meet peoples physical health care needs including short term problems, such as coughs and colds. Where people had wounds or other skin problems, there were detailed treatment plans in place, and monitoring records showed that healing was taking place, or treatments had been reviewed. Those people who needed it, had pressure reducing mattresses and specialist nursing beds. Nursing staff were involved in some project work, monitoring blood pressure fluctuations in people on certain types of medication. They had also developed pain assessment tool for people with impaired communication. We were pleased to this kind of innovation in place. We saw that people looked well cared for and visitors told us, My relatives progress in Yanwath has been overwhelming, she is very content and feels secure, and We are very satisfied with the care here. We looked at the management of medicines on both floors of the home and again, found improvements in the accuracy of record keeping. The manager had updated the homes medicine policy and purchased new medicine reference guides for staff, and had implemented daily checks of medicine records. The supplying pharmacist had visited the home recently and carried out a full audit, which highlighted some issues for them as suppliers to address, and gave some advice to the manager. We saw that this advice had been shared with staff and put into practice. We followed an audit trail of the medicines for the people whose care records we looked at, and found all medicines to be properly accounted for. We saw that periodic medicines were correctly recorded and medicines due at intervals were being properly managed. There was a homely remedy policy in place, which enabled staff to give people simple remedies for things such as mild pain or colds, without having to wait and see the doctor. There was a policy of minimal use of sedating drugs. This benefits people by reducing risk from inappropriate use of these medicines that can cause drowsiness and increased falls. The manager was in the process of arranging some accredited medicines training for staff. Care Homes for Older People Page 14 of 27 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There was a very good range of suitable activities and occupation for people, based on what they wanted and were able to do, and the provision of meals was also very good and suited peoples needs and choices. Evidence: Yanwath employs three social care staff to provide people with a variety of activities and entertainment. Two of these staff were on duty when we visited, and we were able to talk with them about the activities on offer and look at the records of these. There was an activity plan on display for the month of February which listed coffee mornings, lunch clubs, exercise sessions based on using all five senses, nail care, massage and conversation. There was always one visiting entertainer, and one religious event each month. We observed a visiting entertainer running a sing a long and playing the harp for a group of about 16 people who were joining in and thoroughly enjoying the event. There were regular outings either for individual people, or small groups. There were records of each persons involvement in the activities, and by doing this, the staff could make sure no-one was being missed out. A new project was being undertaken to make up a life story board with each person, and their family, to mark significant memories. We saw a completed one of these, and could see how effective it would be Care Homes for Older People Page 15 of 27 Evidence: as a conversation prompt for people. Two of the social care staff were due to attend a two day training course on creative activities for older people that week, and hoped to further increase their range of ideas from that. One of the care staff was also completing some research on activities for people with impairments. Through this many of the residents had been re-assessed to confirm their interests, hobbies and abilities, so activities could be individually suited to them. This was a piece of work in progress and needs to be tied in with the work being done by the social care staff. We received good feedback about social care both from the visitors we spoke with and from the completed surveys. People said, We had a brilliant Christmas party which was wonderful, with music and a buffet, and There are entertainers every month, singing, crafts and outings. Visitors also told us they were made very welcome in the home. One person said, We know we can visit any time, we are always asked if we need a drink and have had many meals over the years. Another told us, We are made welcome by the staff. Since the last inspection, menus had been revised and were now put on display for people to see. We observed lunch being served, and saw that people were offered choices, given the help they needed, and encouraged to eat. One visitor told us they came every day, by choice, as they liked to help their relative eat and it helped to occupy their visiting time. We joined four ladies who were having a lunch group, separate from the main dining room, which encouraged them to engage in conversation. We spoke with the chef and confirmed that people with special dietary needs were being catered for and peoples choices were being taken into account. Nutritional assessments were carried out and there was evidence that staff monitored peoples weight regularly and took advice from the dietitian as needed. Care Homes for Older People Page 16 of 27 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 knew how to complain if they needed to, and felt they would be fully listened to and their concerns acted on. Staff were aware of their responsibilities to keep people safe from harm and knew how to report any concerns they may have through the proper channels. Evidence: Yanwath had a complaints procedure which visitors told us they were aware of. Everyone we spoke with, visitors and staff, told us they would feel quite happy to approach the manager with any concerns, saying He is very approachable, and The manager is very good, he always keeps us well informed. One person wrote, My relative is looked after through the day and night very well, I have never had cause to complain. We looked at the complaint log and saw that the manager had investigated one complaint from a relative since the last inspection, regarding the state of a bedroom when they visited. There were notes from the meeting that was held and evidence that the situation had been resolved satisfactorily. The service had continued to receive anonymous letters, complaining about employment practices. We saw that the provider had responded to these by writing to each staff member to remind them of the independent consultant available to them for confidential advice and assistance. We judged the provider had responded positively and openly and provided staff with Care Homes for Older People Page 17 of 27 Evidence: proper channels through which to pursue any grievances. Staff told us they were quite happy working in the home, and felt morale was good. Staff had previously received training in safeguarding vulnerable people from harm, and there were polices and procedures in place to guide staff in what to do in the event of any allegation being made. There was also information and training for staff on the Mental Capacity Act and three staff were undertaking Deprivation of Liberty Safeguarding training. The manager had planned safeguarding refresher training for March. The manager had correctly made one safeguarding referral to adult social care in respect of protecting a persons finances. The social work team leader confirmed they were looking into to this. Care Homes for Older People Page 18 of 27 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. Yanwath provides a clean, comfortable and safe home for people with dementia to live in. Evidence: Yanwath is a purpose built care home with two levels used to provide accommodation, and a partial third level providing staff rooms and office space. There is a passenger lift and other adaptations to help people with mobility problems. The home is secure, with external doors on key pad locks to control exit and entry. Visitors gain entry by ringing the door bell. There is open access from one of the lounges to an enclosed garden with patios and seating. There is car parking to the rear of the building. There are several comfortable lounges, and dining areas on both floors of the home, and a large foyer which is used for entertainment. There are three assisted bathrooms, two shower rooms and plenty of spacious toilets situated around the building. People have access to specialist equipment as needed, including nursing beds, pressure reducing mattresses and hoists. The service has purchased some new beds, including hi-low beds, which lower fully to the floor, and are safe for people who fall out of bed, but mean staff can raise the bed to provide personal care at a comfortable height. Care Homes for Older People Page 19 of 27 Evidence: Bedrooms have en suite toilets and hand basins, and most had been personalised for the people occupying them. There had been a lot of redecorating over the last two years and some replacement of furnishings and fabrics. New dining chair covers had been provided and a new stair carpet. Work had been done to repair wheelchair damage to corridors and doorways. The manager had used colour to differentiate between different areas of the home to help orientate people, and had taken into account current good practice thinking on dementia friendly environments, such as avoiding wildly patterned carpets, which some people find disturbing to walk on. The laundry is quite small, but well organised and people were seen wearing nicely laundered clothes. Despite having one vacancy for a domestic, the home was clean and fresh throughout. The provider had invested in a new laundry system and a room sanitising machine. Along with the provision of additional opening windows, bad smells had been reduced. Domestic staff worked to a set cleaning schedule but attended to emergency spills as needed. People told us, Cleaning appears to be going on at every visit that I have made, so staff do their best to keep the home clean and tidy, and Staff make a strong effort to keep the home fresh and clean. Another person stated The laundry service is very good, we have never lost anything. Care Homes for Older People Page 20 of 27 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. People are cared for by a competent and caring group of staff, who have been thoroughly vetted and are supported to do their jobs well. Evidence: At the time of our inspection there were 40 people living in the care home. Staffing levels comprised of 2 registered nurses and 6 care staff on duty throughout the day, and 1 nurse and 3 carers on duty at night. There were also 2 social care staff, 2 kitchen staff, 2 domestics, the administrator and the registered manager on site. There was a part time maintenance person. We judged that staffing levels were appropriate to meet peoples needs. The manager was supported by two clinical team leaders who each ran one floor of the home, and who would deputise for the manager as needed. The service employed a mix of general and mental health registered nurses. One new carer was in the process of being appointed and the manager had advertised for a temporary domestic, otherwise the home had a full compliment of staff, and was not using any agency staff. We looked at recruitment procedures for staff and saw that all necessary pre-employment checks, including written references and criminal records bureau checks had been completed. The administrator was in the process of setting up new employment check lists for easier monitoring of the recruitment Care Homes for Older People Page 21 of 27 Evidence: process. The manager had drawn up a training plan for staff and the administrator was pulling together a matrix of all training completed. We also saw some individual staff training records. From this we judged that the manager was providing a good level of suitable training for staff to help them to their jobs well. There had been formal training on, English language, fire safety, safe moving and handling, safe use of chemicals, dementia awareness, the mental capacity act and blood taking. Forthcoming training included deprivation of liberty safeguarding, skin care and medicines. The two clinical team leaders, had also been running small tutorial groups with staff on subjects relevant to peoples needs. These included blood pressure recording, blood sugar testing and thyroid conditions. Care staff were supported to gain National Vocational Qualifications in care, and 67 of care staff had done so, which is very good. New staff handbooks had been provided, and the manager had introduced a monthly briefing paper, which told staff about any changes or new information. These were followed up by team meetings where staff could discuss the briefing in more detail. Staff said they liked this system, as they had some thinking time before meetings to prepare any questions they may have. We received many positive comments about the staff team, with people telling us, We cant praise the staff enough for their care and dedication, Staff have a lot of time for my relative, The staff are very good, we have every confidence in them and, The staff deserve medals. Staff we spoke with told us the atmosphere in the home was really good, there was fantastic morale, and I am very positive about the home, the management and the quality of service we offer. Care Homes for Older People Page 22 of 27 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 care home is being well managed so that it is run in the best interests of the people who live there. Evidence: The registered manager Mr Andrew Shewan is suitably qualified and experienced to run the care home. He is a registered general, and registered mental health nurse. He is supported by two clinical team leaders, one a general nurse, and one a mental health nurse. A representative of the Hemingway Group, who operate Yanwath, visits the home for two days each month. This person provides support to the manager and staff and undertakes some quality monitoring checks. At our last inspection we made two good practice recommendation about staff supervision and quality monitoring, which the manager had addressed. Since the last inspection, the manager has continued to work on carrying out quality assurance checks, to ensure that good standards are maintained in the home at all Care Homes for Older People Page 23 of 27 Evidence: times. He has introduced a daily check of medicine administration records, to ensure there are no omissions or mistakes. A number of care plans are checked each month, to ensure they are fully complete and have been kept up to date in line with peoples changing needs. There were also checks on the standard of cleaning and the upkeep of peoples bedrooms and their belongings. Any shortfalls found were highlighted to the appropriate staff, and the manager re-checked that the necessary improvements had been made. This attention to detail has helped to improve the overall quality of the service since our last inspection. A survey of residents/relatives was carried out in November and December 2008. The survey covered all aspects of the service and the responses we saw were very positive. Where suggestions had been made, the manager had included these items in his action plan. Changes made as a result of the surveys included the four week menus being put on display, and a photograph board of staff being made up. We saw evidence that some staff supervision had taken place, and the records of this showed supervision included discussions about care practices as well as training and development needs, which were added to the managers action plan. The manager held money on behalf of some people for safekeeping. We saw the records of this were regularly audited, and receipts for all spending kept on file. The actual money was securely held, in separate named wallets. We checked the records and money held for two people and these were correct. We saw the maintenance records for fire safety checks, water temperature checks and equipment servicing. We judged that there were good arrangements in the home to protect the health, safety and wellbeing of service users and staff. People told us, The manager is always available if you feel the need to discuss anything. Care Homes for Older People Page 24 of 27 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 25 of 27 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 Care Homes for Older People Page 26 of 27 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. 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