Care Home: Yarborough House Care Home

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What the care home does well The people who live in the home said they were able to decide on their own daily routines. People enjoyed the food provided. Comments about the food included `the food is lovely`, `get different choices everyday` and `we have regular meetings and we are asked what we want on the menus`. The home provided a consistent staff group. Staff were trained to do their job safely and to give care to meet the needs of the people who live in the home. People who lived in the home were very complimentary about the staff. Comments included `staff are very good` and `they are great` and a visitor said `staff are lovely and kind and the communication is good`. People were provided with clear information about the services provided and the complaints procedure. The home had good systems in place to protect people from abuse and all the staff had received training in this area. The home was well maintained and very clean and tidy and there had been an ongoing programme of redecoration and improvement. People living in the home were encouraged to actively participate both in choosing the decor and assisting in the decoration. A sensory garden provided an attractive area for people. The management had consulted with the people who lived in the home and people who visited the home about the quality of the care provided and had acted on the information received. The management provided staff training and safety checks of equipment to protect the health and safety of staff and people who lived in the home. They had provided detailed assessments where people required assistance with moving and handling and they had provided equipment to assist in these tasks. What has improved since the last inspection? The homes assessment formats had been fully completed to ensure that all peoples needs were identified. Where people required care to maintain skin integrity and nutritional status care plans had been consistently developed. To provide evidence that complaints had been fully investigated records of investigations of complaints had been completed. What the care home could do better: Whilst there was some improvement in the frequency of supervison, to meet the standard the staff must receive formal supervision at least 6 times per year. Key inspection report Care homes for older people Name: Address: Yarborough House Care Home 34 Yarborough Road Grimsby North East Lincs DN34 4DG     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: Kate Emmerson     Date: 1 4 0 1 2 0 1 0 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 25 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) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 25 Information about the care home Name of care home: Address: Yarborough House Care Home 34 Yarborough Road Grimsby North East Lincs DN34 4DG 01472355791 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): info@jcareuk.com J Care (UK) Ltd Name of registered manager (if applicable) Mrs Marion Bourn Type of registration: Number of places registered: care home 27 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home The home is situated close to the centre of Grimsby and motorway links and it is well served by local bus routes. The accommodation is situated over two floors with passenger lift access to the first floor. The accommodation is provided in both single and double rooms. The home is comfortable and homely with a variety of communal areas. The fees at the home at the time of the inspection were £361 per week. 2 8 0 1 2 0 0 9 0 0 Over 65 5 27 Care Homes for Older People Page 4 of 25 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 inspection was unannounced and took place over one day in January 2010. To find out how the home was run and if the people who lived there were pleased with the care they got we spent time in the home watching how the care was given and speaking with the people who lived there. Surveys were also sent out and the Commission received a completed survey from one person who lived in the home. We spoke to the person who owned the home, the manager and staff working in the home at the time of the inspection. Visitors were also spoken with during the inspection. Paper work kept in the home was seen to check that staff recruitment checks had been completed and that they had been trained to their job safely. Records of care people had received were also checked. Care Homes for Older People Page 5 of 25 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. Care Homes for Older People Page 6 of 25 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 Care Homes for Older People Page 7 of 25 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 25 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 25 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. Assessments of peoples care needs were recorded prior to admission and the information was used to inform the care provided. Evidence: Three care files were examined. There was evidence that people were assessed with regard to their care needs prior to admission to the home. The home had obtained full assessments and care plans from the placing authorities and the manager had also assessed peoples needs using the homes assessment format. The homes assessments were detailed and included peoples preferences for care delivery. Detailed care plans were developed from the information gathered at assessment. Risks to peoples health, safety and welfare were also identified at assessment and action plans were implemented to minimise the risks. A relative stated that they had chosen the home after visiting many others in the area Care Homes for Older People Page 10 of 25 Evidence: as they liked the atmosphere in the home. Care Homes for Older People Page 11 of 25 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 needs were set out in an individual care plan and their health and personal care needs were being met. People felt they were treated with respect and their privacy was upheld. Medication was handled safely. Evidence: A random selection of care plans was examined. The home had completed a review of the care plan formats after the last inspection and had developed new formats to improve the care planning in the home. Most peoples information had been transferred onto this new format. The information recorded in the new care plans was very detailed. They included specific plans of care to reduce the risk of pressure sores and address poor nutritional intake and mobility issues. There was evidence of very good practice in moving and handling and pressure area care. This included some detailed moving and handling assessments and care plans which also included photos of staff in the hoist slings or using equipment to show the Care Homes for Older People Page 12 of 25 Evidence: correct techniques. The manager had worked with the tissue viability nurse to improve systems for pressure area care in the home. Staff had been provided with information booklets about pressure area care and these were held in some care plans where there was a risk of pressure damage. The providers had purchased a variety of equipment to assist in appropriate moving and handling including a portable overhead hoist, profile beds and a sheepskin sling to protect people with fragile skin. Evaluations of the care plans were completed regularly and care plans had been updated were necessary. The daily diary records and records of contact with District Nurses and GPs were recorded in detail and included the action taken to meet peoples health and care needs on a daily basis. The home had a detailed policy and procedure for the safe handling of medication. Records of receipt, administration and disposal of medication including controlled drugs were maintained. Staff had received training from Boots and had received a half-day training session in drug awareness. The manager stated that the staff had completed a sixteen week accredited course in safe handling of medication with the local college and certificates were held on file. Staff confirmed that they had completed this course. Care Homes for Older People Page 13 of 25 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. People confirmed that they were able to exercise choice and control in the home. People were provided with a varied nutritious diet and they enjoyed the food they received. Evidence: There was evidence from observation and discussion with people that the home was conducted to maximise autonomy and choice. Information with regard to advocacy services, data protection and access to records was displayed in the home. People living in the home confirmed that they were able to exercise choice in their daily routines and always had choices at meal times. The home employed an activities coordinator for sixteen hours per week. She had attended training related to the provision of activities with people with dementia. People had had their needs assessed in this area and records of individuals participation in events was recorded. There was emphasis on meeting peoples individual needs as well as group activities. Group outings were also arranged. Church Care Homes for Older People Page 14 of 25 Evidence: services were held in the home. People living in the home enjoyed the activities, comments included Sue is very good, she does quite a bit in the activities and I enjoy the trips out. There was a good choice of communal space in the home. Five very different spaces were available for people to use and one of the communal rooms had been developed into a dedicated area for activities. This meant that people could have a choice of activity, whether it be sitting quietly, watching television or arts and crafts. Visitors thought that the standard of care was good and the atmosphere in the home was welcoming. The home arranged regular social events at the home for visitors and relatives to join in with. A visitor to the home said I like that they do social things for the realtives to attend with their family. Another said visiting the home was was like going to visit their relative at their own home. It was noted that there was a very inclusive feel in the home. The people who live there had regular meetings about the running of the home and the home had developed a role for a service user representative. People living in the home had been involved in choosing the decor and some had assisted in the decorating which they enjoyed. A visitor said that they liked the way everyone was included and that people with dementia were not isolated. The home had a three-week rotating menu.There were always at least two choices available at meal times including a hot snack at teatime. People spoken with enjoyed the food and comments included the food is lovely, get different choices everyday and we have regular meetings and we are asked what we want on the menus. One person described how staff assisted their relative who has dementia they dont rush her at mealtimes, they put all the choices in front of her so she can pick what she wants. Staff said the food is excellent, always plenty of choice Care Homes for Older People Page 15 of 25 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. Complaints were taken seriously and people were provided with information on how to make a complaints. The policies and procedures, staff recruitment and staff training protect people from abuse. Evidence: The home had a detailed policy and procedure for the management of complaints and a copy of the procedure was provided in each bedroom in the service users guide. A copy of the procedure was also displayed on the notice board in the reception area. People who lived in the home and visitors stated that they knew how to make a complaint but were happy with the services and care at the home. The home had developed the role of service user representative to provide a further link between the people living in the home and the management. There had been no complaints recorded at the home or made to the Commission since the last inspection. To protect people living in the home from abuse the home had safe guarding policies and procedures in place and staff had received external training in safeguarding. Staff recruitment was robust and included checks on staff previous work history and criminal record. Care Homes for Older People Page 16 of 25 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 provided a clean, tidy and homely environment, which was suited to the needs of people living there. Evidence: The home is well situated close to the center of Grimsby and is on local bus routes. The home and gardens were accessible to people who lived in the home. The home has a sensory garden with raised beds and seating. Additional work had been completed including new fencing which had made this area more secure. The home had taken advice to improve the environment for people with dementia and had implemented this. Internally the home was undergoing a continuous programme of redecoration and improvement. The corridors and lounges had been redecorated since the last inspection as well as some bedrooms. One lounge had been refitted to make it more suitable for the provision of activities. The people who lived in the home had been involved in the decision making processes about the decoration and had helped out with decorating where they were able. They said they had enjoyed this activity. The home was very clean and tidy and free from offensive odours and it provided a very homely feel. Care Homes for Older People Page 17 of 25 Evidence: The home had a selection of bathing options over the two floors, which were appropriate to peoples needs. They had a wet room so that people could access an assisted shower. There were a number of communal rooms, which were well decorated and domestic in character. One room was designated as a quiet area and another was used for activities. The dining room was spacious and well furnished. The conservatory was a very pleasant area for the people who lived there to use and take advantage of the views of the sensory garden. The bedrooms had been personalised and lockable storage was provided. The home provided specialist equipment to assist people with poor mobility such as an overhead hoist and profile beds. There were systems in place to prevent the spread of infection in the home and staff confirmed that they had all the equipment they required to assist this process. Care Homes for Older People Page 18 of 25 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 were protected and their needs met by the numbers of staff provided. Checks for safe recruitment had been completed prior to employment. Staff were trained for their role. Evidence: The homes staffing levels was assessed regularly under the Department of Health guidance from the Residential Forum and staffing was implemented to meet the guidance and the needs of people accommodated. People who lived in the home were very complimentary about the staff. Comments included staff are very good and they are great and a visitor said staff are lovely and kind and the communication is good. Two staff files were checked. Employment had commenced following receipt of the full CRB (Criminal Records Bureau) check and a POVA first check (Protection of Vulnerable Adults). Proof of identity and references had been obtained and photos were held. The manager stated that induction training was provided to skills for care standards and there was evidence staff completed the skills for care workbooks. The manager stated the staff kept the workbooks and there was evidence that completion of workbooks was monitored. There were also certificates to indicate that new staff had Care Homes for Older People Page 19 of 25 Evidence: completed training in areas such as moving and handling and fire safety and safeguarding vulnerable adults. There was a training plan in place and records of training provided were maintained. Staff had received mandatory and service specific training including challenging behaviour and dementia. Refresher training had also been provided in areas requiring annual updates. Information provided to the Commission prior to the inspection stated that all of the thirteen care staff had achieved NVQ 2. The manager had achieved NVQ 4. Care Homes for Older People Page 20 of 25 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. An experienced registered manager ran the home. The home was run in the best interests of the people living in the home and the management was proactive in ensuring that peoples health, safety and welfare were protected. Staff supervision had improved and staff felt more supported. Evidence: The manager Marion Bourne had commenced work as acting manager at the home on 20 February 2006. Marion is experienced in the care field and has previously been a registered manager of a care home. She stated she had achieved NVQ 4. The manager completed the registration process and as from 31 May 2009 has become the registered manager. The provider was keen to improve the home and the service provided and had purchased a quality monitoring tool to assist this process. The home regularly consulted with people about all aspects of the service provided through regular meetings. Since the last inspection They had developed the role for a person living in Care Homes for Older People Page 21 of 25 Evidence: the home to be the service user representative to further encourage communication and consultation. People who lived in the home, staff and visitors had been surveyed about the quality of the care in the home and results were being collated. Surveys received by the home in January 2010 showed high levels of satisfaction. They published the results of the surveys on an annual basis and a copy of 2009 results had been provided to the Commission. The home had policies and procedures to support most areas of practice and the provider was proactive at improving these, reviewing and updating as required. There were very positive comments about the quality of the care received from both the people who lived there and relatives. Comments included I am very happy here, the activities outings and care are very good and excellent home. Some people were assisted with their finances. Clear records were maintained and receipts were held for purchases on behalf of people. Records had been regularly audited. Staff had had appraisals and more regular staff supervision since the last inspection although six sessions of supervision as required by the standard had not quite been achieved. The staff spoken with all commented that staff morale had greatly improved since the last inspection and they now felt more supported. They stated that staff were now working as a team. There had been low staff turnover since the last inspection and this ensured consistency for the people living in the home. The management was proactive in ensuring the health and safety of people by making sure that all the equipment was serviced and maintained at appropriate intervals. The staff had received mandatory training including moving and handling and fire safety. Detailed fire and environmental risk assessments had been completed and were regularly evaluated to ensure they were up to date. Fire records were maintained and showed that checks had been completed at appropriate intervals. Individual moving and handling assessments had been completed and equipment such as an overhead hoist had been purchased to assist in these tasks. Detailed care plans including photographs indicating the correct use of equipment were in place to support safe practice. Records of accidents were maintained and these were audited regularly. Care Homes for Older People Page 22 of 25 Are there any outstanding requirements from the last inspection? Yes R No £ 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 1 36 18 The staff must be receive formal supervision at least 6 times per year. To ensure that staff are appropriately supervised in their role and to address staff unrest. 30/06/2009 Care Homes for Older People Page 23 of 25 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 36 18 The staff must receive formal supervision at least six times per year. To ensure that staff are appropriately supervised in their role. 31/05/2010 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 9 Hand transcribed medication records should be dated and signed by the person making the entry. The entry should also be checked and signed by a witness. This is to minimise the risk of errors. Care Homes for Older People Page 24 of 25 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. 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. Care Homes for Older People Page 25 of 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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