Care Home: York House Residential Care Home

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What the care home does well York House is a domestic style property and people commented that it had a very homely atmosphere. One visitor commented that a reason for choosing the home was that it had a good reputation and another that of the many care homes visited, it was the best in the area by far. People are cared for in a clean and comfortable environment and the home is decorated to a good standard. All people spoken with and surveys returned made positive comments about the care they received; comments included `Everyone looks after my needs very well`, `I very much like my room` and `There`s always someone to help with activities and I enjoy what we do`. The staff group is well trained and knowledgeable about the people living at the home and how they prefer to be cared for. The manager and senior staff work well as a team and there is a very stable staff group, enabling good knowledge of the needs of people. Emphasis is placed on staff training and there is an extensive training programme. People are encouraged to make choices about their daily lifestyles and individual likes and dislikes are catered for. What has improved since the last inspection? A recent extension has provided three en suite bedrooms and extra communal space for people. Menus have been updated with the help of residents and an activities organiser now works five days a week. All staff are now trained on safeguarding issues. A large training room now provides easy staff access to training. The staff induction booklet has been updated. The home has gained the Investors in People award for businesses. What the care home could do better: The service user guide should be in large print and should be in a style that is easy for older people with dementia or poor eyesight to read. Key inspection report Care homes for older people Name: Address: York House Residential Care Home Waterside Billinghay Lincoln LN4 4BU     The quality rating for this care home is:   three star excellent 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: Julie Western     Date: 2 8 0 9 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 22 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 22 Information about the care home Name of care home: Address: York House Residential Care Home Waterside Billinghay Lincoln LN4 4BU 01526860378 F/P01526860378 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mrs Linda Petruzziello care home 16 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of people who can be accommodated is 16 The registered person may provide the following categories 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, Dementia - Code DE Date of last inspection Brief description of the care home York House is a detached property, situated in the Fenland village of Billinghay, ten miles north east of the town of Sleaford and sixteen miles from both Boston and Lincoln. The village community incorporates shops, a GP surgery, a church and a library. Accommodation consists of twelve single and two shared rooms, on the first and ground floor. Three have en suite facilities. Access to the first floor is via a stair lift. There is a lounge, sun lounge and main dining room on the ground floor and a further Care Homes for Older People Page 4 of 22 16 0 Over 65 0 16 Brief description of the care home seating area. The home provides personal care for sixteen people over the age of 65. There was one vacancy on the day of inspection. The house stands in large, mature gardens with river frontage and is set well back from the main road. Access to the property is shared with another business but this does not present any difficulties to visitors. A small car parking area is available at the front of the property. The homes philosophy is to provide and maintain high standards of care for all residents, to ensure the environment is comfortable, friendly and therapeutic and to encourage the residents to develop their full potential within a safe, homely environment. Fees are from £360 to £446 per week. Hairdressing, newspapers, toiletries and chiropody are not included in the fees. The home does not advertise; referrals come from local Social Service departments and by personal recommendations. Care Homes for Older People Page 5 of 22 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: three star excellent 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 three star. This means the people who use this service experience excellent quality outcomes. This was an unannounced visit and it formed part of a key inspection, focusing on key standards, which have the potential to affect the health, safety and welfare of people who use the service. Throughout this report the terms we and us refer to The Care Quality Commission (CQC). The visit lasted approximately three and a half hours and we took into account previous information held by us including the previous inspection report, their service history and records of any incidents that we had been notified of since the last inspection. Before we made our visit the provider had returned the Annual Quality Assurance Assessment (AQAA). This gave us information about their own assessment of how well they are meeting standards and their plans to improve aspects of the service. We sent Care Homes for Older People Page 6 of 22 out surveys to people before we visited the service. The main method of collecting information during this visit is called case tracking, which includes following the care of a sample of three people through their records and assessing their care. We spoke with three people who use the service and saw rooms of those people who said we could. We also spoke with two visitors and to three staff members. The manager was present throughout the visit and the general outcomes of the visit were discussed with her and with the provider by telephone. Care Homes for Older People Page 7 of 22 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 22 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 22 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 who use this service have good information about the home in order to make an informed decision about whether the service is right for them. Evidence: We saw the statement of purpose which was very comprehensive and contained terms and conditions and contracts. The service user guide we saw contained useful information for people. Parts of it were not in large print and it was not in an easy style for older people or people with a dementia to read and understand. The manager said it was in the process of being rewritten. The manager said that she or a senior member of staff always visited prospective residents at home or in a care setting such as a hospital to undertake a full assessment of all their care needs. All stays were on a trial basis. Records we saw confirmed this. We saw written admission records that were clear and gave staff all the information they needed to meet the needs of people. A resident we spoke with described how he had visited for the day before he was sure she wanted to move in permanently. Relative told us that this home had been chosen Care Homes for Older People Page 10 of 22 Evidence: because it was the very best of the many services they saw. They said they were especially impressed with the support given to them by the manager and staff at a difficult time. A staff member described the admission process and the importance of making new residents and their families welcomed. Care Homes for Older People Page 11 of 22 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans are in good detail to ensure that the care needs of people can be easily met. Evidence: Care plans we saw contained good, clear information about the health and personal care needs of people. They were reviewed regularly and signed where possible by people or their relatives or advocates. We saw a medication policy that was clear and comprehensive. The pharmacist visited regularly, the last visit being on 20/10/2009 and no issues were identified. People received regular visits from district nurses and other professional agencies involved with their care. People we spoke with said they would not change where they lived because they were so well looked after. One said her son had moved away but she had remained at York House because the care was so good and relatives said the care given to their relative had exceeded their expectations. We saw staff carrying out their duties with kindness and sensitivity towards people, especially when attending to their personal needs. Care Homes for Older People Page 12 of 22 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. Social activities are regular and are tailored to suit the individual needs of residents. People have a choice of meals from a balanced and varied menu. Evidence: Care plans we saw showed that all people have an activities programme tailored to suit their needs and wishes. An activities organiser works from Monday to Friday and offers a programme of regular activities, including entertainers, needlecraft, reminiscence sessions, arts and crafts, memory games, exercises, church services and various board and card games. Some residents told us they preferred more personal pastimes such as crosswords, reading, jigsaw puzzles or conversation. On the day of the visit people were enjoying singing to music or talking with staff and the hairdresser was visiting. Details of forthcoming events were displayed in the entrance area. People we spoke with all said they had a choice of whether or not to take part. Some told us they preferred to sit in the quiet lounge or conservatory instead. People we spoke with all said they enjoyed the meals served and we saw the midday meal being served and eaten. Among comments made were that every bit of food was tasty, that you never went for anything and that they would always find you something you liked. Care Homes for Older People Page 13 of 22 Evidence: We saw the menu which was two weekly and was seasonal. People said they helped devise the menus, both at residents meeting and relatives meetings. Meals were varied, balanced and imaginative. The menu for the day was displayed on the dining room tables and offered alternative choices of meals. Sherry was available at lunchtime for those who wished. There was a large flip board menu with pictures of the meals served, for people who could not speak or make choices from memory. The cook, who has recently started work, has nutrition and food hygiene awards. She was knowledgeable about the nutritional needs of service users and described cooking for people on various diets. Care Homes for Older People Page 14 of 22 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 procedures for addressing complaints and for protection from abuse are clear. People and their families are confident that their comments and concerns will be listened to. Evidence: People we spoke with said they did not want to complain but knew how to make a complaint. The home had an up to date copy of the Local Authority adult protection procedures and staff members said they had read it. The training programme showed that there was a training course for all staff on POVA and safeguarding adults. Staff members spoken with knew what to do in the event of a serious concern and said they had received training. The manager said that residents and their families were regularly asked for their views regarding the running of the home. A resident said I am sure that if I had a complaint the manager would sort it out for me and visitors spoken with said that they were given information on how to make complaints. Comments from 5 returned survey forms confirmed this. There had been no complaints since the last inspection in 2006. The manager has devised a praise and complaints book for visitors and residents to make comments in. This had several comments of praise, particularly for the summer party, and no complaints. Care Homes for Older People Page 15 of 22 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 live in a comfortable and pleasant environment with both private and communal space that is generally suitable for their needs. Evidence: Overall, the standard of decoration internally was high and residents said they were comfortable in their surroundings. The gardens were well maintained and offered pleasant places for people to sit out in good weather. Staff described how any maintenance issues were addressed quickly by the maintenance personnel. Recent improvements included a new extension with three en suite bedrooms, a block paved drive area, a staff training room and office and a new sitting area for residents. There was a new roof for the whole building and some of the existing bedrooms had been redecorated. The wallpaper in the dining room was peeling and faded and the manager said this was the next room to be redecorated in the business plan. The business plan also included the refurbishing of two bathrooms, one to be turned into a wet room for people with wheelchairs to use. There were safety notices around the building to prevent the spread of infection and COSHH regulations were observed throughout. The most recent visit from the Environmental Health Officer found no issues of concern and the service had been awarded five stars, an excellent standard. Care Homes for Older People Page 16 of 22 Evidence: The building smelled clean and fresh throughout and there were many comments from visitors saying the standard of cleanliness and hygiene was excellent. Care Homes for Older People Page 17 of 22 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff numbers are in sufficient quantity and staff members are suitably trained, qualified and competent to meet the needs of people. Evidence: The staff rota we saw showed that there were enough staff members to care for people safely and people and staff we spoke with agreed. We spoke with staff members who described how they had an interview, gave three references and underwent CRB/POVA safeguarding checks and had induction before starting work. Staff records we saw confirmed this. We saw training records for staff and these showed that all but one member of staff have achieved the National Vocational Qualification [a nationally recognised qualification] at Level 2. We saw records showing that the training required by law has been undertaken, and other training has included dementia awareness and challenging behaviour. Staff we spoke with said that they could ask for any training they felt necessary and the manager would put on a suitable course for them. We saw that staff members all receive regular supervision and they confirmed this. There were also minutes of staff meetings, which staff members also confirmed. Care Homes for Older People Page 18 of 22 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed and the health, safety and welfare of people are promoted. Evidence: The registered manager has worked in the care profession for 26 years and has experience and qualifications to run the home successfully. People we spoke with all made positive comments about the way the manager ran the home, finding her approachable and supportive. There is a clearly written quality assurance procedure, with separate questionnaires given to people, their relatives,visitors and staff. The results are discussed with the owner and acted upon. Health and safety policies are well written and demonstrate a clear commitment to ensuring the wellbeing of people. Care Homes for Older People Page 19 of 22 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 20 of 22 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 1 The service user guide should be in large print and should be in a style that is easy for older people with dementia or poor eyesight to read. Care Homes for Older People Page 21 of 22 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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