Care Home: York Lea

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What the care home does well Thorough pre-admission assessments are undertaken before a person moves into York Lea. This ensures that their needs will be met and that the home will be a good place for them to live. Management and staff treat people as individuals and respect their rights to make choices and decisions and to lead their lives in a private and dignified manner. Care plans were informative and clearly set out what tasks staff must undertake to meet each persons needs. The care records we examined had been reviewed regularly and amended where necessary. A tissue viability nurse told us that, `people living in York Lea get better due to the diligence of staff`. Staff are regarded highly by people using this service. One person described staff as `kind and caring` and a visitor said, `staff are absolutely marvellous`. Staff told us that they receive good support from the management and that they have good training and development opportunities. This enables staff to develop the skills and knowledge to meet the assessed needs of people using the service. The manager and staff placed a high priority on health and safety within the home. Risks had been appropriately assessed and were being managed well. Similarly, robust procedures were in place to deal with concerns and complaints and to ensure that people were safe from harm. People living in the home benefit from a pleasant, comfortable and well-maintained environment. A range of equipment is provided to meet individual`s assessed needs and staff have received training to use the equipment safely. The views of people using this service are listened to and this information is used to continually make improvements to the service they receive. This provided evidence that York Lea is managed in the best interests of the people who live there. What has improved since the last inspection? Significant improvements had been made to the way information was being recorded to provide evidence that a person-centred approach was being taken to meeting people`s needs. This meant that care plans contained detailed information about a person`s life history, their interests and choices and preferences for how they would like their care to be provided. Risk assessments contained good guidance for staff on the action they must take to keep people safe from harm. Diary notes provided evidence that risks were being managed well. What the care home could do better: The standards assessed during our visit had been met. We did not make any requirements or recommendations for improvement. Key inspection report Care homes for older people Name: Address: York Lea 15/17 York Road Chorlton Manchester M21 9HP     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: Val Bell     Date: 2 7 0 8 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 24 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 24 Information about the care home Name of care home: Address: York Lea 15/17 York Road Chorlton Manchester M21 9HP 01618629338 01618605815 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Yorklea Limited care home 37 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category physical disability Additional conditions: An experienced RGN trained nurse must undertake all recruitment of qualified nurses. Nursing or personal care may be provided for a maximum of 37 service users of either sex. Registration is subject to compliance with the minimum staffing levels indicated in the Notice previously served in accordance with Section 25(3) of the Registered Homes Act 1984 and dated July 2001. Staffing for service users assessed as requiring personal care only must comply at all times with the minimum levels set out in the Residential Forum Guidelines for Staffing in Care Homes for Older People. The manager must be supported at all times by an experienced RGN trained nurse . Two named service users require nursing care by reason of physical disability. If these service users no longer reside at the home or their primary reason for requiring care changes, these places will revert to the OP category. Date of last inspection Care Homes for Older People Page 4 of 24 Over 65 35 0 0 2 Brief description of the care home Yorklea Nursing Home is registered to provide accommodation for up to 37 older people assessed as requiring nursing or personal care. The home is owned by Yorklea Limited. The Responsible Individual is Ms Helen Claffey. The home is located in the Chorlton area of Manchester. It is close to local facilities, bus routes and the City Centre. There is parking to the rear of the building. The home is a large detached house that has been converted and refurbished from 2 original Victorian dwellings. Accommodation for the people using the service is provided on four floors, served by a passenger lift and the home is accessible to people who use a wheelchair. An extension to the property provides a conservatory style lounge, four single bedrooms with en-suite facilities, a clinical room, walk in shower room and five existing bedrooms include en-suite facilities. The homes redecoration and renewal programme is ongoing. The number of registered places and conditions of registration has remained unchanged as some existing double rooms are being used as single rooms. The current fees for accommodation and care can be obtained by contacting the manager at the home. There are additional charges for chiropody, newspapers, hairdressing toiletries and outings. Care Homes for Older People Page 5 of 24 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: 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: This was a key inspection, which included a visit to the home. Our visit was unannounced, which means that the manager was not informed that we were coming to inspect. During the visit we spent time talking to people living in the home, a visiting relative, a visiting health care professional, the manager, the clinical nurse manager and staff on duty. Prior to our visit the manager had sent us an Annual Quality Assurance Assessment (AQAA) This document is a self-assessment of how well the manager and staff consider the home to be operating. We also received seven surveys completed by staff working in the home. We looked round all areas of the home to assess health and safety, hygiene, cleanliness, maintenance and the facilities provided. We also examined various documents for written evidence of how the National Minimum Standards and Care Care Homes for Older People Page 6 of 24 Homes Regulations were being met. Care Homes for Older People Page 7 of 24 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. Care Homes for Older People Page 8 of 24 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 9 of 24 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 24 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Detailed needs assessments make sure peoples health and personal care needs are assessed and responded to appropriately. Evidence: We looked at three care records to determine what action had been taken to assess the needs of people admitted to York Lea. The service had a robust needs assessment procedure, which meant that places were only offered to people whose needs the service could meet. Records provided evidence of ongoing assessment through regular reviews and prompt referrals to health care professionals where concerns about a persons health and welfare had been identified. We spoke to a tissue viability nurse during our visit. She said, Staff always follow my advice to the letter. They make prompt referrals and as a result people get better due to their diligence. This home does not provide an intermediate care service. Care Homes for Older People Page 11 of 24 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at York Lea have their needs consistently met and their care is provided in a manner that protects their privacy and dignity. Evidence: The three care plans we examined were up to date and contained detailed information to inform nursing and care staff what they needed to do to meet the health and personal care needs of the individual. Daily records provided evidence that staff were following the care plans exactly. Risks had been carefully assessed and through careful risk management, peoples health and welfare had been consistently maintained. Nursing staff regularly liaised with health professionals and consistently followed their advice. Staff had been particularly effective at preventing pressure ulcers, weight loss and recurrent chest infections by closely monitoring peoples health and taking prompt action when concerns were identified. We looked at the medication being administered to the three people whose care plans Care Homes for Older People Page 12 of 24 Evidence: we had assessed. Medication records appeared to be accurate and up to date and medicines were securely stored in the homes clinic room. Accurate records had been taken of all medication received into the home along with medicines which had been disposed of. During our visit we observed that staff had developed good relationships with people using the service. Staff treated people with respect and dignity and were mindful of peoples need for privacy. A person living in the home said she liked all the staff. She added, They are very kind and look after me very well. The home had achieved the Dignity in Care Award from Manchester City Council. Care Homes for Older People Page 13 of 24 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Social activities and mealtimes are well managed and provide daily variation and interest for people living in the home. Evidence: Improvements had been made by introducing Lifestyle Assessments which recorded individuals interests, personal history and preferences for how people would like to spend their leisure time. Two part-time activity co-ordinators were employed to coordinate the varied activity programme. This catered for individuals and group pursuits such as health and beauty, keep-fit, arts and crafts, shopping and visiting entertainers. One to one activities were provided for people who were confined to bed. The outcomes of peoples experiences of participating in activities had been carefully recorded. People accommodated in York Lea are encouraged to maintain family relationships and visitors were observed to come and go throughout the day. One person told us that her daughter regularly visits and that staff always make her welcome. One of the visitors said, the staff are absolutely marvellous. They always phone me if they have any concerns. Care Homes for Older People Page 14 of 24 Evidence: York Lea provides a varied and nutritious menu and the chef is knowledgeable about preparing special diets. People are provided with a choice of meals and these can be eaten in the dining room or the privacy of their own room. Drinks and snacks are available throughout the day and night. Care Homes for Older People Page 15 of 24 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are good procedures so people who live in the home are able to express their concerns and be listened to, their rights are protected and they are safeguarded from harm. Evidence: York Lea has a policy and procedures for dealing with complaints and this was provided in writing to people admitted to the home. Copies of this information was also posted on noticeboards within the home. The people we spoke to during our visit knew who to talk to if they had any concerns or complaints to express. No complaints had been received about this service in the previous twelve months. York Lea also has a policy and procedures for dealing with safeguarding adults and this is in line with Manchester Local Authority protocols for keeping people safe from harm. Staff employed by the home had recently attended training on the action they must take if people using the service were considered to be at risk of harm. The training also covered recent legislation relating to Deprivation of Liberty. There had been one referral for a safeguarding investigation relating to a person living in the home during the previous twelve months. Care Homes for Older People Page 16 of 24 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. York Lea provides people with a comfortable and safe environment that is well maintained and decorated and furnished to a good standard. Evidence: We looked round the home to assess health and safety, cleanliness, hygiene and the facilities provided. We found the home to be safe, bright, airy, clean and decorated to a high standard. Robust procedures were in place to prevent cross-infection and this had been strengthened by the installation of a sanitising system. All staff working in the home had received training in infection control. Equipment used in the home had been maintained in good working order. Furnishings and fittings were suitable and a rolling programme of replacement and refurbishment meant that these were updated when the need arose. The home had been tastefully decorated and bedrooms contained appropriate furniture and facilities to meet peoples accommodation needs. A range of specialised bathing and shower facilities had been provided along with relevant moving and handling and pressure-relieving equipment. Three people we spoke to confirmed that the home was a pleasant and comfortable place to live. Care Homes for Older People Page 17 of 24 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staffing arrangements, recruitment and training ensure that people are cared for and supported safely. Evidence: The home had sufficient staff on duty when we arrived on the day of our visit and records provided evidence that similar staffing levels had consistently been maintained. The staff team at York Lea was comprised of qualified nursing staff and a complement of twenty-three care staff. Twenty-one care staff had achieved a National Vocational Qualification at level 2 or above. Staff on duty told us that they are provided with excellent opportunities for training and development and records were held of all the training provided in the previous twelve months. Staff confirmed that the manager was supportive and takes their development seriously. When asked what the home does well in surveys staff responded as follows, make sure the residents are well looked after at all times, training programmes, the home has an excellent degree of care given to the service user and makes sure that all staff are fully qualified and experienced. The home recognises and rewards all staff for their good work, which is very encouraging and provides all equipment (e.g. hoists, slide sheets etc.) to aid residents and make things as comfortable for them as possible. Care Homes for Older People Page 18 of 24 Evidence: We did not examine recruitment records during our visit, as these were held at the companys head office in Clayton Bridge. Seven staff completing surveys confirmed that the required pre-employment checks had been obtained before they started working in the home and that they had undertaken induction programmes following their appointment. Care Homes for Older People Page 19 of 24 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. York Lea is managed well and is run in the best interests of the people who live there. Evidence: The registered manager was on holiday on the day we visited, although she called in while we were there. The clinical nurse manager was present throughout the inspection visit and he provided us with all the evidence we asked for to demonstrate that National Minimum Standards were being met. The nurse manager was very knowledgeable about the day-to-day management of the home and we found him to be competent and confident at being left in charge of the home. York Lea had a robust quality management system in place to consult people using the service and their representatives and for auditing systems, policies and procedures within the home. The home had also achieved Investors in people status. Regular audits had been undertaken and the outcome of these had informed ongoing improvements in several areas. For example, a care plan audit tool had resulted in the introduction of a new care plan format that was much more person-centred. This Care Homes for Older People Page 20 of 24 Evidence: enabled people using the service to express choices and preferences about how their care and support should be provided. This was evidence of best practice in managing a service in the best interests of the people accommodated in the home. York lea has a policy of not managing the personal finances of people using the service. People living in the home and needing this support have their finances managed either by their relatives or an advocate. Any expenditure by the company on behalf of individuals is invoiced to the relevant person on a monthly basis. We examined a sample of health and safety records, including fire and electrical maintenance and found these to be accurate and up to date. Care Homes for Older People Page 21 of 24 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 22 of 24 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 23 of 24 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. 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. 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