Archived: York House Care Home

Updated 2 October 2019

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection was conducted by one inspector.

Service and service type

York House is registered as a care home. People in care homes receive accommodation and nursing or personal care. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection. The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. This included details about incidents the provider must notify us about, such as abuse. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all this information to plan our inspection.

During the inspection

During the inspection, we spoke with six people who used the service, to ask about their experience of the care provided and three visiting family members. People whose accommodation was in York House were able to tell us about their experiences of living in the service we spoke with them when they were using the main home and we observed interactions between people and staff in the communal areas of the service. This was so we could understand people's experiences. By observing the care received, we could determine if they were comfortable with the support they were provided with.

We spoke with five members of staff including three care assistants, the cook and a member of the domestic staff. We also spoke with the deputy and registered managers. We met and spoke with two health care professionals visiting during the inspection.

We reviewed a range of records about people's care and how the service was managed. This included looking at one person’s care records and a sample of people's medicines administration records. We reviewed records of staff meetings, staff rotas and staff training, we viewed four staff recruitment records. We also reviewed the records of accidents, incidents, complaints and quality assurance audits completed, and survey feedback from relatives.

After the inspection

We continued to seek clarification from the provider to validate evidence found and asked the registered manager to send some additional supporting information in addition to contact details for additional relatives and professionals. We spoke with a relative of a person in York house and received feedback from a further social care professional.

Updated 2 October 2019

About the service

York House is located in the garden of the St Valery Care home but is registered separately as a care home. All staffing , activities and meals are provided by the main home St Valery. York House is comprised of two self-contained flats. Accommodation and personal care support are provided for a maximum of three people, over the age of 65 years with dementia type conditions who have lower dependency needs. The provider and registered manager have chosen to use the two units for single occupancy only. The number of people accommodated at any one time is therefore two. At the time of the inspection the service was full. York House is in the garden area of the larger service St Valery which is registered with the Care Quality Commission separately. People from York House are supported by staff from St Valery and make full use of the facilities at St Valery for their day to day support, meals and activities.

People’s experience of using this service and what we found

We spoke with one of the people from the York House accommodation during our inspection and their relative. They told us that they were happy living at the service but now wanted to move into the main home and this was under discussion. Their relative commented that the whole service had a “lovely family atmosphere”, and that they were very happy to leave their relative there as they knew that they were well looked after. People from York house chose when they wished to make use of the main home facilities or could have their meals provided to them in their accommodation. The person we spoke with came into the main home every day for their meals and activities.

The registered manager fostered a culture of placing people at the centre of everything they do and aspire to do at St Valery. They and staff were passionate about the people they supported living their life to the fullest in the least restrictive way.

People and relatives spoke positively about the service. People told us that they felt safe and found the service homelike. “It’s like living at home really.” The provider had ensured that people lived in a safe well-maintained environment, risks were assessed and managed. Any improvements made were with a view of enhancing peoples experience. There were enough suitable staff available to meet people needs.

Staff were highly trained and motivated. The registered provider and manager fostered a nurturing and empowering environment so that staff could develop and feel confident in their knowledge and skills. Staff enjoyed working in the service and felt valued and supported. Staff retention was therefore very good and provided people with excellent continuity of high-quality care. Peoples dietary and health needs were managed well, and health professionals told us the service referred to them appropriately. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People and their relatives universally told us that staff were kind and caring. Their support was compassionate and there was thought given to way in which they supported to uphold people’s dignity. There was a busy but relaxed atmosphere within the service with lots of chatter, laughter and smiles between people and the staff supporting them. The culture was open and friendly, and visitors were made welcome. There was a sense that people, their relatives and staff knew each other well. A York house relative told us that they were really happy with the service offered to their family member which was not “institutionalised. Another relative told us that they thought people in the service were “treated as equals by staff and given their self-respect.” This approach extended to relatives with one who visited many times in the week saying they were treated by staff “like a pal.”

Staff were very knowledgeable about people's needs and supported people to remain as independent as possible. The service had earned a good reputation with local health and social care professionals who described the service as “one of the best” and “I have always found this service as one that others should take notes from,” The registered manager was a strong advocate for people needing the service who were diagnosed with dementia type illnesses. They and their staff continued to find new ways in which to support people in little but important ways that made their day to day experiences and outcomes consistently good.

The registered manager was a visible presence in the service and knew all the people, their histories and their status well. Both relatives and professionals we spoke with were complimentary of the service and the registered managers leadership and caring values which she promoted across all staff. People received high-quality person-centred care that met their individual needs.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was Good. (Report published 22 December 2016)

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.