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Inspection report

Date of Inspection: 6 September 2012
Date of Publication: 4 October 2012
Inspection Report published 4 October 2012 PDF

There should be enough members of staff to keep people safe and meet their health and welfare needs (outcome 13)

Not met this standard

We checked that people who use this service

  • Are safe and their health and welfare needs are met by sufficient numbers of appropriate staff.

How this check was done

We looked at the personal care or treatment records of people who use the service, carried out a visit on 6 September 2012, observed how people were being cared for and checked how people were cared for at each stage of their treatment and care. We talked with people who use the service, talked with carers and / or family members and talked with staff.

We used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us.

Our judgement

There were not enough qualified, skilled and experienced staff to meet people’s needs.

Reasons for our judgement

Prior to our visit to York House on 06 September 2012, we had received information of concern that told us there were on occasion not enough members of staff on duty to care for the people living at York House.

We spoke to four people using the service who all raised concerns about the numbers staff available to help them with their needs. One person told us "The girls [staff] don't have five minutes to talk to you, I feel the place is falling apart from what it was". When we asked them if they had to wait long periods of time to receive care they responded "Yes sometimes". Another person told us that due to time pressures on staff they sometimes did not get to choose when they went to bed, they commented "I got told I had to go bed now - it was like, now or never". A third person told us that although they got on well with staff they were not supported with the care they required. They commented "it upsets me - my dinner is not brought to me on time and I'm not helped to dress when I require it in the morning". A fourth person stated "staff are a bit slow in coming, especially in the mornings".

We were also told by two people that they only had access to a shower once a week although they would like this to be more. They were both of the opinion they were unable to have more showers because staff did not have the time to do this.

We also spoke to four members of staff who all stated that they felt there was not currently enough staff on duty to meet the needs of the people living at York House.

We also found that on the day of our inspection, a member of staff who should not have been on shift, had stayed to provide care and support whilst the inspection was carried out.

During our inspection we carried out two observational exercises. On one of those occasions, to help us understand people's experiences we used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experiences of people who could not talk with us.

During our general observations over lunch time we found that there were not enough staff to help people eat their meals. For example, we noted that two members of staff were in the dining room whilst 20 people ate their lunch time meal. Four of those people required additional support with their meals such as assistance with cutting up food and eating. We observed that the two members of staff (one of which was the member of staff who should not have been on shift) going between people who required assistance giving one a person a mouthful of food before attending to the next person. We saw one person receiving the assistance become upset and refuse to eat. To ensure that people have their needs met staff should be enabled to provide one to one support to those people who require assistance at meal times.

During our SOFI in the afternoon, we found that although staff interactions were limited, people in the communal lounge were checked upon to see if they wanted a cup of tea or to go to the bathroom.

At the beginning of our inspection we asked the registered manager what staff ratios were in place at the home. We were told that during the morning shift there would be one senior carer supported by six care assistants, in the afternoon one senior would be supported by four carers with the addition of another support member of staff between 5pm and 9pm. We were told that two members of staff would cover the nightshift between 9pm and 7am.

When we reviewed the staff rotas for the last month, we found that staffing was maintained at the levels stated to us by the manager. However, the provider may find it useful to note that we found the registered manager and deputy managers were included in the rotas as members of staff providing care and support. Although extra management support is provided by the area manager, we are not confident that the registered manager is enabled to manage the service effectively.

Whilst we found evidence