Inspection on 16/03/10 for Harry Booth House

This is the latest available inspection report for this service, carried out on 16th March 2010.

CQC found this care home to be providing an Good service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Harry Booth House 15/04/08

Harry Booth House 16/04/07

Harry Booth House 03/01/06

Harry Booth House 19/07/05

Harry Booth House 20/01/05

Harry Booth House 10/07/04

Extracts from inspection reports are licensed from CQC, this page was updated on 16/05/2010.

Key inspection report Care homes for older people Name: Address: Harry Booth House 2 Atha Crescent Beeston Leeds LS11 7BD     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: Dawn Navesey     Date: 1 6 0 3 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 33 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 33 Information about the care home Name of care home: Address: Harry Booth House 2 Atha Crescent Beeston Leeds LS11 7BD 01132760672 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Leeds City Council Department of Social Services Name of registered manager (if applicable) Mrs Michelle Haunch Type of registration: Number of places registered: care home 40 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category physical disability Additional conditions: Date of last inspection Brief description of the care home Harry Booth House is located not far from Elland Road football ground and is situated off Dewsbury Road. There are a number of small shops close by and good public transport links to Leeds and Wakefield. The home can accommodate up to forty people over the age of 65 years who require personal care. Two of the forty beds are used for respite care and the homes registration allows for one person with a disability to be accommodated. Nursing care is not provided but the home is supported by local health care services. Accommodation is over two floors, in single rooms with en-suite facilities. There is a passenger lift giving access to the first floor. Information about the service is available in the form of a statement of purpose and service user guide. Care Homes for Older People Page 4 of 33 Over 65 40 0 0 1 Brief description of the care home These documents are reviewed regularly to make sure that the information is up to date and on request can be provided in Braille and different languages. On the 16th March 2010 the fees ranged from a minimum of 14 pounds and 70p per night to a maximum of 510 pounds 30p per week. Additional charges are made for chiropody, hairdressing and toiletries. More up to date information about fees can be obtained from the home along with copies of previous inspection reports. The home has a no smoking policy. Care Homes for Older People Page 5 of 33 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: The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. The Care Quality Commission (CQC) inspects homes at a frequency determined by how the home has been risk assessed. The inspection process has now become a cycle of activity rather than a series of one-off events. Information is gathered from a variety of sources, one being a site visit. More information about the inspection process can be found on our website www.cqc.org.uk This visit was unannounced and was carried out by one inspector who was at the home from 10-20am until 5-40pm on the 17th March 2010. The purpose of the inspection was to make sure the home was operating and being managed for the benefit and well being of the people who use the service. And also to Care Homes for Older People Page 6 of 33 monitor progress on requirements or recommendations made at the last inspection. Before the inspection evidence about the home was reviewed. This included looking at any reported incidents, accidents and complaints. This information was used to plan the visit. An AQAA (Annual Quality Assurance Assessment) was completed by the home manager before the visit to provide additional information. This was well completed and gave us all the information we asked for. Survey forms were sent out to people using the service, staff and health care professionals. A number of these have been returned and comments from them have been used in this report. During the visit a number of documents and records were looked at and some areas of the home used by the people living at the home were visited. Some time was spent with the people who use the service, talking to them and interacting with them. Time was also spent talking to peoples relatives, staff and the manager. Feedback at the end of the visit was given to the manager and the senior manager for the service. Care Homes for Older People Page 7 of 33 What the care home does well: People said they were happy with their choice of this home. Their comments included: The best place I have been to Its marvellous here, lovely I am happy as anything here Couldnt have chosen better. A number of people said they had come to the home for short stay (Respite) care and then decided to move in as they liked the home so much. People look well cared for clean, tidy and well groomed. People who live at the home and their relatives said they were well looked after. Their comments included: I am getting better with all the good care and attention They look after me They are marvellous with mum, look after her very well Caring very good Kind care and attention, nearly all the time Staff are on hand at all times Mum always looks lovely, clean, tidy, nicely matched clothes Support when needed No complaints, H. B. H. (Harry Booth House) trys at all times to meet my needs. Staff were very familiar with peoples needs and could talk confidently about the support they give. Staff were able to describe peoples preferred routines with regard to their support and what works well for people. Most staff have worked at the home a number of years and have a very good knowledge of peoples individual needs and know people well. People who use the service and their relatives said the staff and manager were always prompt in seeking medical attention for people if needed. Their comments included: They have made sure I get the physio to get my legs going Always get the doctor, even in the night. People who live at the home were very positive about the food. Their comments Care Homes for Older People Page 8 of 33 included: A lot of choice with meals Meals are varied, 2 choices, special diet for diabetics The meals are excellent. People spoke highly of the standards in the home. They said: The home is very clean The home is kept nice and clean Laundry comes back beautiful Everything is always ironed nice, put away for you, lovely service Spotless, always lovely and clean. People who use the service and their relatives spoke highly of the staff team. These are some of the comments they made: The staff are very good, excellent in fact Very good, cant praise them enough We like all the staff, they are all so good, kind and nice. The home is well managed. People who use the service and staff spoke highly of the manager. Comments included: She gives us good support, always there for us Very approachable, very nice, listens to us Very much part of the team Very focussed on the residents and what they want. What has improved since the last inspection? We said the last time we visited that care plans and risk assessments needed to be improved on to make sure peoples needs were properly met. We looked at care plan and risk assessment records for some people who use the service. The manager and the staff team have worked hard to develop the care plans and risk management plans. They now give plenty of detail on the the personal and healthcare needs of the people who use the service and how needs are to be met. The manager has reviewed the activity provided in the home. This is now focussed on what people say they want. Care Homes for Older People Page 9 of 33 Mealtimes in the home are now supervised by more staff to make sure people have the help they need. In the AQAA the manager told us of improvements made to the environment, these included: Some bedrooms and main areas have been re-decorated this year. All bedrooms have now got new furniture and fittings. New carpets have been fitted to the cinima room. Staffing levels have been reviewed and increased to make sure peoples needs are properly met. 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 10 of 33 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 11 of 33 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 the service can be sure that the home will meet their needs following a thorough assessment. Evidence: People said they were happy with their choice of this home. Their comments included: The best place I have been to Its marvellous here, lovely I am happy as anything here Couldnt have chosen better. A number of people said they had come to the home for short stay (Respite) care and Care Homes for Older People Page 12 of 33 Evidence: then decided to move in as they liked the home so much. In the AQAA, the manager said, All potential clients have a pre- visit were they would receive an information pack, they visit the home, if after the visit they are still undecided whether they would like to come and live at Harry Booth House we would arrange an overnight or weekend stay. While the client is with us we complete a preassessment which enables us to identify individuals care needs. We looked at the pre-admission assessment information for some people who use the service, including someone who was having their first visit for short stay care. We found that the manager had obtained assessments carried out through the care management process and then completed their own assessments of peoples needs, fully involving the person and their relatives if appropriate. These assessments were completed before the person moved in to the home and then added to as staff got to know the person better and any risks were identified. The assessments identify peoples needs well and lead on to good care plans being developed. We also discussed with the manager how people whose needs had changed were assessed. She said they are monitored through the care planning process and referred to other agencies for support to meet their needs if this is necessary. She said some people in the past had moved on to specialist services for people with dementia when the home could no longer meet their needs fully. Care Homes for Older People Page 13 of 33 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. The health and personal care that people receive is based on their individual needs. The principles of respect, dignity and privacy are put into practice. People are involved in decisions about their lives, and play an active role in planning the care and suppport they receive. Evidence: People look well cared for clean, tidy and well groomed. Attention had been paid to detail. People had clean glasses and had their hair styled as they wished. Staff were patient, gentle and kind when interacting with people. They were discreet and respectful of peoples dignity when attending to any personal care needs. They gave reassurance and explanations for any tasks that they needed to support people with. People who live at the home and their relatives said they were well looked after. Their comments included: I am getting better with all the good care and attention They look after me Care Homes for Older People Page 14 of 33 Evidence: They are marvellous with mum, look after her very well Caring very good Kind care and attention, nearly all the time Staff are on hand at all times Mum always looks lovely, clean, tidy, nicely matched clothes Support when needed No complaints, H. B. H. trys at all times to meet my needs. People also said they never had to wait long when they needed staffs attention and that staff always answered buzzers promptly. In the AQAA the manager said, All the information received in the care plan, our assesment, information from the resident, family/friends and the keyworker is put together to develop the residents individual life style plan. This is completed so the care staff are informed of how to meet the needs and choices of each individual resident. All care plans are up dated and reveiwed monthly and they are formally reviewed on a six monthly basis. All care planning adopts the person centered care approach, staff are trained to follow this principle. Residents have individual risk assessment and action plans for diagnosed health conditions which now form part of there life style plan. We said the last time we visited that care plans and risk assessments needed to be improved on to make sure peoples needs were properly met. The manager told us in the AQAA that, The life style plans are now been completed electronicaly,we have completed 85 of residents life style plans on the new format. Life style plans are being used more effectively, information is being recorded and reviewed regularly. We looked at care plan and risk assessment records for some people who use the service. The manager and the staff team have worked hard to develop the care plans and risk management plans. They now give plenty of detail on the the personal and healthcare needs of the people who use the service and how needs are to be met. They are very person centred and include some life history plans for each individual. People who use the service and their relatives have been directly involved in the Care Homes for Older People Page 15 of 33 Evidence: development of the care plans and were aware of the contents. There was recorded evidence that the care plans had been continuously reviewed and where necessary amended as peoples needs changed or risks had been identified. A number of people who use the service said they had regular meetings with their keyworker to look at their plans. Staff were very familiar with peoples needs and could talk confidently about the support they give. Staff were able to describe peoples preferred routines with regard to their support and what works well for people. Most staff have worked at the home a number of years and have a very good knowledge of peoples individual needs and know people well. Staff said they found the care plans useful and they had all the information they needed for them to be able to give good support. One person said there was always someone to ask if they needed to know anything that wasnt in the care plan. Help and advice is sought from health care professionals to make sure that people get the special help they need to maintain their health. In the AQAA the manager said, All primary care needs are met and the resident has access to specialist services and facilities such as the district nurse, dentist, chiropodist, O/T (Occupational Therapist), mental health specialists etc. The Nutritional Screening Tool is used for all residents if there is an identified risk residents are weighed weekly /monthly their weight is recorded and progress monitored professional guidance is sought if required. People who use the service and their relatives said the staff and manager were always prompt in seeking medical attention for people if needed. Their comments included: They have made sure I get the physio to get my legs going Always get the doctor, even in the night. Staff have been trained to meet the some specific health needs of people who use the service. Training has included, dementia awareness, medication administration, infection control and first aid. The manager is planning further training in palliative care, pressure care and catheter/stoma care. The home uses a monitored dosage, pre-packed system for medication. All staff, who adminster medication, have been trained to use the system. We looked at medication storage and administration and found everything to be in good order. The manager was reminded to make sure that any handwritten entries on the medication administration records are signed by two people to avoid any errors being made. She Care Homes for Older People Page 16 of 33 Evidence: agreed to do this in the future. We also noticed that medication was given to people at mealtimes. This may interrupt peoples enjoyment of their meal. Some consideration should be given to medication administration at alternative times to meal times. Care Homes for Older People Page 17 of 33 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. People who use the service are able to make choices about their lifestyle. In the main, social, cultural and recreational activities meet peoples expectations. They also benefit from a good, healthy and varied diet. Evidence: In the AQAA the manager said, We provide a varied range of activities which are based on the interests of the residents, we have both internal, and external activities, a daily activity plan. This plan is drawn up after consultation with the residents. Residents are asked in consultation meeting what their interests and hobbies are what they would wish to be doing in the next month and a plan is drawn up. We have Links with the community. The local priest, Salvation Army and Evangelistic congregation visit on a regular basis. Arrangements can be made for any resident who wishes to visit their place of worship to attend as they require. People who live at the home and their relatives were, in the main, positive about what they do at the home. In returned surveys, most people said there were always or usually activities arranged by the home. One said, Plenty of activities, shopping trips. Two people when asked what the home could do better said more activities and outings. Care Homes for Older People Page 18 of 33 Evidence: Other comments included: More stimulation would be beneficial but the staff are doing their best They look after all their needs but generally there could do with more going on Theres plenty of organised activities but not as much socialisation day to day Plenty going off for me and been out twice recently to White Rose shopping centre. The manager said she is looking to improve the service for people who have dementia in that she would like staff to be trained in providing activities especially designed for people with dementia. In the AQAA, the manager also told us of a number of improvements that have been made to the service this last year. These included: We have continued to speak to the residents and our activity programme is reviewed in the residents consultation meeting activities are evaluated and changes are made as required. The cafe corner was opened of wing two for residents and visitors to enjoy a drink / snack at any time of the day. The cinema / sun lounge as been a great success residents enjoy watching films on the big screen. The residents have been party to in-house tournaments on the Wii.(Games console), other homes have been involved and residents have been out to other homes which has received positive feed back from all involved (Harry Booth House won the wii tournaments for the last two events). Staff said they felt they had enough staff to provide people with a decent amount of activity and said they didnt feel people were bored at the home. They said they usually have time to sit and chat with people as well as provide all the care they need. Records showed that there is an activity event offerred each day. Between three and approximately twenty people usually take part in these activities. Other activities such as entertainers and themed bingo evenings take place weekly or monthly. People from the local community and peoples family also attend these events. People spoke highly of these and said they enjoyed them. The atmosphere in the home is relaxed and life seems to go at the pace of people who use the service. People are free to move about the home as they wish and are able to Care Homes for Older People Page 19 of 33 Evidence: have their things around them. People who live at the home were encouraged to make choices throughout the day. Staff said they always ask people what they want to do, what to wear and make sure people can get up and go to bed when they want. Staff said there are no rigid routines for people. This is good person centred practice. People who live at the home were very positive about the food. Their comments included: A lot of choice with meals Meals are varied, 2 choices, special diet for diabetics The meals are excellent. Menus are arranged based on likes and dislikes of people. In the AQAA the manager said, The menus are discussed in all residents meetings,a daily menu is displayed around the home and the meals are reviewed with the residents and chefs in consultation meetings. Meals can be served in peoples bedrooms, sitting rooms or in the dining areas. Staff are sensitive to the needs of people who find it difficult to eat and need help and encouragement with this. Staff sit with people helping them feel comfortable and unhurried which helps people relax and respond in time. Food looked appetizing and people were offered as many choices as required to encourage them to eat. Care Homes for Older People Page 20 of 33 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. People who use the service are able to express their concerns, have access to an effective complaints procedure, and are protected from abuse. Evidence: In the AQAA the manager said, We have a robust complaints compliments system, which responds immediatley to any any issues raised and we learn from our mistakes. People who use the service said they knew how to complain and who to speak to if they are generally unhappy about something. Most said they would speak to the manager or their keyworker. It was clear from staffs interactions with people that the people who live at the home seemed confident to raise their wishes or concerns. We looked at records of complaints and these showed that peoples concerns are taken seriously, complaints are fully investigated and people are informed of their outcome. The manager is currently keeping a record of complaints in one book. We informed the manager that this does not meet the requirements of the Data Protection Act. She agreed in future to make sure complaints records were kept individually in order to meet these requirements. Staff were able to say what action they would take if they suspected abuse or had an allegation of abuse made to them. They were also able to describe the different types of abuse. All staff were clear on their responsibility to report abuse or allegations of Care Homes for Older People Page 21 of 33 Evidence: abuse and confirmed they had up to date training. The manager is familiar with the local authority safeguarding referral system. This means people are properly protected. In the AQAA the manager said, Staff are trained in safe guarding adults issues , any safeguarding issues would be attended to immediately in line with policy requirements, referals are made to the safeguarding adults unit when required. There have been two safeguarding issues since our last visit to the home. These have been addressed properly. Care Homes for Older People Page 22 of 33 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 environment is homely, comfortable and safe for people who use the service. Evidence: In the AQAA the manager said, Harry Booth House is maintained to an high standard the home is re-decorated and has a rolling re-furbishment programe. She also told us of improvements made, these included: Some bedrooms and main areas have been re-decorated this year. All bedrooms have now got new furniture and fittings. New carpets have been fitted to the cinima room. The manager said they are wanting to improve the service further by upgrading the bathrooms and extending the laundry. A tour of the building was carried out. Communal areas, bathrooms and bedrooms were visited. We found the home to be warm, clean and totally free of any offensive odours. Staff clearly work hard to maintain good standards in the service. Care Homes for Older People Page 23 of 33 Evidence: Food preparation is carried out in the homes main kitchen. They had received 5 out of 5 stars from their last environmental health visit in December 2009. People who live at the home were pleased with their bedrooms and had personalised them with their own things such as furniture and pictures. People spoke highly of the standards in the home. They said: The home is very clean The home is kept nice and clean Laundry comes back beautiful Everything is always ironed nice, put away for you, lovely service Spotless, always lovely and clean. One person said they could do with some new covers for the chairs and settees in the lounge. Some signage such as pictures on doors and corridors has been introduced to assist people who have memory problems to find their way about better. There are good sytems in place for the control of infection. Staff had been trained in infection control and could talk about the measures in place to prevent the spread of infection. Care Homes for Older People Page 24 of 33 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. Staff in the home are trained, skilled and in sufficient numbers to support people who use the service and to support the smooth running of the home. Evidence: People who use the service and their relatives spoke highly of the staff team. These are some of the comments they made: The staff are very good, excellent in fact Very good, cant praise them enough We like all the staff, they are all so good, kind and nice. At our last visit to the home, we said that staffing levels must be reviewed and increased. In the AQAA the manager said a review had been undertaken and staffing had been increased to better meet the needs of the people who use the service. She also said, Staffing levels are reviewed on a daily basis ensuring that the ratios reflect the needs of the residents currently residing at Harry Booth House. We saw that there are now five staff on each shift through the day. These are supported by a senior member of staff who is in charge of the shift. At night there are now three staff available and an on-call system from another home nearby has also been introduced Care Homes for Older People Page 25 of 33 Evidence: for additional support. There are also four domestic staff, a laundry assistant, handyman, chef and kitchen assistant on duty each day. The manager said she intends to keep staffing levels under constant review to make sure they are always meeting peoples needs properly. She said she had good support from her senior manager in this matter. In surveys returned to us, a small number of staff raised concerns about staffing in the home. When asked what the home could do better, one said they struggle to get the same agency staff to cover vacancies and sickness, this then affects consistency of care for people who use the service. Others said, More staff of our own and release vacant posts and Have more staff. However, most staff said they had enough staff to meet peoples needs properly and most staff said they use regular agency staff most of the time to provide consistent care for people. We spoke to some agency staff at the home on the day of our visit. One said, We are given a really good induction here, feel safe and given time to get to know the residents needs. People who use the service said they felt there were enough staff available to them, most of the time. In surveys returned to us three out of thirteen people said the home could do better by having more staff. However all thirteen people said they always received the care and support they need and that staff were available to meet their needs. Most people we spoke to during our visit were happy with the staffing levels in the home. Comments included: Generally enough staff unless taking their holidays and agency staff are in Usually enough, but we would always like more Normally runs very well, perhaps not as well with agency staff who dont know the ropes Theres always plenty of staff about, never have to wait long to be seen to. In the AQAA the manager said, We have a robust recruitment and selection process, underpinned by our equal opportunities policy. We looked at the recruitment processes for people working at the home. The files had the relevant information to confirm these recruitment processes were properly managed. This included application forms, references and CRB (criminal records bureau) checks. Also in the AQAA, the manager said, Most of our staff have been employed for many Care Homes for Older People Page 26 of 33 Evidence: years giving the advantages of highly skilled and an experienced staff team. Each member of staff undertakes at least three days training per year. Priority is given to the mandatory training as identified by Skills For Life. e.g Moving and handling, infection control, safeguarding adults, fire awareness. Within their first six weeks of employment care staff undertake Foundation training and then go on to commence N.V.Q. level 2. We looked at staffs training records and saw they were up to date and regularly reviewed by the manager through supervision and appraisal. The majority of the staff team have achieved an NVQ (National Vocational Qualification) in care at level 2 or 3. This means they are qualified to do their job. All staff who returned a survey said they were satisfied with their training. Staff we spoke to at the visit were very positive about their training. They said: We get good training, regular updates Training has made me think differently about what I do (With regard to dementia awareness training). Staff confirmed they received regular one to one supervision meetings with their manager. They said this gave them a good opportunity to discuss their role and progress. Care Homes for Older People Page 27 of 33 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. The home is well managed. The interests of people who use the service are seen as important to the manager and staff and are safeguarded and respected. Evidence: The manager has many years experience of both working with older people and managing the home. She is qualified to NVQ level 4 in care management and has the registered managers award. In the AQAA the manager said, I direct and lead the staff team in a very positive manner ensuring that the Aims of the home are clearly understood and that we are all working towards the same common goal. I am always open to suggestions and encourage innovation and creativity. We adopt an open door policy. People who use the service and staff spoke highly of the manager. Comments included: Care Homes for Older People Page 28 of 33 Evidence: She gives us good support, always there for us Very approachable, very nice, listens to us Very much part of the team Very focussed on the residents and what they want. The manager sends out surveys to people who use the service asking for their views on any improvements that could be made. They then develop an improvement plan from any suggestions that people have made and tell people what they are going to do about them. The manager said, We gain feed back from our residents relatives/friends and visiting professional via our Quality assurance audit feedback, this enables us to develop our service. As a result of listening to people who use the service, the manager said they had redesigned an area of the home to create the cafe corner, hold regular bingo sessions where peoples family and members of the community are also invited and developed more in-house entertainment such as the Wii tournament. She also said more people who use the service have been out to the theatre and got involved in gardening at the home. She said that people had been consulted on how to name the wings in the home, changing to names instead of numbers and had decided they wished to be referred to as residents. The manager receives regular supervision from the senior manager for the home. The senior manager visits the home at least once per month to carry out monitoring visits. These are completed to a good standard. They speak with people who use the service and the staff during these visits and note any areas that require improvement. The manager had completed the AQAA to a good standard. It gave us all the information we had asked for and had identified well the improvements made to the service and future improvements she wanted to make. There are good systems in place to make sure peoples money is kept safe. People are also given good assistance and support to manage their money and look after it themselves. In the AQAA, the manager indicated that all health and safety matters in the home are up to date. Arrangements are in place to make sure of safe working practices. The home has a comprehensive range of health and safety policies and procedures in Care Homes for Older People Page 29 of 33 Evidence: place. Staff said they were familiar with these and explained how health and safety is managed in the home. It was clear that all staff see health and safety as important and part of their responsibility. We looked at accident and incident report analysis that the manager carries out on a monthly basis. She said the number of falls people have had have reduced since the introduction of the increased staffing levels. Care Homes for Older People Page 30 of 33 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 31 of 33 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 9 Some consideration should be given to medication administration at alternative times to meal times so as not to interrupt peoples enjoyment of their meal. The provision of activity should be kept under review to make sure it is meeting everyones needs, especially people who may find individual, one-to-one activity more beneficial. 2 12 Care Homes for Older People Page 32 of 33 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. 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