Inspection on 07/08/08 for Haworth Court

This is the latest available inspection report for this service, carried out on 7th August 2008.

CSCI 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.

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Extracts from inspection reports are licensed from CQC, this page was updated on 08/11/2008.

CARE HOMES FOR OLDER PEOPLE Haworth Court Emmott Road Beverley Road Hull East Yorkshire HU6 7AB Lead Inspector George Skinn Key Unannounced Inspection 7th August 2008 09:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address DS0000071463.V369243.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. DS0000071463.V369243.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Haworth Court Address Emmott Road Beverley Road Hull East Yorkshire HU6 7AB 01482 801509 01482801509 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Bluecroft Estates Ltd Karen Ransom Care Home 37 Category(ies) of Dementia (37), Old age, not falling within any registration, with number other category (37) of places DS0000071463.V369243.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only - Code PC, to service users of the following gender: Either, whose primary care needs on admission to the home are within the following categories: Dementia - Code DE and Old Age, not falling within any other category-Code OP. The maximum number of service users who can be accommodated is: 37 First inspection since change of ownership 2. Date of last inspection Brief Description of the Service: Haworth Court is now owned by Bluecroft Estates Ltd. The home is registered to provide personal care and accommodation for up to 37 people of either gender over the age of 65 some, or all, of whom may suffer from dementia. The home stands in its own grounds with ample parking facilities. It was originally a large stable complex belonging to Haworth Hall and has been a care home since 1987. Haworth Court is situated on Emmott Road (North Hull) off Beverley High Road, which is one of the main routes into Hull city centre. The closest shops and community facilities are a fair walk for most of the residents. Private accommodation is provided in 25 single and 6 double bedrooms. Nine of the single rooms have en-suite facilities (w.c. and wash hand basin). The homes communal accommodation consists of a large lounge/conservatory, dining room and small smoke room. The home has a passenger lift and a small private treatment room. There is a private courtyard area - with seating - to the front of the home. The fees are £343.50 per week. The home charges an extra £5 per week for a single room and £10 per week for an en suite room. Information about the home and the latest inspection report are available in the entrance hall and/or on request. DS0000071463.V369243.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means that the people who use this service experience good quality outcomes. The key inspection has used information from different sources to provide evidence. These sources include: • • • • Reviewing information that has been received about the home since the last inspection. Information provided by the registered person on an Annual Quality Assurance Assessment (AQAA) Comment cards returned from people who live at the home, relatives and staff A visit to the home carried out by one inspector. A site visit was carried out which lasted 7 hours. We spoke with the people who live at the home, their relatives and staff. Records relating to the people who live at the home, staff and the management activities of the home were inspected. During the visit care practices were observed, where appropriate, and time was also spent watching the general activity within the home The Manager was available to assist throughout the day. What the service does well: What has improved since the last inspection? We saw that the new owners have made a lot of improvements to the physical environment which the people live in. They have replaced all of the windows which needed replacing with new UPVC window frames and double glazed glass. They have redecorated a few of the peoples rooms but this still ongoing DS0000071463.V369243.R01.S.doc Version 5.2 Page 6 and there are lots left to do. They have made sure people are safe by fitting a new lock to the front gate. They have redecorated and re-plastered all of the corridors and redecorated the lounges. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. DS0000071463.V369243.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection DS0000071463.V369243.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3&6 People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Peoples needs can be met by the home because there is full need assessment done before they come to live there. EVIDENCE: The home has recently changed ownership. We looked at the statement of purpose and the service user guide and these had been changed to reflect this. This was kept on the homes computer and can easily be printed for anyone making enquires. We looked at the files of those people who have recently been admitted to the home. These contained information on the person’s needs and a recent assessment undertaken by the placing authority. The manager continues to undertake a comprehensive pre-admission assessment. The home do not admit people for intermediate care. DS0000071463.V369243.R01.S.doc Version 5.2 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, & 10 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people 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. EVIDENCE: We looked at the files of four people who use the service. All contained comprehensive assessments and we saw that files were updated on a regular basis. There continues to be at the front of the files an audit form used by the manager or deputy manager to ensure the staff are completing the care plans appropriately, these point out any areas of weakness or gaps in recording and time scales are set for the staff to complete any shortfalls. We saw that people can access health care professionals when required and people spoken with during the site visit told us that they could see their GP DS0000071463.V369243.R01.S.doc Version 5.2 Page 10 when they wanted. We saw that there was regular weight monitoring and nutritional screening and people were referred to health care professionals when needed. At the last inspection it was noted that the files did not contain any information about individual hobbies and interests or any information about past life experiences or strategies for ensuring emotional wellbeing. This is being addressed and some of the files looked at contained a section entitled “Getting to know you”. This section provided information on the persons past life and their hobbies and interests, and also photographs of special times in their lives. Not all of the people’s files contained this information but the manager told us that this is an ongoing piece of work and the home were trying to involve relatives as much as possible with collecting the information. We saw that the home continues to have a medication policy and when we spoke with the staff those who administer medication were aware of this. Observations we made during the site visit indicated that staff had good practise when dealing with medication and the people who use the service were not put at risk. We saw that all of the staff who administer medication have received accredited training. Since the home changed ownership they have changed the supplying pharmacist. The manager told us that this has improved the way the home obtain medication for the people who live there as the pharmacist is now local to the area. At the last inspection it was noted that the staff practise around treating the people who use the service with dignity and respect was variable. We saw that the staff consistently treated people who live at the home with respect and this had much improved since the last inspection. We saw that staff were courteous and spoke with people appropriately and let the people set the pace of the interaction as apposed to hurrying them along. The staff explained what they were dong if they needed to help people and how the person was to help them. We saw that the staff were playing games with some of the people who live at the home and the interaction was friendly and relaxed. DS0000071463.V369243.R01.S.doc Version 5.2 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People can take part in activities that are appropriate to their age. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. People are helped to be as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, wellpresented meals and snacks, at a time and place to suit them. EVIDENCE: At the last inspection it was noted that the people who live at the home lacked stimulation and the staff sometimes displayed poor practice when interacting with them. We saw that the staff practise had much improved since the last inspection and interaction between staff and the people who live at the home was respectful and dignified. At no time did we hear any of the staff belittling any of the people who live at the home or use any derogatory language. DS0000071463.V369243.R01.S.doc Version 5.2 Page 12 The deputy now has the responsibility of organising activities for the people who live at the home and part of her working week is designated for this. She told us that she had organised a selection of activities for the people who live at the home to take part in if they wish; these included reminiscence, one to one discussions, bingo, quizzes, table games, dominoes, crosswords and crafts. At the time of the site visit the home were preparing for a Summer Fate. The people who live at the home had made some greetings cards to sell and the home had received many donations and sponsors from local businesses. The deputy told us she was developing activities especially for those people with dementia and had consulted the Alzheimer’s Society and Age Concern for information. Visitors are made welcome at the home and many were seen visiting during the site visit. Since the last inspection the manager has made an attempt to encourage visitors to see their relatives in private by providing a notice which invites them to take their relatives to their rooms if they require this. During the site visit we saw that visitors still preferred to see their relatives in the main lounge and we saw that they interacted with other people who lived at the home making for a very social gathering. At the last inspection it was noted that the dining room was shabby and in need of refurbishment along with renewal of the furniture. We saw that the dining room had been redecorated, however the furniture continued to pose a safety hazard. The manager told us that there were plans to replace all of the furniture. An action plan submitted by the owners confirmed this is to be achieved within a set time scale. At the last inspection it was noted that the meal times were hurried and people who live at the home did not have time to enjoy their meals at their own pace. It was also noted that staff had poor practise when helping people with their meals and stood over them in an undignified manner. We saw that meal times had much improved since the last inspection. These were less rushed and people were able to enjoy their meals at their own pace. We saw that staff practise had improved and they were helping people in a more sensitive manner. We staff that staff sat with people who needed help and did not hurry them. When we spoke with the people who live at the home they told us the food was of a good standard and they enjoyed the meals which were provided. The cook had taken care when preparing soft diet for those people who needed this and these meals were presented in an appetising way. DS0000071463.V369243.R01.S.doc Version 5.2 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. If people have concerns with their care they, or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and the staff have received the proper training to make sure any allegations are investigated. EVIDENCE: We saw that the home continues to have a compliant procedure which is displayed a round the home. We saw that this includes information on how to contact outside agencies for example Social Services or the Commission for Social Care Inspection (CSCI) if required. Complaints continue to be dealt with in a timely way and the outcome of any investigation is recorded and the satisfaction of the compliant is sought. No complaints have been received by the home since the last inspection; the CSCI have received no concerns and the home has not been the subject of any Safeguarding adults investigations since the last inspection. When we spoke to the people who use the service they told us that they knew who to complain to one stated that they would “see the manager” she was also confident that it would be dealt with properly. DS0000071463.V369243.R01.S.doc Version 5.2 Page 14 When we spoke to staff they were able to describe how to make a safeguarding adults referral and knew what to do if they witnessed any abuse within the home. We saw that staff have now received training on Safeguarding adults, and the manager told us that she is seeking further refresher training for herself and the staff. DS0000071463.V369243.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 People who use this service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People live in an environment which is slowly improving. EVIDENCE: The registered provider continues to charge a top fee of £5.00 per week for a single room and £10.00 per week for an en–suite room. At the last inspection it was noted that the home was in desperate need of refurbishment and redecorating. Since the new owners have taken over there have been a lot of improvements. They have addressed the bad plasterwork in some of the bedrooms, replaced the beds and redecorated the communal areas including lounges and dinning room. New furniture has been provided in the lounges. Some of the bedroom carpets have been replaced and some of DS0000071463.V369243.R01.S.doc Version 5.2 Page 16 the bedrooms have been redecorated. All of the windows have been replaced with double glazed units. All of the corridors have been re-plastered and repainted. Those areas which have been addressed have improved but there is still along way to go; the new providers have an action plan with time scales and are working hard to achieve this. They have a genuine commitment to improve the environment for the people who live at the home. DS0000071463.V369243.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People have safe and appropriate support as there are enough competent, qualified 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. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. EVIDENCE: We saw a rota which demonstrated that, for the number of people who currently live at the home, there are enough staff on duty to meet their needs. The amount of staff will need to be recalculated each time a new person is admitted. We looked at recruitment files for staff who worked at home and we saw that references were being obtained and a Criminal Records Bureau checks (CRB) being undertaken prior to staff commencing work at the home. We saw that staff had received the mandatory training to meet the needs of the people who live at the home and to care for them safely. We saw that staff received training in dementia via video. When we spoke with the staff they told that they would prefer to receive training from an instructor and did not find DS0000071463.V369243.R01.S.doc Version 5.2 Page 18 the video very useful. The manager told us that she was securing training form a training agency and they would be devising between them a training programme for the staff to tap into. Over 50 of the staff are trained to NVQ level 2. DS0000071463.V369243.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. EVIDENCE: The manager is registered with the CSCI and has successfully achieved the registered managers award. We saw that the home continues to have an effective quality assurance system, which seek the views of the people who live at the home and all those DS0000071463.V369243.R01.S.doc Version 5.2 Page 20 stakeholders who have an interest in the home. The new owners are addressing the outstanding requirements set at previous inspection and are showing a commitment to improving the service which is offered by the home. The manager supplies the required notification to the CSCI as required by Regulation 37 of the Care Homes Regulations 2001. We saw that staff continue to receive regular supervision and there is now a plan in place which addresses the short fall in providing specialist training for staff. The new owners continue to undertake the required regulation 26 visit and reports were available for inspection. We saw that the staff have received the required mandatory training in health and safety. The home has effective policies and procedures in place to ensure as far as possible the safety of the people who use the service and the staff and these are updated as required. The home had submitted a well-completed AQAA which effectively addressed outstanding areas and how these were to be addressed. DS0000071463.V369243.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 2 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 DS0000071463.V369243.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 4 5 Refer to Standard OP19 OP19 OP26 OP26 OP30 Good Practice Recommendations The registered person should continue to follow the action plan and complete the refurbishment programme within given time scales The registered person should inform the CSCI of each stage of improvement so this can be monitored and time scales adhered to The registered person should ensure the home is kept free of offensive odours The registered person should replace the dining room furniture, as this is now becoming a hazard to the people who live at the home. The registered person should ensure that the staff have received the relevant specialist training to meet the needs of those service users with dementia or other specialist needs. 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