Inspection on 05/05/10 for Helme Hall Care Home

This is the latest available inspection report for this service, carried out on 5th May 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

Helme Hall Care Home 22/07/08

Helme Hall Care Home 25/07/06

Helme Hall Care Home 10/01/06

Helme Hall Care Home 07/06/05

Helme Hall Care Home 26/01/05

Helme Hall Care Home 04/08/04

Similar services:

Snydale Care Home

Abbey The

Larchfield Manor

Hawkhills

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 17/07/2010.

Key inspection report Care homes for older people Name: Address: Helme Hall Care Home Helme Lane Meltham Nr Holmfirth West Yorkshire HD9 5RL     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: Karen Summers     Date: 0 5 0 5 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 28 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 28 Information about the care home Name of care home: Address: Helme Hall Care Home Helme Lane Meltham Nr Holmfirth West Yorkshire HD9 5RL 01484850165 01484854339 info@helmhall.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Helme Hall Ltd Name of registered manager (if applicable) Type of registration: Number of places registered: care home 46 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users who may be accommodated is: 46 The registered person may provide the following category of service only: Care home with Nursing - Code N To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP; and Dementia - Code DE Date of last inspection Brief description of the care home Helme Hall Care Home provides personal care for up to 46 older people. The accommodation is over three floors, all of which are accessed by a passenger lift. The home, which has recently been extended to provide further bedroom accommodation, has also had more areas provided in the grounds where people can sit out in the warmer months of the year and enjoy the surrounding views of the countryside. Care Homes for Older People Page 4 of 28 Over 65 46 0 Brief description of the care home There is ample parking to the rear of the building, and for ease of access a ramp leading to the entrance. The home is situated approximately half a mile from Meltham Village and five miles from Huddersfield. The bus stops at the end of the drive, which is approximately a quarter of a mile away from the home. However the local community bus will drop passengers off and pick them up at the home by prior arrangement. The local church, shops and public house are within five minutes drive. The Care Quality Commission were informed on the 5th May 2010 that the weekly fees range from £400 to £650. Information about what services are available and included in the fee, together with the last inspection report is available from the home. Care Homes for Older People Page 5 of 28 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: This report refers to an inspection, which included an unannounced visit to the home on the 5th May 2010. Date of the last inspection of this service was 22nd July 2009. The purpose of this inspection was to look at how the needs of people living in the home are being met and we focused on the outcomes of the key standards. During the visit we spoke to people living in the home, visitors, staff and management. We looked at various records including peoples care plans, staff files and training records. We looked around some of the building and we observed staff while they carried out their duties. We did this inspection with an expert by experience who spoke to people who are using this service. An expert by experience is a person who either has a shared Care Homes for Older People Page 6 of 28 experience of using services or understands how people in this service communicate. They visited the service with us to help us get a picture of what it is like to live in or use the service. This is important because the views and experiences of people who use services are central to helping us make a judgment about the quality of care. The home has had a period of unsettlement over the last year and there have been a number of management and staff changes. With the appointment of the new manager the staffing has become more settled and improvements have been made which has improved the outcomes for people living there. As part of the inspection in order to provide information to help us form judgments about the quality of the service, the manager was asked to complete an annual quality assessment (AQAA) document. This she did, and the document provided the Care Quality Commission (CQC) with a lot of information about the way the home is run, and what they hope to achieve in the future. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. Care Homes for Older People Page 7 of 28 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 Care Homes for Older People Page 8 of 28 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 9 of 28 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 28 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 are assessed prior to them moving into the home to ensure that their needs can be met. Evidence: The care records of three people who use the service were looked at, and they contained a Community Care Assessment carried out by the local authority that funds the placements. Each assessment contained detailed information about the persons needs. In addition to this there was evidence in all of the records that the home had also carried out an assessment of the persons current needs in their place of residence. The information in the annual quality assessment document confirmed that all prospective people undergo a pre-admission assessment to ensure the staff are qualified and skilled to meet the needs of the person and the placement will be appropriate. Care Homes for Older People Page 11 of 28 Evidence: Prospective people who use the service and their families are also encouraged to visit the home and spend some time there meeting the staff, other people living at the home and sample the daily routine. This is to gain an insight of how they view the service. Four people who were spoken to on the day of the visit said that they received enough information about the home before they moved in so they could decide if it was the right place for them. One person said that they did not know if they had received enough information as their relatives had chosen the home for them. Care Homes for Older People Page 12 of 28 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. Peoples care plans outline the level of support and care each person requires in ensuring their health and welfare needs will be met. Evidence: Three peoples care plans were looked at, and the records included relevant risk assessments relating to falls, pressure care and nutrition etc. The documentation also included peoples likes and dislikes, their social, cultural and spiritual needs. There was information in the care records of involvement from peoples doctors, social workers, opticians and other health care professionals where needed. Care reviews had taken place, and the care plans had been updated monthly or as the needs of the person changed and this was with the involvement of the person or their relative wherever possible. However, in one of the three records the nutritional assessment had not been reviewed from the 25th January until the 2nd May 2010, and there were also several Care Homes for Older People Page 13 of 28 Evidence: signature omissions in these records. The personal care plan had been reviewed monthly, dated and signed. The nutritional assessment was discussed with the manager at the time and she confirmed that she was in the process of reviewing and updating all the care plan records. There was evidence in the other nutritional assessment records inspected that they had recently been updated and signed by the person carrying out the assessments. Three people spoken with said they had choice when they could go to bed and get up and their preference in having either a bath or shower. Two people commented that: Ive always liked having a bath but I dont mind a shower now. I was not sure about having a bath, but the carer has been so kind and helped me. I am very happy living here, the carers look after me and are very kind. They help me when I cant do something for myself. I would like to go home, but this is the next best thing. We are happy with the care that our.... is receiving. (Relative) Staff were observed knocking on peoples doors before entering. Each persons room had a lockable drawer facility for their security and privacy. People confirmed that different religious denominations visited the home to meet peoples spiritual needs, and on the day of the visit a Priest had visited to give Communion. The home has recently changed pharmacist that supply their medication, and there were a couple of issues identified that the manager said she would be addressing. The manager also said that she is planning to introduce monthly medication audits so that any issues can be quickly identified and addressed to ensure that people are kept safe. Care Homes for Older People Page 14 of 28 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. Meals provided are good, varied and served in a pleasant environment. Evidence: On the morning of the visit people were seen to be having tea and sat in the lounge areas or their rooms, watching television or talking to one another. Staff were seen to be interacting with people in a friendly and caring manner and the movement and handling of people carried out in a dignified way. The activities person said that she presently works Monday to Friday, 9am until 3pm, however due to a number of people choosing not to get up until later in the morning; she often becomes involved in care duties and does not spend as much time on activities. The activities person said that this has been discussed at residents meetings and agreed with management that she will start at 10am until 4pm and this will be purely as a dedicated activities coordinator. The manager and the home owner also confirmed this. An activities plan is displayed in the reception area which provides an overview of the Care Homes for Older People Page 15 of 28 Evidence: activities intended for that week. A sample of three weeks plans were looked at and the activities varied from week to week offering choice for people to join in something that may appeal to them, e.g. quiz, outside entertainers, PAT dogs, children from the local primary school coming to read to people, visit to Meltham Church Hall, baking, Easter decorations, dominoes and cards. Activities on a one to one basis include, reading a newspaper/magazine with someone, manicures, feeding the birds at the bird station, accompanying someone on a visit for a coffee at the local supermarket, or engage someone in general conversation. The activities person was observed as enthusiastic and caring towards people she interacted with. On the day of inspection, the hairdresser was visiting and the activities coordinator was taking people backward and forward upstairs to have their hair cut or styled. People were observed enjoying having their hair washed and set. One person said I always feel better when I look in the mirror and see my hair looking nice. Another person said I always used to go to the hairdresser before I came in here so it is grand that I can still have my hair done. Because of the visiting hairdresser no other activities took place that day. People were observed sitting in the lounge quietly or reading. A large plasma TV was on in one of the lounges and one person commented that it was too noisy to sit in there. Comments from people about what they are involved in on a daily basis include: I prefer to sit and read I dont like joining in, but I do enjoy someone coming to talk to me. I dont mind what it is; I do my best within my limitations. I like it when someone can take me outside to have a little walk in the fresh air; I heard birds singing yesterday, I think it must be Spring. As well as having the menu displayed in large print in the dining room, each morning at breakfast the Chef goes to everyone to ask what their choice is for lunch and tea that day, and people confirmed this at the time of the visit. There was evidence of a choice at meal time and the two choices for lunch were Chicken or Lasagne. Specialised diets are catered for and peoples likes and dislikes were recorded along with vegetarian options and food allergies. These dishes were served with a full compliment of vegetables in tureens placed on the table along with gravy boat. Side salad was also available. People were given choice along with any assistance required in choosing/serving their vegetables. Drinks included lemonade or blackcurrant juice and glasses of white wine was also served. Some people had beakers for their tea/coffee, some had cups. The cup handles Care Homes for Older People Page 16 of 28 Evidence: appeared to be difficult for some people to hold as the handles were quite small and this was discussed with the manager and owner at the time of the visit. People were quiet, but friendly banter was observed between staff and people in making this a social and happy occasion. On the whole, people said they were happy with the food, observations made at the time showed that people were eating and enjoying their lunch. These are the comments of three people spoken with about their meals. There is always something that I like on the menu. As long as the food is hot I will eat most things. I enjoy my glass of wine with my lunch. Care Homes for Older People Page 17 of 28 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 can be confident that their complaints will be listened to and acted upon. Evidence: The home has a complaints procedure of which a copy was seen in the entrance of the home, and they also have a Whistle Blowing procedure. There was evidence in the complaints log that the home has received three complaints this year, and all of which were responded to within the 28 day timescale as written in the complaints procedure. There has been a problem with one of the fire doors not having an alarm fitted to it to alert staff if someone opens it and goes out of the home. The owner is aware of this and steps have been taken to have an alarm fitted to keep people safe. Staff and the manager showed knowledge of the complaints and whistle blowing procedures. There was evidence in the training records to suggest that staff have had safeguarding (adult protection) training that provides information on how to protect people from abuse, and staff who were spoken with confirmed this. Two people and two relatives said they would feel confident in bringing to the attention of the staff or management any complaint or issues they were not happy about. Care Homes for Older People Page 18 of 28 Evidence: One person said, I feel confident that if I made a complaint or wanted something changing I would be listened to by the staff. (Relative) Care Homes for Older People Page 19 of 28 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 home offers people a homely, comfortable and clean environment. Evidence: As part of the inspection a tour of the home took place, which included the communal areas and a number of bedrooms. There was evidence to suggest that ongoing refurbishment continues to take place and the decorative condition of the home is of a high standard. People said that they are encouraged to bring small items of furniture into the home, and one person made the comment, My room is delightful; I have brought my pictures and books. Specialised equipment and specialised mattresses and beds were also seen to be in use. The home has a specially designated room used by Community Nursing Team and GP Surgery. Having this room allowed people to be seen by the visiting professionals in private. Screen monitors were in evidence in areas for the call system which alerted staff to any person needing assistance. The call system incorporated a mobile hand set which Care Homes for Older People Page 20 of 28 Evidence: enabled people to take them out of their rooms if they wished. People had freedom of movement around the home and some people were observed returning to their rooms with their visitors. The standard of cleanliness throughout the home was good, and systems are in place to control the spread of infection. Without exception, people said that the home is always clean. Care Homes for Older People Page 21 of 28 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. People are supported and protected by the homes recruitment practices. Evidence: On the day of the visit there were thirty four people in residence. The duty rota was looked at. The manager confirmed and there was evidence to suggest that there were sufficient care staff and support staff on duty to care for the number and dependency levels of the people living at the home. Care practice observed during this visit, and the relationship between staff and people being cared for was positive. Three peoples recruitment records were inspected and the records contained the required information and employment checks. These checks are necessary to help protect people from potentially unsuitable staff. There was evidence in the staff records and staff confirmed that they had induction training when they came to work at the home, which provides them with the knowledge and skill to look after people in their care. A number of staff have also had Dementia awareness training to ensure that they Care Homes for Older People Page 22 of 28 Evidence: have the knowledge and skill to care for people who have this disability and records were seen to confirm this. Fifty five percent of care staff have a level 2, National Vocational Qualification in Care (NVQ) in care, and qualified staff have a better understanding of peoples needs. Care Homes for Older People Page 23 of 28 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. People benefit from the management approach of the home, and the home is run in the best interests of people who live there. Evidence: The manager has recently been appointed and is currently applying to Care Quality Commission to be the registered manager. Staff and people spoke positively about the deputy manager and said she is very approachable. The home has had a period of unsettlement over the last year and there have been a number of management and staff changes. With the appointment of the manager the staffing has become more settled and improvements have been made which has improved the outcomes for people living there. Care Homes for Older People Page 24 of 28 Evidence: Relatives said that for a period of time there has been some disruption in Helme Hall with regards to management and staff problems. However, they all agreed that things seemed to be improving. Relatives commented on the welcoming approachability of the new manager and all agreed they are happy with the care their relative is receiving and felt that the outlook is more positive. One person said, Theres been a lot of instability, but it is getting better, the new manager seems very nice. (Relative) As part of the inspection in order to provide information to help us form judgments about the quality of the service, the manager was asked to complete an annual quality assessment (AQAA) document. This she did, and the document provided the Care Quality Commission (CQC) with a lot of information about the way the home is run, and what they hope to achieve in the future. The owner of Helme Hall visits the home a minimum of weekly to give support to the manager. On a monthly basis he writes a report on the conduct of the home and this is used to monitor the quality of service and the outcomes for people living in the home. The manager said that she also carries out surveys on different aspects of care/improvements within the home. The one in February was relating to how the dining room and catering service could be improved and the outcome of the surveys are fed back to the residents/relatives meeting. The minutes of the meeting were seen to verify this. As a result of the dining room survey the environment and the mealtime service was improved and this was confirmed by people living at the home. There was evidence that staff supervisions have now commenced and staff confirmed this. Staff are supervised to ensure they are competent to do their job. Records were also seen of fire alarm and emergency lighting tests. Fire drills and a fire lecture had also been carried out and the staff confirmed that they had regular fire lectures. The manager was aware that more fire drills were need and she said that she would be contacting the fire safety officer to arrange more training. There was evidence in staff files that not everyone has had an up to date fire drill. Care Homes for Older People Page 25 of 28 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 26 of 28 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 8 To ensure that people receive the care and treatment that they need their nutritional assessment must be kept under review and revised when there are any changes in circumstances. All staff should have regular fire drills to ensure they know what to do in the event of a fire. 2 38 Care Homes for Older People Page 27 of 28 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. © 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. 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