CARE HOMES FOR OLDER PEOPLE
Haddon Court Nursing Home High Street Beighton Sheffield South Yorkshire S20 1HE Lead Inspector
Mr Rob Curr Unannounced Inspection 14th November 2005 08:00 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 Haddon Court Nursing Home DS0000021781.V251873.R01.S.doc Version 5.0 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. Haddon Court Nursing Home DS0000021781.V251873.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Haddon Court Nursing Home Address High Street Beighton Sheffield South Yorkshire S20 1HE 0114 251 1318 0114 251 1354 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) Amocura Limited Mrs Janet Sharp Care Home 83 Category(ies) of Dementia - over 65 years of age (62), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (10), Old age, not falling within any other category (21) Haddon Court Nursing Home DS0000021781.V251873.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. Of the 62 dementia elderly (DE/E) beds 10 can be used for mental disorder elderly (MD/E). One service user, named on the variation to registration application form dated 21/04/03 and who is under the age of 65, may reside at the home. 26th May 2005 Date of last inspection Brief Description of the Service: Haddon Court is situated in Beighton Village, approximately five miles from the city centre. The home is within easy access of the local community, which has a selection of shops and churches. Haddon Court is a purpose built care home. It provides both nursing and personal care for older people who are mentally infirm or those who suffer from a mental illness. Haddon Court Nursing Home DS0000021781.V251873.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection took place between the hours of 8.00 am and 3.30 pm. Janet Sharp was present during the inspection process and has been managing the service for a number of years. The inspector undertook a tour of the home and a variety of policies, procedures, and records were checked. The residents and relatives were very helpful during the inspection process, offering ample opportunity to talk about what life was like at the home. In all – 6 residents, 3 staff members, and 2 visiting relatives were interviewed. What the service does well:
All of the residents and relatives that met with the inspector were happy at the home. One relative said that ‘nothing was too much trouble for the staff’. This relative told the inspector that they ‘did not know what we would have done without the help of the manager and her staff’. Cleanliness and hygiene standards in the home and kitchen area were good and there were no unpleasant odours. Relatives said that they were always made to feel welcome and that they could approach ‘all’ the staff if they wanted anything. There were planned activities. The residents said that the staff were busy organising the Christmas party. The recommendation that 50 of the care staff team are qualified to National Vocational Qualifications (NVQ) level 2 was on target. There was a friendly and cheerful atmosphere promoted by the staff. The manager, nursing and staff team displayed a real commitment and enthusiasm to improve the service at Haddon Court. Haddon Court Nursing Home DS0000021781.V251873.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? 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. Haddon Court Nursing Home DS0000021781.V251873.R01.S.doc Version 5.0 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 Haddon Court Nursing Home DS0000021781.V251873.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 and 3.. Residents’ needs were assessed prior to admission. Residents and their relatives were fully involved in the assessment and admission process, so this ensured that the home was able to meet their needs. The manager did not offer places to any individual whose needs they could not meet. The staff training plan was on target. EVIDENCE: Copies of full needs assessments were in the residents files. All the relevant information from the assessments had been built into the care plan. Two relatives said that they had been invited to view the home and attend a variety of meetings prior to their relative moving into the home. Staff training records indicated that they had undertaken relevant training required to assist them in caring for the people that reside at Haddon Court.
Haddon Court Nursing Home DS0000021781.V251873.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7 and 9. The information within the care plans was clear. Health care was monitored and care plans were reviewed. This ensured the well-being of the residents. A range of health care professionals visited the home to assist in meeting the needs of the residents. Residents could choose their GP and could see them in private so that their privacy and dignity was respected. The organisation had a clear medication policy. All medication administered was signed for. EVIDENCE: A number of care plans were checked. They contained details of the action required by staff to meet the residents needs. The plans contained records of health assessments such as moving and handling. Haddon Court Nursing Home DS0000021781.V251873.R01.S.doc Version 5.0 Page 10 All the residents said that their health needs were met. Four residents said that they were ‘very happy’ with the care they received and that they had a named ‘key-worker’. The relatives said they were fully involved with the care planning and that they could approach members of staff for information and support at any time. Medication Administration Records (MAR) were checked. Staff had signed to indicate that medication had been administered. Staff were observed respecting residents privacy by knocking on bedroom doors before entering and closing bathroom and toilet doors when in use. During the lunchtime meal, staff were seen and heard treating residents kindly and respectfully. Haddon Court Nursing Home DS0000021781.V251873.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 and 15. The home creates a varied programme of social and recreational activities. The routines at the home were flexible. The home had an open visiting policy in order to develop and maintain good relationships with resident’s friends and relatives. The residents had a clear choice of menu. EVIDENCE: Residents were seen to walk freely around the home. One visiting relative said that she was ‘always made to feel welcome’ and that she ‘had no concerns’ about the care of her relative. There was a programme of activities on display, which had been developed with the residents. During the lunchtime meal, staff were heard encouraging residents to make choices. All residents spoken to stated that the ‘food is good’ and ‘there is plenty of it’, ‘the cook will do me anything’.
Haddon Court Nursing Home DS0000021781.V251873.R01.S.doc Version 5.0 Page 12 The staff team had undertaken training in nutrition and dietary needs. The training focused on dietary needs of people suffering from different forms of dementia. Haddon Court Nursing Home DS0000021781.V251873.R01.S.doc Version 5.0 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18. An adult protection procedure was in place to ensure service users safety was promoted. EVIDENCE: Staff training in adult abuse had been identified within the training plan and a number of staff had already undertaking this training. The residents, relatives, and staff all stated that they had confidence in the homes manager. They said that she would listen and respond to any concerns they raised. Haddon Court Nursing Home DS0000021781.V251873.R01.S.doc Version 5.0 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,22. The home was clean and generally well maintained. One care practice observed did not promote residents safety. EVIDENCE: The inspector carried out a tour of the home. One member of staff was seen to mobilise a resident in a wheelchair without footplates in place. Haddon Court Nursing Home DS0000021781.V251873.R01.S.doc Version 5.0 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30. Sufficient staff were provided to meet the needs of the residents. The recruitment procedures operated in line with equal opportunities. The recommendation that 50 of the care staff team are qualified to National Vocational Qualifications (NVQ) level 2 in care was on target. The manager could identify the training needs of the staff group. EVIDENCE: There were enough staff on duty during the day and night to care for peoples needs. One resident and a relative said that the staff were ‘very good’ and ‘nothing was too much trouble’. All staff files checked had an appropriate Criminal Records Bureau (CRB) disclosure. A number of care staff had completed the National Vocation Qualification (NVQ level 2 & 3) in direct care. A further group of staff are currently on the course and some have registered to commence the training. Haddon Court Nursing Home DS0000021781.V251873.R01.S.doc Version 5.0 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 34,35,36,37 and 38. There was a positive style of management in the home. This clearly benefits the residents and their relatives and representatives. There was a quality assurance system in place, which gave residents and visitors an opportunity to express their views and suggest ways in which the service may be improved. Residents monies that had been deposited at the home were accurate. Staff supervision systems were in place to ensure best practice was maintained. All records were securely stored. Health and safety checks were in place to ensure residents were safe. One care practice observed did not promote residents safety. All staff had undertaken fire training. EVIDENCE: Staff said that the manager was approachable, supportive and was a ‘good listener’. The manager had an annual plan that identified and prioritised areas for improvement, to enhance the service provided. One relative said that there
Haddon Court Nursing Home DS0000021781.V251873.R01.S.doc Version 5.0 Page 17 were questionnaires that she could complete to express her level of satisfaction of the care her mother received. Fire records were maintained of fire alarm tests. The fire drill records indicated that staff (including night staff) had undertaken a fire drill practice within the last year. One member of staff was seen to mobilise a resident in a wheelchair without footplates in place. The inspector noted that there was a high number of accidents reported. All these reports were clear and accurate. It was suggested by the inspector that the manager begins a comprehensive monitoring system for falls management. Haddon Court Nursing Home DS0000021781.V251873.R01.S.doc Version 5.0 Page 18 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 3 3 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 x 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 x 17 3 18 3 3 3 X 2 X X 3 3 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 3 3 3 3 3 3 2 Haddon Court Nursing Home DS0000021781.V251873.R01.S.doc Version 5.0 Page 19 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. 1 Standard OP38OP22 Regulation 13 Requirement Residents must not be transported in wheelchairs without footplates. A risk assessment must be produced for any resident not requiring footplates on their wheelchairs. Timescale for action 14/11/05 2 OP22OP38 13 14/11/05 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 Refer to Standard OP28 OP38 Good Practice Recommendations 50 of the care staff should hold NVQ level 2 in care. The management should consider introducing a falls management system. Haddon Court Nursing Home DS0000021781.V251873.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Doncaster Area Office 1st Floor, Barclay Court Heavens Walk Doncaster Carr Doncaster DN4 5HZ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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