CARE HOMES FOR OLDER PEOPLE
Haddon Court Nursing Home HIgh Street Beighton Sheffield S20 1HE Lead Inspector
Rob Curr Unannounced 26 May 2005 07:50 am 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 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 J55 S21781 Haddon Court V218806 26.05.05 UI Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Haddon Court Nursing Home Address High Street Beighton Sheffield S20 1HE 0114 2511318 0114 2511354 Not known Amocura Limited Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mrs Janet Sharp N Care Home with Nursing 83 Category(ies) of DE(E) Dementia - over 65 - 62 registration, with number OP Old age - 21 of places MD(E) Mental Disorder -over 65 - 10 Haddon Court Nursing Home J55 S21781 Haddon Court V218806 26.05.05 UI Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Of the 62 dementia elderly (DE/E) beds 10 can be used for mental disorder elderly (MD/E). 2. 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. Date of last inspection 27th July 2004 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 J55 S21781 Haddon Court V218806 26.05.05 UI Stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection took place between the hours of 7.50 am and 3:00 pm. Janet Sharpe was present during the inspection process and has been managing the service for a number of years. The inspector was escorted on a partial tour of the home. A variety of policies, procedures, and records were checked. The residents were very helpful during the inspection process, offering ample opportunity to talk about what life was like at the home. In all – 6 residents, 5 staff members, and 3 visiting relatives were spoken to. What the service does well:
All of the residents that met with the inspector were very happy at the home. One resident said that staff were ‘very helpful’. Cleanliness and hygiene standards in the home and kitchen area were very good. Despite a number of residents having difficulties with continence there were no unpleasant odours. The domestic team are to be commended for the cleanliness of the environment. Relatives said that they were always made to feel welcome and that they could approach ‘all’ the staff if they wanted anything. Systems were in place to ensure that the health safety and welfare of residents was maintained, including the safe storage of medication. The organisation had produced an Annual Development Plan and this was shared with the residents and their relatives. There was a friendly and cheerful atmosphere promoted by the staff. The manager and the care team displayed a real commitment to the service at Haddon Court. Haddon Court Nursing Home J55 S21781 Haddon Court V218806 26.05.05 UI Stage 4.doc Version 1.30 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 J55 S21781 Haddon Court V218806 26.05.05 UI Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Haddon Court Nursing Home J55 S21781 Haddon Court V218806 26.05.05 UI Stage 4.doc Version 1.30 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 standard(s) 3 and 5. Standard 6 was not applicable. Resident’s records included a detailed assessment of their needs. EVIDENCE: Three care plans included assessments carried out by staff at the home, and information from the placing authority. Three relatives stated that they had been asked for information prior to their admission. Haddon Court Nursing Home J55 S21781 Haddon Court V218806 26.05.05 UI Stage 4.doc Version 1.30 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 standard(s) 7,8,9,10 and 11. Health care was monitored and care plans were reviewed on a monthly basis, however, residents and or their representatives were not involved in the care plan reviews. A range of health care professionals visited the home to assist in meeting the needs of the residents. Medication was in the main managed safely, however there were some difficulties around the recordings of the medication system, which could provide a risk to the residents’ health and welfare. Service users privacy and dignity was respected. Service users wishes regarding dying and death required recording, to ensure these were carried out. EVIDENCE: Three care plans set out in detail the residents needs and the action to be taken by the qualified and care staff of the home to ensure all these could be met. Residents could see their GP in private so that their privacy and dignity was respected.
Haddon Court Nursing Home J55 S21781 Haddon Court V218806 26.05.05 UI Stage 4.doc Version 1.30 Page 10 There was a medication policy and the medication and records were stored in secure rooms on each floor. When the staff were questioned about the use of the MAR sheets, there was some confusion about what to record when medication had not been administered. This was a ‘new’ MAR sheet system and this was discussed with the manager. Staff closed doors before assisting residents with personal care. Staff knocked on residents does and waited before being invited in. residents and relatives said that said that staff were ‘polite’ and ‘helpful’. Although the majority of residents have communication difficulties, some residents said that they were happy in the home and said, “the staff are nice and kind” and ”I’m happy here”. Relatives said they were “very satisfied” with the care delivered by staff. Haddon Court Nursing Home J55 S21781 Haddon Court V218806 26.05.05 UI Stage 4.doc Version 1.30 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 standard(s) 12,13,14 and 15. Residents and relatives were happy with the activities, but there were no outings planned. Mealtimes were well managed with dining areas to accommodate all service users. The home had clear visiting policies and procedures to ensure that residents could maintain contact with their family and friends. Residents are encouraged to bring in personal items of furniture and ornaments to help them settle into their own bedroom. The cook had reviewed the menu, to improve choice and reflect service users preferences. The cook/catering team would benefit from some formal training in ‘special diets’. EVIDENCE: A new activities co-ordinator was now in post. A number of activities were organised. The home was having ‘tea mornings’ to encourage visitor to become involve in the home and this has resulted in some fund raising.
Haddon Court Nursing Home J55 S21781 Haddon Court V218806 26.05.05 UI Stage 4.doc Version 1.30 Page 12 Residents said that they had not been on an outing for a long time. The manager stated that when the weather improved there would be more outings. This would enhance their lifestyle experience. Visitors to the home praised the staff. Visitors confirmed that they liked to visit their relative in the main lounge, while others preferred to see their relative in their own bedroom. Residents receive support from other people visiting the home, e.g. hairdresser, optician, chiropodist, and representatives from the local church, maintaining contact with the local community. A partial tour of the building provided evidence that service users were able to personalise their bedrooms, many had brought in small items of furniture and pictures of their family. The mealtime was well organised and the inspector was able to observe residents being assisted with their meal where required. Staff were unhurried and there were sufficient numbers to ensure those residents who were being cared for in their bedroom were taken a meal that looked appetising. The cook had work hard to develop the menus. This had resulted in a clear choice at mealtimes. The cook kept a clear record of the food that had been offered and served. The catering team had gained a food hygiene certificate at an ‘Intermediate’ level. This had also been instrumental in the catering staff being awarded a food hygiene rating of ‘excellent’ by the Health Protection Service. Haddon Court Nursing Home J55 S21781 Haddon Court V218806 26.05.05 UI Stage 4.doc Version 1.30 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 standard(s) 16 and 18. Relatives and staff were aware of how to make a complaint and were confident that they would be listened to. An adult protection procedure was in place to ensure service users safety was promoted. Staff needed to undertake formal training in adult protection. EVIDENCE: The complaints procedure was on display in the foyer, which contained relevant information and provided the reader with details of who to contact outside the home, to ensure complaints were taken seriously. The home kept a record of complaints. Staff spoken to were unaware of the local Adult Protection Procedures. 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. One relative said that he was invited to relatives meetings to discuss issues. All the residents spoken to said they felt safe at the home. Haddon Court Nursing Home J55 S21781 Haddon Court V218806 26.05.05 UI Stage 4.doc Version 1.30 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 standard(s) 19,20,21,22,23,24,25 and 26. The home was clean and generally well maintained. Communal areas were homely, and were well decorated. Sufficient bathing facilities were provided. The bedrooms seen were personalised by residents and their relatives. The home was free of any offensive odours. Systems for the control of infection were in place. A lack of storage space was evident. A call system was available in all rooms used by the residents so that they could summon assistance at all times. EVIDENCE: The inspector carried out at tour of the home. All of the residents spoken with were happy with their bedrooms and the furniture provided. The home was well decorated and well maintained, to provide a comfortable environment for the residents. It was evident from care plans that a number of people needed support with continence difficulties. One of the communal lounges was being used for the storage of equipment and the ‘re-charging’ of electrical lift aids etc. Haddon Court Nursing Home J55 S21781 Haddon Court V218806 26.05.05 UI Stage 4.doc Version 1.30 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28,29 and 30. Sufficient staff were provided to meet the needs of the residents. The recommendation that 50 of the care staff team are qualified to National Vocational Qualifications (NVQ) level 2 in care had not yet been achieved. The manager could identify the training needs of the staff group. There were no staff vacancies at the time of the inspection. This assists in maintaining the well being of the residents. Recruitment policies are followed ensuring the safety and protection of the residents. EVIDENCE: Staff rotas examined showed sufficient staff to meet the needs of service users. Staff had adequate skills to meet the needs of service users, although they do not yet meet the recommendation of 50 NVQ qualified care staff. A number of staff continue to work towards the award. A number of staff recruitment files were examined and discussed with the person in charge, and there was evidence that all the required employment checks had been undertaken prior to commencing work at the home. Haddon Court Nursing Home J55 S21781 Haddon Court V218806 26.05.05 UI Stage 4.doc Version 1.30 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33,36,37 and 38. The registered manager has the required skills and competencies to ensure the safety and protection of the residents and has successfully gained the management qualification required to carry out her role and responsibilities. Staff are provided with formal supervision. Health and Safety policies are in place for the health, safety, and welfare of those individuals who work and live at the home although some accident records were not monitored. EVIDENCE: The registered manager has been in post for a number of years. She has gained an NVQ level 4 in Management. Staff supervision has not taken place at the recommended frequency, although this has not been detrimental to the care of service users.
Haddon Court Nursing Home J55 S21781 Haddon Court V218806 26.05.05 UI Stage 4.doc Version 1.30 Page 17 Servicing of essential equipment takes place within the recommended timescale and records examined provided evidence of this. Of the accident records checked, it appeared that an accident had occurred whilst a resident was in bed. There was no subsequent investigation into this incident. This could compromise the safety of the residents. Haddon Court Nursing Home J55 S21781 Haddon Court V218806 26.05.05 UI Stage 4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2
COMPLAINTS AND PROTECTION 3 3 3 2 3 3 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 Standard No 16 17 18 Score 3 x 2 3 3 3 x x 2 2 2 Haddon Court Nursing Home J55 S21781 Haddon Court V218806 26.05.05 UI Stage 4.doc Version 1.30 Page 19 YES Are there any outstanding requirements from the last inspection? 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. 2. Standard 7 9 Regulation 15 13 Requirement Residents or their reprsentatives must be involved the review of care planning. All staff administering medication mus be aware of what to record when medication is not administered. Residents must be consulted over their recreational and social needs. The catering team must have training with regard to special dietary needs. Staff must have awareness of the local Adult Protection Procedures. Lounges must not be used for the storage of equipment and re-charging electrical equipment. Staff supervision must be implimented within the agreed timescale. The accident reported on 8.4.05 must be fully investigated. Timescale for action 25.07.05 25.07.05 3. 4. 5. 6. 12 15 18 22 16 Sch 3,4 13 23 25.07.05 19.09.05 19.09.05 25.07.05 7. 8. 36 38 18,19 37 22.08.06 27.05.05 Haddon Court Nursing Home J55 S21781 Haddon Court V218806 26.05.05 UI Stage 4.doc Version 1.30 Page 20 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. Refer to Standard 28 Good Practice Recommendations 50 of the care staff should hold NVQ level 2 in care. Haddon Court Nursing Home J55 S21781 Haddon Court V218806 26.05.05 UI Stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection Ground Floor, Unit 3 Waterside Court Bold Street Sheffield S9 2LR National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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