Inspection on 03/11/06 for Haddon House

This inspection was carried out on 3rd November 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 9 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Haddon House 08/06/09

Haddon House 28/06/07

Haddon House 08/12/05

Haddon House 27/06/05

Haddon House 15/03/05

Haddon House 26/10/04

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 Haddon House 145 West Heath Road West Heath Birmingham West Midlands B31 3HD Lead Inspector Jennifer Beddows Unannounced Inspection 3 November 2006 09:00 Haddon House DS0000016889.V314871.R01.S.doc Version 5.2 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 House DS0000016889.V314871.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 Adults 18-65. 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 House DS0000016889.V314871.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Haddon House Address 145 West Heath Road West Heath Birmingham West Midlands B31 3HD 0121 475 1681 F/P 0121 475 1681 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) Haddon House Limited Mr Christopher Higgins, Ms Susan Newton Ms Joanne Tuke Care Home 6 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (6) of places Haddon House DS0000016889.V314871.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Residents must be aged under 65 years Date of last inspection 8th December 2005 Brief Description of the Service: Haddon House is a large detached house situated in the West Heath area of Birmingham. It is situated along a service road adjoining the main West Heath Road. The home has six single bedrooms, two of which are on the ground floor and four on the first floor all of which have en-suite facilities. The lounge and dining room are to the rear of the premises. A toilet and shower room are situated on the ground floor. There is a bathroom on the first floor with a grab rail. There is room for parking on the front driveway and access to the house is via sloped wooden decking area, providing wheel chair access. There is a well maintained rear garden that also benefits from a wooden decking area that is covered over. This provides an attractive seating area for service users. A sloping ramp leads to a further small patio area and lawn. There is a range of garden furniture for the service users to use. The home has access to vehicles to transport its residents on occasions, but encourages them to use public transport enabling service users to access local facilities and Birmingham City Centre. Local amenities such as shops, banks and the GP practice are close by and the home has good transport connections via bus and rail services. The home is registered to provide personal care and accommodation to a maximum of six adults who have a mental disorder. The home provides three meals a day and is staffed on a twenty four hour basis. Fees. £1,050 min Haddon House DS0000016889.V314871.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This fieldwork visit was unannounced and took place over one day. Since the last inspection two more residents have moved in and the home has reached its capacity. Four residents were at home on the day of the inspection and were able to express their views regarding their experience of the home. Three residents care plans and records were inspected including those who had recently moved into the home. Also two members of staff were spoken to and their working practice with the residents was observed. The recruitment and training records of the two most recently appointed members of staff were inspected and a tour of the premises took place. There were also discussions with the registered manager and the district nurse who was visiting the home at the time of the inspection. A pre-inspection questionnaire was provided by the home, and surveys were also received from the General Practitioner, relatives and all of the residents. The comments from these were positive. What the service does well: The residents live in a large domestic building similar to other properties around them. Its purpose as a care home does not distinguish the residents from the other families living in the street. This provides residents with a level of anonymity in their community, as the venue does not identify them as having any particular special needs. The residents bedrooms are spacious and well decorated and each resident has their own key which affords them independence and privacy. The staff observed appeared to be familiar with the residents’ personal circumstances and showed interest in supporting them to make choices and to promote their independence. They engaged with residents in a consistent friendly manner throughout the inspection and were approachable and available to residents throughout the day. The residents’ case records observed on the day of the inspection, showed that comprehensive assessment had been made of their respective needs, preferences and interests. Also comprehensive risk assessments had been made in order to best manage any issues regarding their physical, mental and social well-being. Haddon House DS0000016889.V314871.R01.S.doc Version 5.2 Page 6 Specialist support continues to be available from the Community Psychiatric Nurse and Consultant Psychiatrist in order to provide treatment and monitoring of residents ongoing mental health needs. These care plans had been regularly reviewed and updated. All the residents spoken to on the day stated that they liked living at Haddon House and had a good relationship with the staff. Two residents were going out for the day on the day of the inspection and were making their own personal arrangements with staff, who were observed promoting these residents independence and respecting their autonomy. These residents seemed relaxed and comfortable and had unlimited access into the managers office. Also on a number of occasions residents asked staff for their advice and responded to their comments. Two residents stated that they would prefer to live independently in their own home and plans have been made for one to move into supported accommodation. This was reflected in her care plan. The other resident said that she found communal living stressful and too noisy but it was better than being in hospital. What has improved since the last inspection? What they could do better: The manager must evidence how the views of residents and staff are obtained regarding the running of the home and development of the service. Fridge temperature readings were above the required temperature and the manager thought this was because the temperature rises every time the fridge door is opened. This could impact on the health and safety of the residents. Haddon House DS0000016889.V314871.R01.S.doc Version 5.2 Page 7 The manager is required to make arrangements for fridge temperatures to be regularly checked and recorded, and to ensure they meet the statutory requirements. Insulin for a resident is being stored in the fridge, which would be better stored in a fridge specifically allocated for this purpose. It is a requirement that the manager makes a formal assessment of any risks attached to the keeping of non- food items in this area. Water temperatures are not being taken and recorded on a regular basis, which could impact on the health and safety of the residents and staffing groups. As required medication protocols have improved since the last inspection and there is written information to ensure that staff do not over administer this type of medication to its residents. Safe systems must be put in place regards administration either by staff or residents for homely remedies, in order to promote the health and safety of the residents. As the amount of as required (PRN) and home remedies are not carried forward, systems need to be in place to regularly audit those staff that dispense medication, in order to promote the health and safety of the residents. Staff ratios at the time of the inspection were low due to absence and sickness. There was only one member of staff in the home during the morning of the inspection. There was also difficulty-gaining entrance into the home, as the front doorbell had been turned off for most of the day, which could impact on those callers wishing to meet with residents. The complaints process needs to be made aware to all residents, relatives and professionals to ensure they are aware of how to raise their concerns. Wardrobes are not secured to walls causing a potential risk to residents health and safety, as they could easily be pulled over. The storage of residents property on top of wardrobes is also potentially a hazard. This has already caused an accident to one resident according to the accident book, who fell attempting to retrieve her property from the top of the wardrobe. The manager must ensure such risks are assessed and action taken to protect residents. 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 House DS0000016889.V314871.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Haddon House DS0000016889.V314871.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2, and 4 Quality in this outcome area is good. This judgement has been made using available evidence and a visit to the service. Prospective residents individual needs and aspirations were assessed prior to them moving in, and they were encouraged to have a trial period before moving into the home. Prospective residents have all the information they require, in a format they can access to help make an informed decision about living in the home. EVIDENCE: From the residents records inspected, appropriate information had been provided to prospective residents in order for them to make informed choices regarding whether or not the home could meet their needs. Two residents had moved into the home since the last inspection. Their records had a pre-admission protocol, which showed a comprehensive assessment of their needs prior to their admission. These assessments had information from a number of professionals already involved with them including psychologists, psychiatrists and other health professionals, as well as their relatives. Records showed that the residents had pre-admission meetings with staff at the home on more than one occasion and there was evidence to support that residents had been invited to stay for a few days before moving in. Haddon House DS0000016889.V314871.R01.S.doc Version 5.2 Page 10 There was hand written correspondence between the registered manager and the prospective resident to confirm this, and the tone of these letters emphasised that these residents had had been thoroughly involved in the admission process. A written agreement outlining the respective roles and responsibilities between the staff and the resident had been signed and dated by the referrer, the resident and the registered manager. This showed that the resident been encouraged to fully participate in the admission process, and had been consulted at every opportunity, before moving in. When one of these residents’ was asked about this, she stated she could not remember visiting the home before she moved in. She said that she would prefer to reside with a peer group of the same age, but it was better than living in hospital. A copy of the homes statement of purpose and service user guide had been signed and dated by the residents, which provided them with information they needed, to make an informed decision about moving into the home. Haddon House DS0000016889.V314871.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 and 9 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to the service. Residents are involved in regular reviews, which reflect their personal goals and changing needs, which are recorded in their care plans. Residents are supported to make decisions about their lives within the home, and are supported to take risks as part of their individual lifestyles. EVIDENCE: Residents are encouraged to make decisions about their lives on an individual basis by consulting with staff. Two residents were observed on the day of the inspection consulting with staff discussing a range of options available to them. Residents are involved in meetings but according to the minutes these do not take place every month. Residents confirmed they contribute to the planning of the weekly menus and are able to buy their own food if they wish. Haddon House DS0000016889.V314871.R01.S.doc Version 5.2 Page 12 One resident stated she had chosen the wallpaper in her bedroom and had a choice of bedrooms. Another confirmed she was moving into more independent accommodation in the near future, which was recorded, on her care plan. Residents have the option to have their own fridge and tea making facilities in their bedrooms, which are large enough to accommodate this additional furniture. Some also choose to have their own bank accounts and manage their own money independently of the home. The home has adopted a no smoking policy indoors and one resident whose records showed she had signed this written contract prior to moving in, continues to smoke in her bedroom, because she said it was too cold to smoke outside. Staff were observed discouraging her from smoking too frequently in a supportive manner. However those residents who smoke are required to use the garden patio outside, which is dry but cold during the winter months. The registered manager stated that she intends to buy a patio heater for the winter in order to make this area warmer for them. It is therefore a requirement that the manager makes a formal risk assessment regarding this in relation to those residents who smoke, in order to ensure their health and safety is consistently supported. It was observed that residents get up later in the day if they so choose. One resident said that she could lie in at the weekend but needs to rise earlier during the week when she goes out to college. This was reflected in her care plan, and demonstrated that the home was competently delivering its services in relation to the needs they had assessed. It was observed that those residents who are more vulnerable and unable to travel alone do so with a member of staff. Comprehensive risks assessments are detailed in individuals care plans covering issues regarding their vulnerability and any limitations regarding their independence. These risk assessments also include early signs of potential relapse to their mental health. Care plans include the residents personal preferences in daily living as well as preferred weekly activities. Residents care plans also reflect those residents who self medicate. The care plans described a range of behaviours, focusing on residents positive behaviour and abilities. Two residents records inspected showed individual weekly activity programmes. One attended college but the other stated she felt too anxious to Haddon House DS0000016889.V314871.R01.S.doc Version 5.2 Page 13 go out and was agoraphobic. Her records stated she attended church and the priest had also visited her at the home as well as her relatives visiting. This showed that the home had been receptive to this particular residents vulnerability and had attempted to provide in house support in accordance with the wishes and need expressed in her care plan. Haddon House DS0000016889.V314871.R01.S.doc Version 5.2 Page 14 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to the service. Residents have opportunities for personal development, and can take part in community activities appropriate to their age and peer group. The home supports good relationships between the residents and their families, and offers emotional support. Weekly menus show a wide range of wholesome food is offered to residents in order to meet their dietary and daily requirements. The food provided at the time of the inspection was wholesome and appetising. The home encourages residents to recognise their responsibilities in their daily lives. EVIDENCE: The residents care plans sampled showed they participated in weekly activity programmes. These activities included attendance at college courses, which included flower arranging, computer training, arts and crafts, and gardening. Haddon House DS0000016889.V314871.R01.S.doc Version 5.2 Page 15 These activities had been reviewed regularly and signed by the resident and their key worker. Those residents spoken to said that they attended community facilities such as clubs, cinemas and leisure activities and are encouraged to use public transport whenever possible. This promotes their confidence in travelling independently. The home arranges regular outings to the cinema and pub lunches as well as organising and paying for a yearly holiday for the residents. The registered manager also said the home covers the travel expenses for the residents activities. Residents records show that family and friends are encouraged to visit the home, and have family contact. One resident stated that her brother visits her regularly and she likes attending church. Her records show the priest had also visited her at the home. Another resident was keen to tell the inspector that she was going shopping that day to buy some new clothes. A member of staff accompanied this resident as her care plan stated she was unable to travel independently. Little was recorded on another residents activity programme apart from visits from her family and attendance at church. This resident said that she was anxious about going out even with a member of staff. Residents are encouraged to do their own laundry and although they have been involved in organising a weekly laundry rota, the manager stated that the home was flexible as some residents had difficulty keeping to this timetable. From records observed, residents have access to a qualified counsellor and alternative therapies in order to reduce their anxieties and promote their emotional well-being. Residents stated that they helped staff shop for food, were able to choose what they wanted to eat and enjoyed the meals. Records showed that a range of food is provided by the home, and the meal that was observed was wholesome and nutritious. Residents stated that they are encouraged to prepare their own breakfast and lunches. The evening meal is the main meal of the day and usually prepared by staff. Haddon House DS0000016889.V314871.R01.S.doc Version 5.2 Page 16 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Observations of staff indicated that they maintained residents privacy and dignity, and offered personal support in a manner acceptable to the residents. The residents physical and emotional health needs are met. The homes auditing of as required medication (PRN) needs to be more rigorous and protocols need to be put in place for the administration of home remedies. EVIDENCE: Residents have choices in the way they receive personal support and are given the opportunity to self medicate where appropriate. Those residents observed were dressed in a style individual to themselves, and it was apparent they had been supported with personal hygiene that day. At the time of this inspection the district nurse stated she was confident in the staffs management of the medical condition of the particular resident she was visiting. A member of staff was observed sharing a considerable amount of information about this resident’s progress with the nurse and was gathering Haddon House DS0000016889.V314871.R01.S.doc Version 5.2 Page 17 information from her as to how to best manage the residents’ medical symptoms. Residents weight was being recorded on a monthly basis and their records also showed they were registered with a community physician, and they were accessing community health service such as the chiropodist, dentist and optician. One resident requires medication in cold storage and this was being kept in a locked box in the domestic refrigerator in the kitchen. It is advisable that a small fridge is provided solely for the storage of medication. Records on residents files confirmed specialist health professionals were involved including the Consultant Psychiatrist and the Community Psychiatric Nurse. One resident was refusing to see her GP and this had been recorded on her file as well as plans for her to have a medical review. Clinical risks assessments were also on record, as well as signs of early relapse in order to best manage potential challenging behaviours, and full psychiatric histories. Protocols regarding the dispensing of residents as required (PRN) medication are in place, but these need to be audited more regularly as some members of staff have not recorded the amount of tablets carried forward when new prescriptions are issued. Also the home needs to introduce written protocols for home remedies in order to promote the residents health and safety. Staff training records confirmed they had completed medication training with Boots the chemist and the Safe Handling of Medication through Solihull College. Haddon House DS0000016889.V314871.R01.S.doc Version 5.2 Page 18 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is adequate. This judgement has been made using available evidence, including a visit to the service. Residents can be confident that their views are listened to and acted on, and they are protected from abuse and self-harm. The residents personal financial allowances are managed appropriately. EVIDENCE: Neither the service nor the Commission has received any complaints since the last inspection, although one questionnaire received from a resident stated they had no issues with the home, but did not know how to make a complaint if they had. Records of resident’s personal allowances showed an individual record was being kept of all monies going in and out resident’s accounts. Each transaction had been signed by one member of staff and the resident. Evidence supported that the registered manager as a secondary check regularly audited and signed these accounts. Receipts and records itemised each transaction and purpose of expenditure, making it easy to track expenditure. Residents have been provided with an individual written record from the Benefits Agency, showing a breakdown of their weekly income. This was helpful to make an accurate audit of their income and the balance of their weekly expenditure. Haddon House DS0000016889.V314871.R01.S.doc Version 5.2 Page 19 Residents have their own bank accounts. The home also has an adequate float of money in order that its services are properly resourced. A complaints procedure and telephone number of the Commission needs to be made available to all residents, relatives and professionals, in order that people are made aware of the process of how to make a complaint or raise any issues. Other findings at the time of the fieldwork including the number of staff on duty, and the management of risks to residents health and safety indicate further work is required by the manager to fully protect residents. These matters are fully explained at standards 33 and 42. Haddon House DS0000016889.V314871.R01.S.doc Version 5.2 Page 20 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26 27 28 and 30 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to the service. The residents live in a homely, comfortable and safe environment. The home is clean and well decorated. Resident’s bedrooms are spacious and have en-suite bathrooms, which suit their needs and are personalised to suit their own lifestyle. All residents have their own key to their bedrooms affording them privacy and independence. Bedrooms sampled with resident’s permission met their needs and wishes. Shared bathrooms and toilets meet resident’s needs. The resident’s health and well-being is promoted as the systems in place control infection and promote good hygiene. EVIDENCE: The building was clean and tidy and fresh. The home was decorated and furnished to a good standard. Large bowls of fresh fruit were placed about the home for residents to eat as they wished. The lounge is large with adequate seating where the residents can watch television. Haddon House DS0000016889.V314871.R01.S.doc Version 5.2 Page 21 The rear garden has a decked patio and veranda with modern garden furniture where the residents can sit. This is also the smoking area. The manager is arranging to buy a patio heater so that residents can continue to use these facilities during the colder weather. It is a requirement that the home adjusts the legs on those garden tables that wobble, in order to minimise residents from scalding themselves when they take hot drinks outside. Residents bedrooms reflect their individual lifestyles and some have teamaking facilities in their rooms as well as a fridge. Other residents have televisions, DVD players, bookcases and stereo systems. The bedroom furniture appeared to be robust and well made. However wardrobes have not been secured to walls, which could be a safety hazard to the residents as they could fall. Also residents store their property on the tops of wardrobes, which could cause an injury to someone if it fell. It is therefore a requirement that the home makes individual risk assessments regarding these aspects in order to promote the health and well being of its residents and staff. There is a separate laundry on the ground floor containing a washing machine, and tumble dryer. All cleaning equipment is stored in a locked cupboard. Staff provide the residents with washing powder and fabric conditioner when they wash their clothes. It is a requirement that the home ensures the boiler room is kept locked as this houses electric circuitry and the main plumbing to heat the home. In keeping with COSHH standards, it is a requirement that the home locks the shed doors at the rear of the property as in one emulsion is being stored and in another firelighters. Also on inspection a large stepladder was leaning upright at the rear of the house leading to the lower roof and a residents bedroom window. It is a requirement that the home secures the ladder when not in use. A coded lock is fixed to the front door and residents need to ask staff to let them out when they leave the building. The manager confirmed that this is released when the fire alarm rings to ensure that residents can immediately exit the building in an emergency. Residents also have access to an un- coded door as an alternative route out of the building. The home has facility for residents to have access to a telephone in the main hall. A member of staff stated that this is linked to a cordless phone in the main office, which residents can use in order to afford them some privacy when making calls. Environmental service made a positive inspection of the kitchen area in July 2006. However the fridge temperature was above the recommended Haddon House DS0000016889.V314871.R01.S.doc Version 5.2 Page 22 temperature. It is a requirement that the home remedies this problem. It is also a requirement that the home takes fridge and freezer temperatures on a regular basis as well as hot water temperatures. Haddon House DS0000016889.V314871.R01.S.doc Version 5.2 Page 23 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34 and 35 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to the service. The systems in place to recruit staff are good, and their records meet the requirements of the regulations. New staff are inducted appropriately and are provided with training in order to meet the needs of the residents. EVIDENCE: Two new members of staff have been recruited since the last inspection and from their records it showed that prior to them being appointed, references had been taken and disclosures sought from the Protection of Vulnerable Adults (POVA) and Criminal Records Bureau (CRB). This was evidence that the homes recruitment systems protected and supported the residents to ensure that only appropriate members of staff were recruited to deliver their care. Staff had been properly inducted and trained in basic food hygiene, emergency fist aid and fire drills. The manager stated that 60 of the permanent staff were NVQ trained in care, and the manager was arranging for the remainder of the team to complete this qualification. This qualification is a national requirement to ensure that appropriately qualified staff care for the residents. The home also ensures the staff receive training to meet the residents specific needs. Staff were observed to relate positively with the residents, having regard for their privacy and confidentiality. They were aware of the residents needs and Haddon House DS0000016889.V314871.R01.S.doc Version 5.2 Page 24 were willing to engage with them and offer appropriate support. The residents were observed to be at ease with the staff and willing to ask for their advice and support. Initially at the start of the inspection only one member of staff was found to be on duty. Four residents were in the home although most of them were in their bedrooms. Cover had not been found for one member of staff who was off sick, and the manager on duty was at the accident and emergency department with a relative. The manager stated that this was not usual practice and was taking steps to remedy the problem. It is concerning that staff on duty chose to leave the premises knowing that only one member of staff would be available to meet the needs of four residents. It is therefore a requirement that the manager makes all efforts in future to ensure that the proper ratios of staff are made available at all times, regardless of sickness or other issues, in order to promote the well being of the residents’ it has a duty to promote. The off duty registered manager was available to staff by telephone, who then participated in the inspection. Haddon House DS0000016889.V314871.R01.S.doc Version 5.2 Page 25 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39 and 42 Quality in this outcome area is adequate. This judgement is based on available evidence, including a visit to the service. The residents benefit from a well run home that promotes their welfare. The atmosphere in the home is friendly and relaxed and is supportive of the staff and residents. EVIDENCE: The registered manager is trained in nursing people with learning disabilities (RNMH) registered, and is also trained to work with people who have mental ill health. During the inspection residents regularly came to her office and appeared comfortable and at ease with her. The manager was observed to respond in a respectful manner toward the residents showing a regard for their needs, by making herself available and making efforts to ensure these needs were met. Staff’s relationship with the manager appeared to be a positive one. Haddon House DS0000016889.V314871.R01.S.doc Version 5.2 Page 26 The managers quality assurance systems ensure an adequate service to the residents. These involve monthly audits from within the group homes organisation. Records show that these audits involve the individual views of the residents and staff regarding the management of the home. However records show that resident and staff meetings do not take place regularly and as such their group views are not being made known to the home. It is therefore a requirement that the home makes every effort to remedy this problem in order that resident and staff views are responded to appropriately. Testing of the fire alarms is on a weekly basis, and the emergency lighting is tested every month. A risk assessment had been completed for the prevention of fire. Records regarding health and safety were current. The home had notified the Commission via Regulation 37 of an incident affecting the welfare of a resident since the last inspection. However other incidents recorded in the accident book had not. It is a requirement that risk assessments need to be in place to help reduce the risks to these residents. Records in the Accident book showed one resident had fallen off a chair without injury, attempting to retrieve something off the top of the wardrobe. Two other incidents had occurred where residents had been hurt but not so severe as to warrant professional medical treatment. The home did not notify the Commission of the later. As residents’ property was observed to be stored on the tops of wardrobes at this inspection, the home is required to assess the risks involved and how to reduce them in order to minimise the risks of harm to its residents. Also risk assessments need to be completed regarding the two other incidents. Haddon House DS0000016889.V314871.R01.S.doc Version 5.2 Page 27 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 3 2 3 3 x 4 3 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 x 30 3 STAFFING Standard No Score 31 X 32 3 33 1 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 x 3 x 2 x x 2 x Haddon House DS0000016889.V314871.R01.S.doc Version 5.2 Page 28 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. Standard YA8 Regulation 12(3) Requirement The Registered Person must evidence how the views of its residents and staff are obtained regarding the running of the home and the development of the service. The Registered Person must ensure written protocols are in place for home remedy medication, and must ensure that the amount for as required and home remedies is carried forward. The Registered Person must make a formal assessment of any risks attached to keeping non-food items in the domestic refrigerator. The Registered Person must ensure that water temperatures are recorded on a regular basis. The Registered Person must assess the risks involved to residents and staff with regard to items stored on the tops of wardrobes and wardrobes not being secured to the walls. DS0000016889.V314871.R01.S.doc Timescale for action 28/01/07 2. YA20 13(2) 28/01/07 3. YA20 13 28/01/07 4. YA42 12 13 (4) (a) (c) 13(4) (c) 28/01/07 5. YA24 28/01/07 Haddon House Version 5.2 Page 29 6. YA33 18 (1) (a) 7. YA42 13(4) (c) 8. YA42 13(4) (c) 9. YA33 18 (1) (a) The Registered Person must at all times ensure there are sufficient numbers of staff on duty. The Registered person must ensure that fridge temperature readings are taken regularly in order to ensure it is at the correct temperature. The Registered Person must make risk assessments regarding those residents whose accidents have been recorded in the accident book, to ensure their safety. The Registered Person must at all times ensure there are sufficient numbers of staff on duty. 01/01/07 28/01/07 28/01/07 01/01/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Haddon House DS0000016889.V314871.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection Birmingham Office 1st Floor Ladywood House 45-46 Stephenson Street Birmingham B2 4UZ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © 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 Haddon House DS0000016889.V314871.R01.S.doc Version 5.2 Page 31 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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