Inspection on 09/02/06 for Haddon House Care Home

This inspection was carried out on 9th February 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Haddon House Care Home 22/08/07

Haddon House Care Home 12/06/06

Haddon House Care Home 07/09/05

Haddon House Care Home 07/03/05

Haddon House Care Home 09/09/04

Haddon House Care Home 25/03/04

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

CARE HOMES FOR OLDER PEOPLE Haddon House Care Home 38 Lord Haddon Road Ilkeston Derbyshire DE7 8AW Lead Inspector Brian Marks Unannounced Inspection 9th February 2006 09:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Haddon House Care Home DS0000052159.V282907.R01.S.doc Version 5.1 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 House Care Home DS0000052159.V282907.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Haddon House Care Home Address 38 Lord Haddon Road Ilkeston Derbyshire DE7 8AW 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) 0115 9444222 0115 9444110 www.fshc.co.uk Tamaris Healthcare (England) Ltd (wholly owned subsidiary of Four Seasons Health Care Limited) Rita Flanaghan Care Home 30 Category(ies) of Dementia - over 65 years of age (30) registration, with number of places Haddon House Care Home DS0000052159.V282907.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. One MD Place For The Service User Named In The Notice Of Proposal Letter Dated 18 May 2004 One MD place for the Service User named in the Notice of Proposal dated 06.02.06. 7th September 2005 Date of last inspection Brief Description of the Service: Haddon House is registered as a home providing nursing care for up to 30 residents with dementia. Built approximately 12 years ago, the accommodation is on two floors with all communal areas being on the ground floor. Bedrooms are located on both floors, with 14 of the places in shared rooms, and a passenger lift is available to ease access within the home. There is a small secure garden at the rear of the home, which is accessed from patio doors from within the lounge. The home is within easy access of the town centre of Ilkeston and all local shops and community facilities. Haddon House Care Home DS0000052159.V282907.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced visit that took place at the home over a morning. Additionally, time was spent in preparation for the visit, looking at previous reports and other documents. At the home, apart from examining the home’s documents, care files and records, time was spent looking around the building and speaking to the manager and staff who were on duty at the time. Because of the nature of their medical condition, the majority of the residents were not able to give a clear opinion of their life at the home. However one was spoken to and she was able to speak out for herself. Staff were observed throughout the visit, looking after and dealing with residents and visitors and the manager was present throughout the inspection visit. The aim of inspection activity during the current inspection year is to assess a service against the ‘key’ National Minimum Standards and these are identified at the beginning of each section of the report. The majority of these keys standards were examined at the last inspection so, for a more complete picture of this service, this report should be read in conjunction with the report dated 7th September 2005. What the service does well: The home occupies a specialist position in local care services to older people, in that all residents have been assessed as suffering from dementia illnesses and are highly dependent on staff support for their day-to-day needs. Additional health care needs are well managed and care records indicate success with the management of complex problems. The home has been particularly successful with specific individual residents about whose admission to the home special registration arrangements have been made. The activities of staff at the home are supported by a good range of documents and records, which allow them to work safely and consistently. Social life at the home is supported by the appointment of an activities coordinator who works with both individuals and small groups throughout the week, and family members and friends are actively encouraged to visit and participate in the life of the home. Relationships between residents and staff were observed to be warm and supportive and the staff spoken to are committed to their work at the home and the residents they care for. A professional-looking Newsletter that is produced in-house keeps everyone involved with the home informed about events and developments. A good number of bedrooms have been redecorated in individual bright colour schemes and the housekeeping and laundry staff maintain good standards of cleanliness. Staff have continued in a good programme of training and Haddon House Care Home DS0000052159.V282907.R01.S.doc Version 5.1 Page 6 development which has helped them to work safely and professionally and to stay committed to the caring task. 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 House Care Home DS0000052159.V282907.R01.S.doc Version 5.1 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 House Care Home DS0000052159.V282907.R01.S.doc Version 5.1 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): EVIDENCE: These standards were not specifically looked at this inspection, other than as part of a general examination of individual care records. For the full assessment of the key standards see the inspection report dated 7 September 2005. Haddon House Care Home DS0000052159.V282907.R01.S.doc Version 5.1 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, 8, 9 and 10 The care of all residents, including health care, is planned and given in a professional way that respects individuality and the differing needs of residents. EVIDENCE: The records of 2 residents were looked at closely, including those of a resident recently admitted under special circumstances because of her complex health care needs. She was also spoken to during the visit. The standard of care planning records was commented on in detail in the last inspection report, and since that time some additional work has carried out to improve the range of completed risk assessments. However both the files examined did not contain details of the continence needs of the resident, subjected to this ‘risk assessment’ approach and the programme for helping them is not explicit. This may lead to potentially unsafe care activities being carried out. All the care plans examined had been looked at and evaluated regularly by the home’s staff, and revised where necessary, so that their actions are based on up-todate information. As noted above, the care of people with complex physical and psychological health needs has been successful, partially through the application of Haddon House Care Home DS0000052159.V282907.R01.S.doc Version 5.1 Page 10 additional staff time and the work of the manager and staff in this area is to be commended. The respect for personal privacy and individuality, frequently lost in this type of care setting, is also given a central focus and this was supported by the relative of another resident spoken to. ‘The staff are more knowledgeable about her condition than the other places and treat her calmly and with respect at all times’. A more complete audit of the administration of medicines was made at the last inspection but a visit to the clinic room indicated that the written records contained the improvements required at the last inspection, and produced a safer and more consistent system. Haddon House Care Home DS0000052159.V282907.R01.S.doc Version 5.1 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, 13, 14 and 15 Residents at the home experience a range of activities and social events that are aimed at maintaining their independence. Residents are also assisted to enjoy a varied and healthy diet that is based on their preferences and individual needs. EVIDENCE: It was noted from a discussion with the home’s activities coordinator and a relative of a resident, that the programme of social life at the home is developing well and residents join in where they are able. The coordinator works with both individuals and small groups and focuses on sensory experiences, exercise and small craft projects. Some professional entertainers visit the home but this is less regular due to financial pressures. Family members are also encouraged and about a third of the residents have regular visitors; a number were seen at the home during this inspection. The home has a regular newsletter that is widely circulated to keep everyone in touch with what is happening there. Examination of the menus at the home and discussion with staff indicated that a planned menu is provided at the home. Most meals are traditional in style to reflect the preferences of an older age group, and a choice is offered at all main meals with a cooked option additionally available for the teatime meal. Meals are based in principles of healthy eating, although the amounts of fresh Haddon House Care Home DS0000052159.V282907.R01.S.doc Version 5.1 Page 12 fruit and vegetables in the store were not as high as might be expected for a home of this size. Regular deliveries of food are made to the home through suppliers centrally contracted by the company; aspects of storage were satisfactory. Specific health needs are reflected within the catering arrangements, such as weight loss and weight gain, diabetic problems and for those residents who require a softened or liquid diet. With the latter the kitchen staff make a good effort at presentation so that the meals are appealing to look at and encourage people to eat. The residents mostly take their meals together in the dining area but those residents with higher dependency are assisted with their meals in the lounge areas or eat in their rooms. Haddon House Care Home DS0000052159.V282907.R01.S.doc Version 5.1 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): 16 and 18 The home has comprehensive policies and procedures in relation to making complaints and the protection of vulnerable people, and staff are made aware of their responsibilities in these areas. EVIDENCE: The home has a comprehensive complaints policy and procedure, a copy of which is included in the Service Users Guide, which is given to residents or their representatives, and is also on display at the home. There were written records of 4 complaints dealt with by the manager in 2005, one of these was made through CSCI. All were dealt with satisfactorily and responded to appropriately. The manager’s style is very open with residents and their families and those spoken to expressed confidence that they can approach at any time and will be taken seriously. The home has a detailed policy and procedure in relation to the protection of vulnerable adults, and this includes the local statutory procedure to be followed. Staff are given instruction at the time they join the home and through other later training but not all had done so. The manager and 2 senior staff have been approved as trainers and are able to pass on their knowledge of this key subject. There had been no incidents of use of the statutory procedures during the past 12 months but the manager has previous experience of the matter. Haddon House Care Home DS0000052159.V282907.R01.S.doc Version 5.1 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): EVIDENCE: These standards were not specifically looked at this inspection, other than as part of a general examination of bathrooms and toilets, where improvements had been made since the last inspection. For the full assessment of the key standards see the inspection report dated 7 September 2005. Haddon House Care Home DS0000052159.V282907.R01.S.doc Version 5.1 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 The home is now properly staffed with people who have a good cross-section of experiences and skills. They join the home after the proper checks are made, and only people who are right for the job look after the people living there. EVIDENCE: Records on staff files showed that 8 care staff had completed or were completing an NVQ qualification at a minimum of level 2, and the required target of 50 of staff should be achieved within 6 months. Staff were observed with the residents during the inspection and interactions were seen to be warm and professional. Since the last inspection recruitment of new staff, and substantial reduction in sickness leave, has resolved a longstanding problem of the levels of staff supporting residents, and recent rotas indicated that the right numbers had been on duty. Examination of staff files indicated that a satisfactory recruitment process is followed at the home and that only the right people for the job are employed; all checks required to ensure protection of the residents are routinely made. A copy of the staff contract was noted on each file. This contained details of the terms and conditions of their employment so that they have full knowledge of their rights and responsibilities as employees of the home. Haddon House Care Home DS0000052159.V282907.R01.S.doc Version 5.1 Page 16 From the examination of staff records all have received training in relation to basic food hygiene and fire safety but other key areas had not been covered for all staff – manual handling, infection control and emergency first aid. Given the nature of the home it would also be expected that staff receive training in the care of people with dementia and the manager indicated that this was planned. Completion of a carefully planned programme will make sure that the care provided to residents is done so safely and by properly trained staff. Haddon House Care Home DS0000052159.V282907.R01.S.doc Version 5.1 Page 17 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): 31, 33, 36 and 38 The home’s manager has continued to make a positive impact on the home and has established systems to make sure that staff deliver care to residents safely and consistently. This includes a re-established system of staff supervision and consultation. EVIDENCE: The manager has continued to take part in training taking place in the home for other staff, and has commenced on a Registered Manager’s course, which is required by law. She receives good support from her line manager, who submits regular reports of her visits, which were available for examination during the inspection. As an organisation the owner of the home, Four Seasons Healthcare, is committed to providing a quality service and employs a number of systems to make sure that standards are monitored and maintained. Apart from monthly Haddon House Care Home DS0000052159.V282907.R01.S.doc Version 5.1 Page 18 internal quality checks carried out by the home’s manager, the home’s line manager makes a comprehensive annual audit and an annual business plan is produced to indicate how the home’s operation is to develop. Staff surveys and surveys about the views of relatives have been used in the past and these have indicated areas of concern or praise. Examination of staffing records indicated that the level of formal 1-to-1 meetings between the manager and care staff has now been put into place and all have received an appraisal of their work, which will be repeated annually. Regular 2-monthly meetings are due to commence. This allows for individual and confidential support being given to staff as well as allowing for their work to be monitored. A full examination of records indicated a good standard of health and safety activity at the home and this protects the residents; the maintenance man carries out an extensive range of routine activities and the last inspections of the Environmental Health and Fire Officers were satisfactory. As noted above some aspects of staff training need completing to make sure that the home is as safe as possible for the residents. Haddon House Care Home DS0000052159.V282907.R01.S.doc Version 5.1 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X X X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 X X 2 X X X X X STAFFING Standard No Score 27 3 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X X 2 X 3 Haddon House Care Home DS0000052159.V282907.R01.S.doc Version 5.1 Page 20 Are there any outstanding requirements from the last inspection? Yes 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 OP8 Regulation 13 (4, 5) Requirement Timescale for action 31/03/06 2. OP21 23(2) 3. OP28 18 4. OP30 18(1) The registered person must ensure that all residents have their care needs fully assessed and that any areas of specific concern are further assessed under a comprehensive system of risk assessment. This specifically applies to the continence needs of residents. The registered person must 30/06/06 urgently review and adapt the provision of assisted bathing facilities so that variety of provision is available and the numbers required by the standard is met. (Previous timescale of 31/12/05 not met). The registered person must 31/07/06 achieve the target of 50 of care staff having achieved at least NVQ level 2 by the due date. (Previous timescale of 31/12/05 not met). All staff must receive appropriate 31/07/06 training or instruction in infection control,emergency first aid and the care of people suffering from DS0000052159.V282907.R01.S.doc Version 5.1 Haddon House Care Home Page 21 5. OP31 9(2) 6. OP36 18 dementia. The manager must complete a training course that leads to a qualification at NVQ level 4 (Registered Managers Award) or its equivalent. Formal supervision must be given to staff at least 6 times annually and records of this maintained and signed by the staff member and supervisor. (Previous timescale of 31.12.04 not met). 31/12/06 30/06/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. 5. Refer to Standard OP9 OP10 OP14 OP15 OP18 Good Practice Recommendations The registered person should provide a thermometer that reads maximum and minimum temperatures for the refrigerator in the clinic room. All residents should be routinely assessed as to their ability to hold the keys to their own rooms. Residents must be given information regarding their right to access care records in an appropriate format. The manager should review the availability of fresh fruit and vegetables within the catering arrangements of the home. All staff should undertake regular update training in adult protection. Haddon House Care Home DS0000052159.V282907.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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. 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