Inspection on 22/07/08 for Haisthorpe House

This inspection was carried out on 22nd July 2008.

CSCI found this care home to be providing an Good service.

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Haisthorpe House 09/11/06

Similar services:

Larch Avenue

Alderson Road 12

Cranworth Close Registered Care Home

John Street Nursing Home

Pennine Camphill

Muston Road (70)

Grayling

The Cornerstone

Extracts from inspection reports are licensed from CQC, this page was updated on 08/11/2008.

CARE HOME MIXED CATEGORY MAJORITY ADULTS 18-65 Haisthorpe House 139 Holgate Road York YO24 4DF Lead Inspector Dawn Navesey Key Unannounced Inspection 22nd July 2008 10:30 Haisthorpe House DS0000064101.V367353.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 Haisthorpe House DS0000064101.V367353.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 Older People and 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. Haisthorpe House DS0000064101.V367353.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Haisthorpe House Address 139 Holgate Road York YO24 4DF 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) 01904 654638 01904 674000 haisthorpe@aol.com Haisthorpe House Care Ltd Miss Sally Anne Plant Care Home 27 Category(ies) of Learning disability (27), Learning disability over registration, with number 65 years of age (27), Mental disorder, excluding of places learning disability or dementia (27), Mental Disorder, excluding learning disability or dementia - over 65 years of age (27) Haisthorpe House DS0000064101.V367353.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users to include up to 27 (LD), up to 27 (MD), up to 27 (LD(E)) and up to 27 (MD(E)) up to a maximum of 27 users. 9th November 2006 Date of last inspection Brief Description of the Service: Haisthorpe House is a care home providing personal care and accommodation for 27 adults with mental illness and/or a learning disability. Haisthorpe House Care Ltd took over the ownership of the home in December 2005. The home is situated on Holgate Road close to the centre of York and is easily accessible to its facilities and amenities. The accommodation is of both single and double rooms over two floors and has single accommodation in selfcontained flats. There is a garden to the rear of the house and private parking for visitors. The current weekly fees at the time of the visit are £360 per week and did not include costs for holidays, hairdressing, private chiropody, toiletries and newspapers. Some people receive additional funding to meet their specific needs. These costs are agreed on an individual basis with people’s care managers or social workers. Haisthorpe House DS0000064101.V367353.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. The Commission for Social Care Inspection (CSCI) inspects services at a frequency determined by how the service has been risk assessed. The inspection process has now become a cycle of activity rather than a series of one-off events. Information is gathered from a variety of sources, one being a site visit. More information about the inspection process can be found on our website www.csci.org.uk This unannounced visit was carried out by one inspector who was at the home from 10.30am until 5.35pm on 22 July 2008. The purpose of the inspection was to make sure the home was providing a good standard of care for the people who use the service. Before the inspection, evidence about the home was reviewed. This included looking at any reported incidents, accidents or complaints. This information was used to plan the visit. The manager of the home completed an Annual Quality Assurance Assessment (AQAA) before the visit to provide additional information. We looked at a number of documents during the visit and visited areas of the home used by the people who live there. We spent a good proportion of time talking with the people at the home, staff and the manager. Comments made to us during the day appear in the body of the report. Survey forms were sent to people living at the home and their relatives. Information from those returned is reflected in this report. Feedback at the end of the visit was given to the deputy manager. What the service does well: People who use the service or their relatives spoke well of the home. These are some of the things they said: Haisthorpe House DS0000064101.V367353.R01.S.doc Version 5.2 Page 6 • • • • • • • • • • • • I like staying here. I feel Haisthorpe House supports my son very well. I am very happy my brother is getting the best of care. As my brother cannot read and write they help him to phone me to keep in touch. Very nice to myself and family. Makes sure my brothers personal life is looked after and is always clean and tidy. The staff are very good to him when he is having a bad day. I have lived here a long time, this is my home and I like it. I am very happy here. The staff are nice. The food is good. I am very happy with the move, everything going well so far. People who live at the home said that staff treat them well and always listen to them and act on what they have said. Most people knew how to make a complaint if they needed to. People who live at the home and the staff get on well together. Staff showed they were respectful of people’s rights and choices. There is a good atmosphere in the home. What has improved since the last inspection? All staff now have the required pre-employment checks carried out properly. This means that people who use the service are safeguarded. Some bedrooms in the home have been re-decorated, had new carpets and new furnishings. This has made them more pleasant and comfortable for people. Some new chairs have been provided for one of the sitting rooms. One person said they liked these and that they were very comfortable. The manager has successfully completed the registered managers award and is therefore suitably qualified to manage the home. The manager has introduced a simplified version of the review document to encourage people to get more involved in planning and reviewing their own care. Haisthorpe House DS0000064101.V367353.R01.S.doc Version 5.2 Page 7 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. The summary of this inspection report can be made available in other formats on request. Haisthorpe House DS0000064101.V367353.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home Individual Needs and Choices Lifestyle Personal and Healthcare Support Concerns, Complaints and Protection Environment Staffing Conduct of Management of the Home Scoring of Outcomes Statutory Requirements Identified During the Inspection Adults 18 – 65 (Standards 1–5) (Standards 6-10) (Standards 11–17) (Standards 18-21) (Standards 22–23) (Standards 24–30) (Standards 31–36) (Standards 37-43) Older People (Standards 1–5) (Standards 7, 14, 33 & 37) (Standards 10, 12, 13 & 15) (Standards 8-11) (Standards 16-18 & 35) (Standards 19-26) (Standards 27-30 & 36) (Standards 31-34, 37 & 38) Haisthorpe House DS0000064101.V367353.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 (Adults 18 – 65) and Standards 1 – 5 (Older People) are: 1. 2. 3. Prospective service users have the information they need to make an informed choice about where to live. (OP NMS 1) Prospective users’ individual aspirations and needs are assessed. No service user moves into the home without having been assured that these will be met. (OP NMS 3) Prospective service users’ know that the home that they choose will meet their needs and aspirations. Service Users and their representatives know that the home they enter will meet their needs. (OP NMS 4) Prospective service users’ have an opportunity to visit and “test drive” the home. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. (OP NMS 5) Each service user has an individual written contract or statement of terms and conditions with the home. Each service user has a written contract/statement of terms and conditions with the home. (OP NMS 2) 4. 5. The Commission considers Standard 2 (Adults 18-65) and Standards 3 and 6 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Overall, people who use the service can be sure that the home will meet their needs following assessment. EVIDENCE: In the AQAA the manager said that assessments are carried out that include records of introductory visits. Records we looked at showed that some people had detailed assessments carried out by the manager of the home, before they moved in. One person’s Haisthorpe House DS0000064101.V367353.R01.S.doc Version 5.2 Page 10 assessments carried out by the manager were not available. The manager said they had been shredded once the information had been transferred to the care plan. She also said she had used the detailed care management assessment for this person as the information in this had proved more reliable. Daily notes records showed that introductory visits had been carried out for this person and some assessment information such as trying out aids and adaptations had been recorded here. The manager was informed that assessments which relate to people who use the service should be kept at the home. This will make sure the person’s needs and any changes in needs can be properly monitored. People who use the service said they were happy with the way they hade been introduced to the home. One person said, “This is my home”. Another said, “I am very happy with the move, everything going well so far”. Haisthorpe House DS0000064101.V367353.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6-10 (Adults 18-65) and Standards 7, 14, 33 & 37 (Older People) are: 6. Service users know their assessed and changing needs and personal goals are reflected in their Individual Plan. The Service Users health, personal and social care needs are set out in an individual plan of care. (OP NMS 7) Service users make decisions about their lives with assistance as needed. Service Users are helped to exercise choice and control over their lives. (OP NMS 14) Service users are consulted on, and participate in, all aspects of life at the home. The home is run in the best interests of service users. (OP NMS 33) Service users are supported to take risks as part of an independent lifestyle. The service users health, personal and social care needs are set out in an individual plan of care. (OP NMS 7) Service users know that the information about them is handled appropriately and that their confidences are kept. Service Users rights and best interests are safeguarded by the home’s record keeping, policies and procedures. (OP NMS 37) 7. 8. 9. 10. The Commission considers Standards 6, 7 and 9 (Adults 18-65) and Standards 7, 14 and 33 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8 and 9 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. People are encouraged to make decisions about their lives and are involved in planning their care and support. EVIDENCE: We looked at care plan and risk assessment records for some people who live at the home. Haisthorpe House DS0000064101.V367353.R01.S.doc Version 5.2 Page 12 Most of the plans seen gave some clear and detailed instruction on how the needs of people who use the service are to be met. They had good information about how people should be supported with personal care, and their health needs. There were some minor shortfalls with the care plans and risk assessments. Some plans did not give the detail of how care needs are carried out. Terms such as ‘monitor, ‘needs support’ and ‘needs assistance’ do not tell staff how much support a person needs and could lead to needs being overlooked. However, staff were familiar with what was written in people’s care plans and could talk confidently about the support they give. Staff also showed a good understanding of person centred care. They said it was important to respect people and treat them as individuals. We observed staff being very respectful in their interactions with people. In surveys returned to us, most people said ‘always’ or ‘usually’ when asked, “do staff listen and act on what you say”. Relatives of people who live at the home spoke highly of the care and support received. They said, “I feel Haisthorpe House supports my son very well” and “I am very happy my brother is getting the best of care”. In the AQAA the manager said that they ‘have produced a simplified version of the review document to encourage the involvement with the care planning/review process of service users who are reluctant to do so/find the process challenging’. This should make sure that reviews are carried out that meet people’s needs properly. Most people who live at the home had signed their care plans to show they are in agreement with them. There is a good attitude to responsible risk taking for people in the home. Staff gave good examples of how people have been supported to gain more independence through good risk management. This included people gaining skills to travel independently. People said they had regular meetings in the home to discuss activities, the menus, staff issues and anything that was bothering them. We saw minutes of these meetings that showed people had been able to voice their opinions. It was clear that people can choose how to spend their time and make decisions about their lives. Haisthorpe House DS0000064101.V367353.R01.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 (Adults 18-65) and Standards 10, 12, 13 & 15 (Older People) are: 11. Service users have opportunities for personal development. 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. (OP NMS 12) Service users are able to take part in age, peer and culturally appropriate activities. 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. (OP NMS 12) Service users are part of the local community. Service users maintain contact with family/ friends/ representatives and the local community as they wish. (OP NMS 13) Service users engage in appropriate leisure activities. 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. (OP NMS 12) Service users have appropriate personal, family and sexual relationships and maintain contact with family/friends/representatives and the local community as they wish. (OP NMS 13) Service users’ rights are respected and responsibilities recognised in their daily lives. Service users feel they are treated with respect and their right to privacy is upheld. (OP NMS 10) Service users are offered a (wholesome appealing balanced) healthy diet and enjoy their meals and mealtimes. Service users receive a wholesome appeaing balanced diet in pleasing surroundings at times convenient to them. (OP NMS 15) 12. 13. 14. 15. 16. 17. The Commission considers Standards 12, 13, 15, 16 and 17 (Adults 1865) and Standards 10, 12, 13 and 15 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15,16 and 17 People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. Haisthorpe House DS0000064101.V367353.R01.S.doc Version 5.2 Page 14 People who use the service are able to make some choices about their lifestyle. Overall, social, educational, cultural and recreational activities meet most people’s expectations. They also benefit from a good, healthy and varied diet. EVIDENCE: Most people said that in the main they had enough to do at the home. Some people go to day centres or colleges in the community. Some people have paid or supported employment. Other activity on offer to people includes, attending a local church, walks in the park, shopping, occasional day trips out, watching TV, listening to music or sitting in the garden. Records showed that for some people their level of activity was quite minimal. One person’s records showed they had not left the home in two months. Staff said they felt this was due to staff not recording activity and said this person had definitely been out in the community on outings in that time. In surveys carried out by the home, a significant number of people had said they feel bored and wished they had more to do. Comments included: • • Would like to go to the garden centre more often. I’d like to go out for a drink more often. The deputy manager was not sure of what had been done to address these concerns. However, in the AQAA the manager said they ‘plan to explore with the staff team and service users new ways of developing and supporting regular activities for service users’. It is recommended that this review of activities is carried out to make sure peoples social and recreational needs are being properly met. The manager said they try to meet all the different needs that people may have. There is a wide age range of people who live at the home. The manager said they try to encourage people to mix well and support each other, drawing on people’s strengths and experiences. Overall, staff said they felt there were enough staff to make sure people who use the service get a reasonable level of activity. Some staff said it could be more difficult to get people out on occasions when they have staff shortages. Staff said people are given support to help them keep in touch with their family and friends. Staff said they assist people to make regular phone calls to their family and send cards or letters. Relatives were positive about the service. They said, “As my brother cannot read and write they help him to phone me to keep in touch” and “Very nice to myself and family”. In the past, holidays from the home have been organised for people. The manager is reviewing this at the moment, as there have been difficulties in Haisthorpe House DS0000064101.V367353.R01.S.doc Version 5.2 Page 15 finding suitable places. Some of the people who like to take a holiday wish for somewhere where they can smoke. Now the smoking ban is in force availability of places is very limited. She said that additional day trips would be arranged in the meantime. Menus are developed in the home from meetings with people who use the service. In the AQAA the manager said they had recently improved these by, ‘increasing the choice of menu options at lunch time and ensuring a stock of ‘ready meals’ is available for service users who do not wish to have the main menu option’. People who live at the home spoke highly of the quality of the food and choices available. We observed the lunchtime and teatime meal. The food looked attractive and appetising. People made positive comments which included: • • • • Good cooks here. It’s always nice. Plenty of choice. Can have something different if you don’t like what’s on. People were given support at mealtimes in a discreet and respectful manner. Staff respected people’s choices and requests. There was a lively atmosphere in the dining room and it is clear that meal times are seen as a social occasion. Haisthorpe House DS0000064101.V367353.R01.S.doc Version 5.2 Page 16 Personal and Healthcare Support The intended outcomes for Standards 18 – 21 (Adults 18-65) and Standards 8 – 11 (Older People) are: 18. 19. 20. Service users receive personal support in the way they prefer and require. Service users feel they are treated with respect and their right to privacy is upheld. (OP NMS 10) Service users’ physical and emotional health needs are met. Service users’ health care needs are fully met. (OP NMS 8) 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. Service users, where appropriate, are responsible for their own medication and are protected by the home’s policies and procedures for dealing with medicines. (OP NMS 9) The ageing, illness and death of a service user are handled with respect and as the individual would wish. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. (OP NMS 11) 21. The Commission considers Standards 18, 19 and 20 (Adults 18-65) and Standards 8, 9 and 10 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Overall, people’s general healthcare needs are well met and based upon their individual needs. EVIDENCE: Staff had good knowledge of people’s personal support needs. Staff were courteous, polite and respectful of people’s dignity when attending to any personal care needs. In a survey a relative told us when asked, ‘what does the home do well’, “Makes sure my brothers personal life is looked after and is Haisthorpe House DS0000064101.V367353.R01.S.doc Version 5.2 Page 17 always clean and tidy”. People looked well dressed and groomed and said they had the support they needed. In the AQAA, the manager said they always try to provide staff of the same gender for personal care for people who live at the home. Good records are kept of health appointments and their outcomes. Staff make sure that people are given support to attend appointments to meet their health needs. Staff are prompt in supporting people at the home to get health checks and referrals as their needs arise. New people to the home are given good support to get registered with local practitioners. One person said, “They will get us what we need”. Where people’s needs have changed due to health issues, care plans have been updated. A person who now requires some aids to help with their independence has a care plan regarding this. As mentioned in the Individual Needs and Choices section of this report there were some minor gaps in information which could lead to needs being overlooked. For example, a person who uses pressure relieving equipment had no plan in place for its use or a risk assessmnt showing the risks of pressure ulcers. However, staff were able to say what they do to prevent pressure ulcers and how the equipment is used. Staff have received some training on meeting the specific health needs of people who live at the home. A number of staff have undertaken mental health training. Other courses such as manging continence are planned. However, staff have been undertaking some health screening checks for people at the home. This practice must stop as staff have not been trained to do this and it could lead to health needs being missed. The practice must be reviewed with a health practitioner and any screening must be agreed with the people using the service. In the AQAA the manager said ‘medication is administered by staff who have completed medication management training’. The home uses a monitored dosage pre-packed system for medicines. There are good ordering and checking systems in place. We checked some medication administration records (MAR) sheets. Most were found to be in order. However one person’s MAR sheets had the wrong dates on. The senior support worker said this was an oversight and agreed to correct it. We also noticed that the person responsible for giving out medication was ‘potting up’ (dispensing) some liquid medicines and leaving them unlabelled in the medicines cupboard while they gave out other medication. The senior support worker explained the person who had ‘potted’ them up would give them out and they were not left for someone else to administer. However, this is unsafe practice and must cease. Medicines must be given from the container that is labelled with the name of the medicine and the dose required Haisthorpe House DS0000064101.V367353.R01.S.doc Version 5.2 Page 18 at the time of administration. This will make sure that mistakes in administration are avoided. The senior support worker agreed to do this. The medication cupboard is in the home’s kitchen. At the last inspection of the home, the manager was advised to seek advice from the supplying pharmacist in relation to the medicine cupboard being located in the kitchen. The manager said they had done this and the pharmacist said the storage was satisfactory. On the day of the visit it was very warm in the kitchen. It is recommended that the temperature is monitored to make sure medicines are being stored safely as they can deteriorate if stored above 25 ° C. Haisthorpe House DS0000064101.V367353.R01.S.doc Version 5.2 Page 19 Concerns, Complaints and Protection The intended outcomes for Standards 22-23 (Adults 18-65) and Standards 16-18 & 35 (Older People) are: 22. 23. Service users feel their views are listened to and acted on. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted on. (OP NMS 16) Service users’ are protected from abuse, neglect and self-harm. Service users legal rights are protected. (OP NMS 17) Also Service users are protected from abuse. (OP NMS 18) Also Service users financial interests are safeguarded. (OP NMS 35) The Commission considers Standards 22-23 (Adults 18-65) and Standards 16-18 and 35 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. Overall people are protected. People are confident that they will be listened to and that action will be taken when necessary. EVIDENCE: The home has a complaints procedure, which people who live at the home are made familiar with when they move in to the home. Making complaints is also discussed at house meetings to keep it fresh in people’s minds. In the AQAA the manager said they are ‘planning to introduce a more accurate record of informal concerns and suggestions from service users, their friends/relatives and other professionals’. The manager said this would also be used to address minor everyday concerns with a view to resolving them before they become complaints. Haisthorpe House DS0000064101.V367353.R01.S.doc Version 5.2 Page 20 We looked at the complaints book. Complaints received have been properly recorded and responded to. Everyone we spoke to said they knew how to complain. Most staff have received training in safeguarding adults. They were able to say what action they would take if they suspected abuse or had an allegation of abuse made to them. They were also able to describe the different types of abuse. The home have their own policy and procedures for safeguarding people from abuse and had a copy of the City of York’s Multi-Agency Adult Protection Policy and Procedure. However, at the last inspection they were asked to make sure that staff were given clear guidance on local authority procedures for reporting abuse issues. The policy has been reviewed and updated. However, some staff were still not clear on their responsibilities to report safeguarding issues to the local authority. The policy must be updated further so that contact details for the local authority are clearly written in the procedure. This will make sure people are properly safeguarded. Haisthorpe House DS0000064101.V367353.R01.S.doc Version 5.2 Page 21 Environment The intended outcomes for Standards 24 – 30 (Adults 18-65) and Standards 19-26 (Older People) are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users live in a safe, well-maintained environment (OP NMS 19) Also Service users live in safe, comfortable surroundings. (OP NMS 25) Service users’ bedrooms suit their needs and lifestyles. Service users own rooms suit their needs. (OP NMS 23) Service users’ bedrooms promote their independence. Service users live in safe, comfortable bedrooms with their own possessions around them. (OP NMS 24) Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Service users have sufficient and suitable lavatories and washing facilities. (OP NMS 21) Shared spaces complement and supplement service users’ individual rooms. Service users have access to safe and comfortable indoor and outdoor communal facilities. (OP NMS 20) Service users have the specialist equipment they require to maximise their independence. Service users have the specialist equipment they require to maximise their independence. (OP NMS 22) The home is clean and hygienic. The home is clean, pleasant and hygienic. (OP NMS 26) The Commission considers Standards 24 and 30 (Adults 18-65) and Standards 19 and 26 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. The environment is fairly comfortable and safe for people who live at the home. However, further refurbishment work is needed to improve the living conditions for people. EVIDENCE: Haisthorpe House DS0000064101.V367353.R01.S.doc Version 5.2 Page 22 Some areas of the home have been re-decorated since the last inspection. This includes some bedrooms and bathrooms. Some bedrooms have also had new carpets or non-slip floor covering. There are some new chairs in one of the sitting rooms. However there are a number of areas in the home that are in need of re-decoration or re-furbishment. The décor is looking tired and worn in many areas. Furnishings and carpets are in need of replacement. They look old, worn and stained. The outside paintwork of the home is in disrepair. In the AQAA, the manager had identified some priorities for re-furbishment. The refurbishment plan is discussed on a monthly basis with the owner of the home. Priorities identified for this year include, electrical tests and repair work, some bedrooms décor and flooring, some fittings in the staff bedroom and the decoration of the dining room. These must be done to make sure the home is comfortable for everyone. Staff work hard to make sure the home is kept clean. They were observed to be doing this on the day of the visit. There are no malodours in the home. The pull chord light switches in some of the toilets looked grubby and in need of cleaning to make them more hygienic. We asked staff if there was anything they would change at the home. All staff said the environment and they would like to see it looking nicer for people. People said they liked their rooms and were able to have their own things in them. People had a key for their rooms and were able to lock them. People also said they enjoyed the gardens at the home. Many people chose to sit out on the day of the visit. The kitchen was clean and proper procedures were, in the main, being followed to promote safe food hygiene practices. The deputy manager was advised that open sauce bottles should be stored in the fridge as advised on the manufacturers instructions. The home has separate laundry facilities to attend to people’s personal clothing. Some people are given support to manage their own laundry to further their independence skills. Clinical waste is properly managed and staff wear protective clothing when attending to the personal care needs of people who live at the home. Most staff have received training in infection control as part of their induction and were able to say what infection control measures are in place. Hand washing and hand drying facilities were available in all areas of the home. Liquid soap or paper towels were available. This ensures good hygiene practice. Haisthorpe House DS0000064101.V367353.R01.S.doc Version 5.2 Page 23 Staffing The intended outcomes for Standards 31 – 36 (Adults 18-65) and Standards 27 – 30 & 36 (Older People) are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported and protected by the home’s recruitment policy and practices. (OP NMS 29) Service users are supported by competent and qualified staff. Service users are in safe hands at all times. (OP NMS 28) Service users are supported by an effective staff team. Service users needs are met by the numbers and skill mix of staff. (OP NMS 27) Service users are supported and protected by the home’s recruitment policy and practices. Service users are supported and protected by the home’s recruitment policy and practices. (OP NMS 29) Service users’ individual and joint needs are met by appropriately trained staff. Staff are trained and competent to do their jobs. (OP NMS 30) Service users benefit from well supported and supervised staff. Staff are appropriately supervised. (OP NMS 36) The Commission considers Standards 32, 34 and 35 (Adults 18-65) and Standards 27, 28, 29 and 30 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35 and 36 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. There are enough staff. They are, in the main, trained and competent to meet the needs of the people who use the service. People are protected by the home’s recruitment procedures. EVIDENCE: Haisthorpe House DS0000064101.V367353.R01.S.doc Version 5.2 Page 24 There are usually three staff on duty throughout the day and evening, with the manager or deputy manager being available office hours during the week. During the night there is one staff on waking night duty and one sleeping in who can be called upon for emergencies. The manager or deputy provide on call support. One staff member said they had “Never failed” in their response to on call matters and that they felt very well supported. The manager said they had received additional funding to give more staff hours to people whose needs had changed and they had become more dependant. This should be kept under review as the needs of people change due to their age and disability. Most staff said they had enough staff to meet people’s needs as long as there was no sickness. One person thought having more staff would lead to more activity outside of the home for people. People who live at the home said there was enough staff and they didn’t have to wait long for staff’s attention if they needed them. We looked at the recruitment process for three people working at the home. The files had all the relevant information to confirm these recruitment processes were properly managed. This included application forms, interview notes, references and CRB (criminal records bureau) checks. People who use the service and their relatives spoke highly of the staff. These are some of the things they said: • • • The staff are very good to him when he is having a bad day. The staff are nice. They look after us well. In the AQAA the manager said they ‘provide all staff with induction training that equips them to provide good quality care’. She also said that staff receive training in mental health care. Staff follow an induction programme based on the “Skills for Care” common induction standards. This is provided at a local college and includes, essential care skills, moving and handling, health and safety and safeguarding vulnerable adults. They also complete an in-house induction that has been developed by the manager. Records also showed that most staff were up to date with their mandatory training. Although some people had been in post a number of months and had not completed their induction training courses. The deputy manager said this depended on availability of courses at the local college. A number of staff in the home have achieved an NVQ (National Vocational Qualification) in level 2 or above. Other staff are also working towards this. Staff said they felt they had a good team and that communication in the home is good. Some staff have not been receiving regular supervision from the Haisthorpe House DS0000064101.V367353.R01.S.doc Version 5.2 Page 25 manager. However, they said she is always available to talk to them and is supportive. Haisthorpe House DS0000064101.V367353.R01.S.doc Version 5.2 Page 26 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 (Adults 18-65) and Standards 31-34, 37 & 38 (Older People) are: 37. Service users benefit from a well run home. 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. (OP NMS 31) Service users benefit from the ethos, leadership and management approach of the home. Service users benefit from the ethos, leadership and management approach of the home. (OP NMS 32) Service users are confident their views underpin all self-monitoring, review and development by the home. The home is run in the best interests of service users. (OP NMS 33) 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 homes record keeping, policies and procedures. (OP NMS 37) Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. Service users rights and best interests are safeguarded by the homes record keeping policies and procedures. (OP NMS 37) The health, safety and welfare of service users are promoted and protected. The health, safety and welfare of service users and staff are promoted and protected. (OP NMS 38) Service users benefit from competent and accountable management of the service. Service users are safeguarded by the accounting and financial procedures of the home. (OP NMS 34) 38. 39. 40. 41. 42. 43. The Commission considers Standards 37, 39 and 42 (Adults 18-65) and Standards 31, 33, 35 and 38 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Haisthorpe House DS0000064101.V367353.R01.S.doc Version 5.2 Page 27 37, 38, 39 and 42 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home is well managed. The interests of people who use the service are seen as important to the manager and staff and are safeguarded and respected. EVIDENCE: The home has an experienced manager who is a qualified social worker and has successfully completed the registered managers award. She works alongside staff to make sure of good practice. All staff said she was supportive and a good leader. One said, “She leads by her own good example”. Another said, “She is a good listener and she loves the residents”. The owner of the home, visits on a on a monthly basis to carry out monitoring visits. This involves talking to people who live at the home and to staff. A report of these visits is made showing details of any action to be taken to improve the service. In addition to this, the manager sends out annual questionnaires to people who live at the home asking for their views on any improvements that could be made. Staff said the owner of the home always makes themselves available to staff on these visits and they are told they can raise any concerns. In the AQAA the manager said they are planning to do a more detailed survey for service users and other stakeholders such as relatives and friends of people who live at the home. It is recommended that the questionnaires be extended to others such as visiting health professionals or care managers. Feedback from the questionnaires should also be analysed, the results published and used to form a development plan for improving the service provided. Arrangements are in place to make sure of safe working practices. The home has a comprehensive range of health and safety policies and procedures in place. Staff are given opportunity to read and become familiar with these during their induction. Health and safety checks are carried out around the home and fire records are maintained. In the AQAA, the manager confirmed that all health and safety checks are up to date. The homes electrical wiring has been checked this year to make sure it is safe. Accident or incident reports are completed. It would be good practice for the manager to analyse these to see if there are ways of preventing accidents or to identify any patterns or trends. Haisthorpe House DS0000064101.V367353.R01.S.doc Version 5.2 Page 28 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. Where there is no score against a standard it has not been looked at during this inspection. 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 X 2 2 3 X 4 X 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 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 2 CONDUCT AND MANAGEMENT Standard No Score 37 3 38 3 39 3 40 X 41 X 42 2 43 X 3 3 3 3 X LIFESTYLES Standard No Score 11 X 12 2 13 3 14 2 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Haisthorpe House Score 3 2 2 X DS0000064101.V367353.R01.S.doc Version 5.2 Page 29 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 Standard YA19 Regulation 13.1 Requirement The practice of staff carrying out health screening checks for people who live at the home must stop as they have not been trained to do this The practice must also be reviewed with a health practitioner and any screening must be agreed with the people using the service. This will make sure that people’s health needs are not missed. 2 YA20 13.2 The current practice of “potting up” the medication prior to its administration must cease. This will make sure that mistakes in administration are avoided. 3 YA23 13 The policy on safeguarding adults must include contact details for making safeguarding referrals to the local authority. DS0000064101.V367353.R01.S.doc Timescale for action 30/08/08 01/08/08 30/08/08 Haisthorpe House Version 5.2 Page 30 This will make sure that people are properly protected. The previous time scale of 09/12/06 has not been met in full. 4 YA24 23 The planned refurbishment programme of the home must be implemented in order to improve the standard of the decoration and furnishings of the home. 30/12/08 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 YA2 Good Practice Recommendations Assessments which relate to people who use the service should be kept at the home. This will make sure the person’s needs and any changes in needs can be properly monitored. 2. YA12 YA14 3. YA20 A review of activities should be carried out to make sure peoples social and recreational needs are being properly met. The temperature in the kitchen should be monitored to make sure medicines are being stored safely as they can deteriorate if stored above 25 °C. All staff should receive appropriate supervision. This should be done to make sure staff are properly aware of their job role and responsibilities and given clear guidance on what is expected of them. The home’s quality assurance questionnaires should be developed further to include relatives of people living at the home and health and other professionals. DS0000064101.V367353.R01.S.doc Version 5.2 Page 31 4. YA36 5. YA38 Haisthorpe House Feedback from the surveys should be analysed, the results published and used to form a development plan for improving the service provided. 6. YA42 Accident reports should be analysed to see if there are ways of preventing accidents or to identify any patterns or trends. Haisthorpe House DS0000064101.V367353.R01.S.doc Version 5.2 Page 32 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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. Haisthorpe House DS0000064101.V367353.R01.S.doc Version 5.2 Page 33 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!