CARE HOMES FOR OLDER PEOPLE
Halcyon Days The Old Rectory Church Lane Graveley Nr. Stevenage Hertfordshire SG4 7LU Lead Inspector
Mr Neil Fernando Unannounced Inspection 14th September 2005 10:00 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 Halcyon Days DS0000019403.V253142.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Halcyon Days DS0000019403.V253142.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Halcyon Days Address The Old Rectory Church Lane Graveley Nr. Stevenage Hertfordshire SG4 7LU 01438 315588 01438 312587 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) Karlamain Limited Care Home 33 Category(ies) of Old age, not falling within any other category registration, with number (33) of places Halcyon Days DS0000019403.V253142.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 20th April 2005 Brief Description of the Service: Halcyon Days is a detached, late Victorian building that has been sympathetically extended to create the current home. Bedrooms are located on the lower ground, ground, first and second floors, and are mainly offered for single occupation. There are two lounges, a reception seating area and two dining rooms. The kitchen and hairdresser’s room are located on the ground floor. The bathroom, shower room, and toilet facilities are adequate to meet the requirements of the service users accommodated. The office, laundry and extensive storage area are located in the lower ground floor. The home stands in three acres of mature landscaped grounds and offers fine views over the surrounding countryside. It is located in a quiet rural area on the outskirts of the village of Gravely and the towns of Stevenage and Hitchin are easily accessible by public transport. Halcyon Days DS0000019403.V253142.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection was undertaken by one inspector who was present in the home for just over four hours. There were 32 service users in residence and, during the inspection at least ten spoke with the inspecting officer. In addition, a tour of the premises was undertaken, all staff on duty were spoken with and records were examined. Since the last inspection took place, the home has joined the Gold Care Homes organisation but the inspecting officer was pleased to note that the unique atmosphere associated with Halcyon Days has remained unchanged and there has been no noticeable change in the staff group. The deputy manager has taken over the mantle of manager since the last inspection took place and the Commission is processing her application for registration. Standards not covered during this inspection were covered during the inspection that took place on 20 April 2005. This report contains two recommendations. What the service does well:
Care plans are well maintained and ensure that standards of care are maintained. There is also a thorough admission process. Service users enjoy full support from local community health services and medication administration is good. Staff are courteous and treat service users with respect at all times. There is a good range of social and recreational activities on offer. Service users are encouraged to retain control over as much of their personal lives as they wish. Staff are conversant with the processes designed to protect vulnerable adults against the risk of abuse. The premises and gardens are well maintained and provide a safe environment. The home is kept to a high level of cleanliness. Staff are well versed in appropriate infection control practices and they benefit from good leadership and training. There are robust recruitment practices in the home which means that service users are in safe hands. There are a number of care management systems in operation that focus on the wellbeing, autonomy and independence of service users. Recording systems were good and provided evidence that safety procedures are being followed. Halcyon Days DS0000019403.V253142.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Halcyon Days DS0000019403.V253142.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Halcyon Days DS0000019403.V253142.R01.S.doc Version 5.0 Page 8 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 5. Standard 6 is not applicable, as intermediate care is not offered. Prospective service users are provided with enough information and have every opportunity to make sure that Halcyon Days will be suitable for them. EVIDENCE: Six case records were examined in detail and these demonstrated that service users, their relatives and/or representatives are involved in the initial assessment of care and social needs and that the identified areas of care can be provided by the staff at the home. Service users confirmed that, as part of the admission process, they and their supporters were invited to visit the home to make sure that the facilities on offer suited their needs. Halcyon Days DS0000019403.V253142.R01.S.doc Version 5.0 Page 9 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8 & 10. Standard 9 does not apply at present All aspects of health and personal care are delivered appropriately and service users are treated with respect and courtesy. EVIDENCE: Eight care plans were examined and the two most recently admitted service users were particularly helpful in confirming that care planning is carried out with the individual fully consulted. Each care plan examined contained full information and would enable care staff to ensure care practice was provided in a consistent manner. Care plans were reviewed every month to ensure that they reflected the most current situation. It was noted, however that the cultural needs and religious preferences of service users were not reflected on their care plans and a recommendation was made. Service users enjoy full support from local community health services and a District Nurse visits as needed. Medication was appropriately stored and administered. At present, no service user administers their own medication although the home would support anyone who wished to and was able to do so.
Halcyon Days DS0000019403.V253142.R01.S.doc Version 5.0 Page 10 Throughout the inspection, staff were seen to be courteous and the interaction between staff and service users was pleasant and relaxed. Staff treat service users with respect at all times and all aspects of their privacy and dignity are assured. Any medical examination or treatment is carried out in the privacy of the service user’s own bedroom. Halcyon Days DS0000019403.V253142.R01.S.doc Version 5.0 Page 11 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 and 14 Service users are able to exercise as much control over their own lives as they wish. There are a range of recreational, cultural and leisure pursuits available for service users to enjoy if they wish. EVIDENCE: An Activities Co-ordinator has been in post since early August and service users confirmed that her involvement has positively enhanced their social lives. There was abundant evidence to show that service users were encouraged to participate in gentle exercise as well as social and recreational activities. Although the documentation in the home generally demonstrated that cultural, social and religious needs were being met, cultural needs and religious preferences were not clearly reflected on all care plans. Service users confirmed that staff enable and encourage them to retain control over as much of their personal lives as they wished. Obvious examples included a choice of meals, personal taste in respect of the layout and style of their bedrooms, choice of clothing etc. At present, no service users were controlling their own financial affairs and had generally elected that their relatives should deal with these matters. Staff at the home have no involvement in service users finances. Halcyon Days DS0000019403.V253142.R01.S.doc Version 5.0 Page 12 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): 16,17 & 18 Staff have been trained to ensure that service users are protected from all forms of abuse. There is an appropriate complaint system that is easily accessible and in which service users have confidence. EVIDENCE: Details of the complaint procedure are easily accessible and are contained in the statement of purpose as well as the service user’s guide. Service users who were asked for their opinion on the subject, were confident that they would be able to make a complaint and that it would be dealt with without fuss. There have been no complaints received by the home since the last inspection took place, although the relative of a service user who was formerly at Halcyon Days has raised some issues with the Commission and these are being investigated. Staff were conversant with the processes designed to protect vulnerable adults against the risk of abuse and appropriate training has been given. Service users said that Halcyon Days is a safe place in which to live. Halcyon Days DS0000019403.V253142.R01.S.doc Version 5.0 Page 13 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 24, 25 and 26. The environment is safe, well maintained and kept to a good standard of cleanliness. EVIDENCE: A tour of the building revealed that the premises are maintained to a good standard of maintenance and decoration and the whole premises are kept to a high level of cleanliness. Staff were well versed in appropriate infection control practices. The garden was both safe and attractive and no hazards were identified both within the building and the extensive surrounding grounds. Service users confirmed that they were encouraged to personalise their bedrooms and that their bedrooms were both appropriate to their needs and comfortable. Halcyon Days DS0000019403.V253142.R01.S.doc Version 5.0 Page 14 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, 29 and 30. Staffing levels continue to e satisfactory to ensure that the needs of the current service users are being met. The training requirements of staff are being addressed appropriately. EVIDENCE: Appropriate staffing levels have been maintained since the last inspection took place and an Activities Co-ordinator took up a new post at the home in early August. She is available between nine and twelve hours a week and this addition to the staff group represents a positive enhancement to the social lives of service users in the home. Conversations with service users and staff confirmed that they consider the staffing levels to be appropriate and service users were very positive about the support they received. Evidence in staff files demonstrated that there are robust recruitment practices in the home which means that service users are in safe hands. Staff continue to receive ‘mandatory’ training and four staff members have so far achieved their NVQ awards at level 2. In addition, seven staff are currently undertaking this training, which means that the home continues to work towards achieving a 50 total of trained staff. Halcyon Days DS0000019403.V253142.R01.S.doc Version 5.0 Page 15 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, 32, 36, 37 and 38 The management of the home is positive and both staff and service users benefit accordingly. Policies and practices are designed to safeguard the safety and welfare of both service users and staff. EVIDENCE: Karlamain Limited has been purchesed by Gold Care Homes since the last inspection, but continuity of good practices associated with the former company has been assured by retaining the former staff group and offering the registered manager’s post to the former deputy manager. There are a number of care management systems in operation that focus on the wellbeing, autonomy and independence of service users. Recording systems were good and provided evidence that safety procedures are being followed although the names of staff who attend fire drills should be recorded to enable management to ensure that no staff miss this essential training.
Halcyon Days DS0000019403.V253142.R01.S.doc Version 5.0 Page 16 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 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 N/A 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 3 15 x COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 3 3 X 3 3 3 3 STAFFING Standard No Score 27 3 28 X 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 X X X 3 3 3 Halcyon Days DS0000019403.V253142.R01.S.doc Version 5.0 Page 17 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard OP12 OP37 Good Practice Recommendations It is recommended that the cultural needs and religious preferences of service users are reflected on their care plans. It is recommended that the names of staff who attend fire drills are recorded to enable management to ensure that no staff miss this essential training. Halcyon Days DS0000019403.V253142.R01.S.doc Version 5.0 Page 18 Commission for Social Care Inspection Hertfordshire Area Office Mercury House 1 Broadwater Road Welwyn Garden City Hertfordshire AL7 3BQ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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