This inspection was carried out on 4th July 2005.
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 made no statutory requirements on the home as a result of this inspection
and there were no outstanding actions from the previous inspection report.
CARE HOMES FOR OLDER PEOPLE
Halsdown Nursing Home 243 Exeter Road Exmouth Devon EX8 3NA Lead Inspector
Michelle Oliver Announced 04 July 2005 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Halsdown Nursing Home D54 D06_S26694_Halsdown_V227843_040705 stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Halsdown Nursing Home Address 243 Exeter Road Exmouth Devon EX8 3NA 01395 272390 01395 272390 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr Ronald William Thomas Blake Mrs Amanda Jane Sharon Allison Care Home 17 Category(ies) of OP Old age (17) registration, with number of places Halsdown Nursing Home D54 D06_S26694_Halsdown_V227843_040705 stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: 1 Notice of Proposal to Grant Registration for staffing/environmental conditions of registration issued 29/4/1993 2 Registered for 17 - Elderly General Nursing Care 3 Registered for 3 Elderly Residents Date of last inspection 19 January 2005 Brief Description of the Service: Halsdown House provides care and accommodation for 17 older people with nursing and residential care needs.It is situated on the main road to Exmouth and is convenient for the bus service to Exmouth and Exeter. The home is surrounded by well-tended gardens. Halsdown Nursing Home D54 D06_S26694_Halsdown_V227843_040705 stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This announced inspection was the first statutory inspection of the current year; the inspection started at 9.20am and finished at 2.30pm. There were 14 residents living at Halsdown on the day of inspection and the inspector saw the majority of them. The inspectors spoke at length with 3 residents and 4 members of staff. The inspectors toured the premises and inspected a number of records including residents care plans, fire log book, pre inspection questionnaire and the home’s accident book. The providers were present throughout the visit. Staff were friendly, co operative and hospitable throughout the inspection and helped where they could. What the service does well: What has improved since the last inspection? What they could do better:
Although photographs of residents enjoying themselves at a variety of celebrations at the home are displayed in the entrance hall no photograph of individual residents is kept at the home. This was discussed with the provider who readily agreed to arrange for all residents to have a photograph taken and kept on file to meet the recommended standard.
Halsdown Nursing Home D54 D06_S26694_Halsdown_V227843_040705 stage 4.doc Version 1.30 Page 6 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. Halsdown Nursing Home D54 D06_S26694_Halsdown_V227843_040705 stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Halsdown Nursing Home D54 D06_S26694_Halsdown_V227843_040705 stage 4.doc Version 1.30 Page 8 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 & 6 Service users benefit from good admission and assessment practice that ensures that the home is able to meet their needs. EVIDENCE: Care needs are well met through a full assessment process that is carried out before a resident decides to live at the home. Care plans are completed from this information. The assessment includes all the elements listed in the standard. Comprehensive assessments were seen for 3 resident, 1 who had recently moved to the home. The home does not admit residents for intermediate care. Halsdown Nursing Home D54 D06_S26694_Halsdown_V227843_040705 stage 4.doc Version 1.30 Page 9 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7 & 9 Residents’ health and social care needs are well met and promoted by good planning arrangements. Medications are well managed. EVIDENCE: Records are properly kept for each resident. They include good guidance on help needed with mobility and risk of falls. The home promotes resident’s welfare in co-operation with families and health care professionals. Plans do not include a photograph of individual residents. This is required to meet the recommended standard. Halsdown Nursing Home D54 D06_S26694_Halsdown_V227843_040705 stage 4.doc Version 1.30 Page 10 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13 & 14 Residents are encouraged to maintain their independence, exercising choice and taking control of their lives and to maintain contact with their families and friends. Social activities are well managed and provide daily variation and interest for people living in the home EVIDENCE: Staff and management have worked hard to gain information about individual residents social and leisure needs and this is included in care plans. Some residents confirmed that they were asked what they would like to do daily but often they did not want to take part and enjoyed watching TV or listening to the radio. Staff showed clear respect for residents’ privacy, for example they knocked on bedroom doors and waited to be asked in before entering. The home promotes residents’ welfare in co-operation with families and health care professionals. Visitors are encouraged to visit whenever they like. Residents confirmed that visitors are always made welcome at the home. Halsdown Nursing Home D54 D06_S26694_Halsdown_V227843_040705 stage 4.doc Version 1.30 Page 11 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18. Arrangements for protecting residents and responding to their concerns are satisfactory. EVIDENCE: There is no evidence to suggest that the home’s service users are any other than safe and properly protected from undue risk. The home has developed a policy in respect of adult Protection and restraint. Staff said that they had never seen any sign of abuse or poor practice in the home and demonstrated a good understanding of what constituted abuse. Residents said that they felt safe and protected living at Halsdown. Halsdown Nursing Home D54 D06_S26694_Halsdown_V227843_040705 stage 4.doc Version 1.30 Page 12 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 & 26 The standard of the environment is high, providing residents with attractive, safe and clean surroundings. EVIDENCE: The standard of accommodation is high. Rooms have high ceilings and large windows. Considerable thought has been given to achieving suitable décor and furnishings to suit residents and the building. Attention has been made to small details such as fresh flowers, and complimentary colour schemes to make the home comfortable and homely. Since the last inspection several rooms have been redecorated. Rooms are routinely refurbished as they become vacant. The gardens are attractive and well maintained. The home is kept exceptionally clean and this is greatly appreciated by residents. Halsdown Nursing Home D54 D06_S26694_Halsdown_V227843_040705 stage 4.doc Version 1.30 Page 13 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 & 29. Staff are employed in sufficient numbers to meet the needs of residents. Residents benefit from having skilled experienced and friendly staff that have a good understanding of their needs. The procedures for the recruitment of staff are consistent and safeguard residents living at the home. EVIDENCE: At the time of the visit 1 RGN, 4 carers, 2 cleaners and a cook were on duty. This decreased to 2 carers and an RGN at 2pm until 9pm when 1 RGN and 1 carer came on duty until 8am the following morning. Three members of staff were spoken to during the visit. All clearly explained their role and responsibilities. The staff team is stable and staff turnover is low. Staff were able to give accurate details of residents who they care for. Residents spoken to said that the staff were kind and caring and always there to help. During the visit staff were observed spending time with residents and responding to their needs promptly. Staff said that they all work well as a team and the home is a very happy place to work. Three staff files were looked at. All showed consistency of police checks, references and proof of identity. Halsdown Nursing Home D54 D06_S26694_Halsdown_V227843_040705 stage 4.doc Version 1.30 Page 14 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 33, 35, & 38 The management of the home ensures clear leadership and direction, giving staff and support to meet the needs of the residents. The systems in place for resident consultation are good with a variety of evidence that indicates that service users’ views sought and acted upon. EVIDENCE: The provider gives a clear lead and direction to staff. Residents said that the provider was approachable, always ready to listen and nothing was too much trouble for her or her staff. The system for consultation with residents is good with evidence that residents’ views are sought and acted upon. Safe working practices are followed at the home. All staff receive regular training in the prevention of fire, all fire equipment is regularly checked and the home has a comprehensive fire risk assessment. All documents and records were well documented and stored securely.
Halsdown Nursing Home D54 D06_S26694_Halsdown_V227843_040705 stage 4.doc Version 1.30 Page 15 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 x 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 x
COMPLAINTS AND PROTECTION 3 x x x x x x 4 STAFFING Standard No Score 27 3 28 x 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x 3 x x 4 x 3 x x 3 Halsdown Nursing Home D54 D06_S26694_Halsdown_V227843_040705 stage 4.doc Version 1.30 Page 16 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 OP7 Regulation Schedule 3 Timescale for action Record to be kept in a care home 04.09.05 must include a photograph of the service user. [the provider agrred to undertake this at the time of the visit.] Requirement 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 Good Practice Recommendations Halsdown Nursing Home D54 D06_S26694_Halsdown_V227843_040705 stage 4.doc Version 1.30 Page 17 Commission for Social Care Inspection Suites 1 & 7 Renslade House Bonhay Road Exeter EX4 3AY National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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