CARE HOMES FOR OLDER PEOPLE
Hannah Levy House Trust 15 Poole Road Bournemouth Dorset BH2 5QR Lead Inspector
Marjorie Richards Unannounced Inspection 2nd November 2005 09:35 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 Hannah Levy House Trust DS0000003944.V263344.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. Hannah Levy House Trust DS0000003944.V263344.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Hannah Levy House Trust Address 15 Poole Road Bournemouth Dorset BH2 5QR 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) 01202 765361 01202 751007 Hannah Levy House Trust Miss Julie Carol Wareham Care Home 35 Category(ies) of Old age, not falling within any other category registration, with number (35) of places Hannah Levy House Trust DS0000003944.V263344.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Hannah Levy House Trust DS0000003944.V263344.R01.S.doc Version 5.0 Page 5 Date of last inspection 9th March 2005 Brief Description of the Service: Hannah Levy House Trust has charitable status and has been set up to provide care, including personal care, to those members of the Jewish Faith who need such assistance. The home has a Board of Trustees that has regular contact with the home and there is a registered manager, Miss Julie Wareham in dayto-day charge of the home. The “Responsible Individual” is Mrs Jessica Blooman OBE, one of the trustees, who has regular contact with the home. Hannah Levy House Trust is situated half a mile from the centre of Westbourne, with its local shops, library and other amenities. The home is on a bus route providing easy access to Bournemouth town centre and the Travel Interchange. There is plenty of on site parking as well as parking on the roads surrounding the home. Hannah Levy House Trust is registered to accommodate a maximum of 35 older people and provides both permanent and respite care as well as day care. All rooms are for single occupancy although some are large enough to be used as doubles should this be requested by residents. Bedrooms are situated on the ground, first and second floors. There is a dining room, large lounge and also a large conservatory all of which are well furnished and equipped. Aids and equipment are available for residents who may have disabilities, to help promote independence. There are passenger and stair lifts to aid access to all floors of the home as well as assisted baths, hoists etc. The home has a small synagogue where services are held on Shabbat and Holy Days. All festivals are also celebrated within the home. The home has good links with the local congregation and has its own minibus to enable residents to make trips out to either local synagogues, visit members of the Jewish community, clubs etc. The home is centrally heated throughout and twenty-four of the thirty-five bedrooms are provided with ensuite facilities. There is an accessible rear garden with garden furniture and a patio area. Hannah Levy House Trust provides twenty-four hour personal care, all meals, laundry and domestic services. Residents are encouraged to participate in a wide range of activities, including weekly outings to local places of interest. The home’s brochure states that its aims and objectives are as follows: “The aim of the management of Hannah Levy House is to enable Jewish residents of Bristol and Bournemouth and their environs, to enjoy the optimum possible quality of life having regard to the individuals age and state of health. The objectives through which this aim may be achieved are: Hannah Levy House Trust DS0000003944.V263344.R01.S.doc Version 5.0 Page 6 1. To provide a strictly kosher environment in which facilities are available to meet the emotional, religious, spiritual and cultural needs of all residents. 2. To assess the care needs of each individual resident and to provide a high standard of care and support to meet those needs through the employment of well trained staff. 3. To create a safe, secure and pleasant home for residents and a good atmosphere in which to work for staff. 4. To involve relatives and friends, where possible, in all aspects of the residents care, keeping them informed and encouraging them to maintain family life. 5. To facilitate the interaction between residents and the local Jewish community by participation in communal activities and maintaining an open visiting policy. Hannah Levy House Trust DS0000003944.V263344.R01.S.doc Version 5.0 Page 7 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection took place over 5.5 hours on the 2nd November 2005 and was one of the two statutory inspections carried out each year. The main purpose of the inspection was to check that the residents living in the home were safe and properly cared for. There were no requirements from the previous inspection. A tour of the premises took place and a variety of records and related documentation was examined, including the care records for three residents and a deceased resident. Time was spent observing interaction between staff and residents, also talking with twelve residents, as well as the manager and staff on duty, in order to get a real feel of what it is like to live at Hannah Levy House. As part of the inspection process, comment cards were distributed by the Commission and, to date, the following completed cards have been received: 10 from residents, 12 from relatives and visitors, 5 from GPs, 3 from Care Managers and 3 from health and social care professionals. Some of these comments are included in the following report. What the service does well:
Written information about Hannah Levy House is available for prospective residents to help them decide if the home is right for them. Every resident has a written statement detailing the terms and conditions of residency. The home has a thorough admissions policy and pre-admission assessments are carried out to ensure that only people whose needs can be met are offered places within the home. Prospective residents are invited to visit the home and a trial period can be arranged. Every resident has a care plan, which sets out in detail the individuals care needs and how these are to be met. Communication on the needs of residents is good, ensuring continuity of care. Residents and their relatives are encouraged to contribute to care plans. Staff carry out monthly reviews of care plans to ensure regular updating as necessary. Good support is provided by community health professionals, ensuring that health care needs are well met. Staff were observed throughout the inspection to be treating residents with courtesy, patience and kindness. The staff here are good, they are polite and show respect. Residents say their privacy is respected, I can go to my room whenever I want. I spend most of my time in my room, thats my choice.
Hannah Levy House Trust DS0000003944.V263344.R01.S.doc Version 5.0 Page 8 As part of the Jewish faith and culture, strict guidelines are observed regarding the care of the dying and the dead. The rabbis have confirmed to the Trustees that they are satisfied with the way this is dealt with at Hannah Levy House. A range of cultural, recreational and social activities is provided so that residents are able to experience a varied life within the home. A resident commented, “There is always plenty to do here. You could never be bored. Residents are able to maintain contact with the local Jewish community, as well as with family and friends. Religious services are held on the Sabbath and on holy days and rabbis from both local synagogues visit the home. Flexibility of lifestyle is encouraged and residents have the opportunity to choose their own way of living in the home. Hannah Levy House provides a kosher diet under strict supervision. All meals are usually taken in the dining room or in the residents own bedroom. Mealtime arrangements are flexible enough to accommodate individual preferences and any care needs etc. Residents commented, I enjoy most of my meals, we have a good standard of food here. The food is satisfactory for our needs. I have no complaints about the food. The food is not bad. We have a chef who is very obliging if we want something different to the menu. A system is in place for dealing with any complaints. Residents are confident that complaints would be listened to and dealt with appropriately. No complaints have been received by the home or the Commission since the last inspection. Residents commented, I have never had to complain about anything here. If something is not right, then you go to the office and tell them. They soon put it right. Continuous investment in the upkeep of the home results in a well-maintained, comfortable and safe environment for residents. A full-time maintenance person is employed to deal with minor repairs. Equipment is regularly maintained to ensure resident safety. The communal rooms at Hannah Levy House are all located on the ground floor and provide an attractive resource for residents. A garden is also available, with a patio area and a range of garden furniture. Bedrooms are comfortably furnished and well personalised by their occupants. The home is clean and there are no unpleasant smells. A well-equipped laundry is available. Residents commented, I think the staff work hard to keep the home clean and tidy. There are no horrible smells here, like you get in some places. The laundry service is good. We get everything back very quickly. Miss Wareham is assisted by a team of experienced care, catering, cleaning and maintenance staff. The needs of residents are well met by the numbers and skill mix of a staff team well trained and competent in their work. A
Hannah Levy House Trust DS0000003944.V263344.R01.S.doc Version 5.0 Page 9 resident said, I feel I am well looked after. The staff are very helpful when you need them. The staff here are wonderful. Nothing is too much trouble for them. The home accepts the importance of training in ensuring the safety and wellbeing of residents. Over 50 of the care staff working at Hannah Levy House have National Vocational Qualifications at level 2 or 3. A thorough recruitment procedure is in place and appropriate checks are taken before staff are employed, to ensure the protection of residents. Miss Wareham has successfully completed her NVQ level 4 in management and care. She provides clear leadership within the home and promotes a happy, relaxed atmosphere where residents and staff are at ease. Good management practice ensures the health and safety of all in the home. Staff said, Miss Wareham is a very good manager. She always has time to listen. “The manager is very good, very supportive. Hannah Levy House welcomes comments and ideas from residents, staff, relatives and visitors. Quality Assurance questionnaires are distributed annually to seek feedback about the homes performance. Staff are regularly supervised and appraisals are carried out annually to ensure they are fulfilling their role satisfactorily and meeting the needs of residents. What has improved since the last inspection? What they could do better: Hannah Levy House Trust DS0000003944.V263344.R01.S.doc Version 5.0 Page 10 The home carries out pre-admission assessments to determine whether or not a prospective residents care needs can be met. Although verbal feedback is given, the outcome of these assessments is not confirmed in writing, so prospective residents are not fully assured that their care needs will be met. Although the Adult Protection policy and procedure has been updated, not all staff in the home have received training in Adult Protection issues to ensure a proper response to any suspicion or allegation of abuse. The home has a comprehensive staff training programme in place. However, a training audit is needed to ensure that all staff have the necessary skills and experience to deliver the services and care which the home offers to provide. 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. Hannah Levy House Trust DS0000003944.V263344.R01.S.doc Version 5.0 Page 11 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 Hannah Levy House Trust DS0000003944.V263344.R01.S.doc Version 5.0 Page 12 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): 1, 2, 3 and 5 Standard 6 is not applicable as intermediate care is not provided Information provided about Hannah Levy House and a thorough admissions procedure, including a statement of terms and conditions, allows prospective residents to make informed decisions about admission to the home and ensures that only those whose needs can be met by the home are offered places there. However, the outcome of pre-admission assessments is not confirmed in writing, so prospective residents are not fully assured that their care needs will be met. Residents are issued with a contract describing Terms and Conditions of occupancy at the point of admission to the home. Prospective residents and their relatives or representatives are invited to visit the home prior to admission to enable them to assess the facilities and services provided. A trial period is also available before making any decision about whether or not to stay. EVIDENCE:
Hannah Levy House Trust DS0000003944.V263344.R01.S.doc Version 5.0 Page 13 A brochure, Statement of Purpose and Residents Handbook contain all of the information required about the home and its facilities. The Handbook gives a good indication of what a resident can expect from the home and is made available to prospective residents and/or their representatives. Copies are also available in each residents bedroom. All residents at Hannah Levy House are issued with terms and conditions of residence. At the last inspection it was recommended that the terms and conditions be updated and this is currently taking place. Hannah Levy House has a written admissions policy. Individual care records are kept for each resident and three of these were examined. All showed that, prior to moving to the home, care needs had been fully assessed by the registered manager, Miss Wareham. However, at present, the outcome of such assessments is not confirmed in writing, so prospective residents are not fully assured that their care needs will be met. The information contained in pre-admission assessments and also any assessment supplied by Social Services, is then used to draw up a detailed plan of care. Miss Wareham says she always encourages prospective residents and their relatives to visit the home prior to admission. She feels it is helpful to have opportunities to look round the home, perhaps enjoy a meal and meet with other residents and staff, assess facilities and ask any questions. A trial period is available and further information can be found in the brochure. Staff and residents confirmed that prospective residents and their relatives/friends visit the home prior to admission. Hannah Levy House Trust DS0000003944.V263344.R01.S.doc Version 5.0 Page 14 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 and 11 Hannah Levy House has a detailed care planning system in place, which ensures that staff have the information they need to meet the needs of residents. Good support from community health professionals helps to ensure that the health needs of residents are well met. Residents are treated respectfully and care is offered in a way that protects their right to privacy and dignity. Residents are treated with sensitivity and respect at the time of their death. EVIDENCE: All three of the care plans examined flow from the assessments made earlier and are clearly set out, informative about the needs of each resident and how staff are to meet these needs. Relatives are encouraged to be involved in the provision of care if they wish. Records demonstrate that care plans are reviewed and updated monthly, or more often where necessary. Where care needs have changed, appropriate professionals have been consulted and
Hannah Levy House Trust DS0000003944.V263344.R01.S.doc Version 5.0 Page 15 further assessments carried out. Daily care notes, written by staff, support and evidence the care of residents. Risk assessments are in place and appropriate steps are taken to minimise any risks identified. Records also demonstrate that residents have access to GPs, district nurses, dentists, opticians, chiropodists, etc and attend for hospital appointments as necessary. This was later confirmed in discussion with residents and staff. If I need to see anyone, say my doctor, I have only to ask the staff and they arrange it. Five comment cards were completed by GPs. All were positive in their assessment of the home and comments, such as Excellent care and Appropriate use of our services. Very caring atmosphere were received. Staff were observed throughout the inspection to be treating residents with courtesy, kindness and respect. A resident commented, The staff here are good, they are polite and show respect, - which we are entitled to at our age. Staff knock and wait to be invited into my room. One of the first things I was asked on arrival here was what did I want to be called and how did I wish to be addressed. All residents have their own single bedrooms, thereby offering an opportunity to be on their own if they wish, or allowing privacy for any visitors or personal care needs. Residents commented, I can go to my room whenever I want. I spend most of my time in my room, thats my choice. As part of the Jewish faith and culture, strict guidelines have to be observed regarding care of the dying and the dead. This information is made available to all staff in the home in the form of policies and procedures and is backed up by staff training. All aspects of religious life within the home are supervised by the local rabbis, including dying and death. The rabbis have confirmed to the trustees of Hannah Levy House that they are satisfied with the way in which this is handled within the home. The care plan of a recently deceased resident was examined and found to be well detailed, showing that relatives had been kept informed of the situation. Health care professionals provided support to the home’s staff. Hannah Levy House Trust DS0000003944.V263344.R01.S.doc Version 5.0 Page 16 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 A range of cultural, recreational and social activities is made available so that residents are able to experience a varied life within the home. Open visiting arrangements are in place, so residents are able to maintain contact with visitors as they wish. Residents are encouraged to choose their own lifestyle within the home and their individual preferences and routines are respected. Kosher food is provided at times and locations convenient to residents. EVIDENCE: Hannah Levy House has a wide range of leisure, social and cultural activities available to residents. These include twice weekly entertainment, armchair exercises to music and music therapy. An arts and Craft group has recently been commenced and this is proving popular. A large notice board details events, activities etc taking place in the home. Some residents like to go out to shows, the cinema, walks, shopping etc and a number participate in the regular weekly outings in the homes minibus. A travelling theatre group recently performed Give My Regards to Broadway in the home and they are booked to come again in December. A new video player has been provided for
Hannah Levy House Trust DS0000003944.V263344.R01.S.doc Version 5.0 Page 17 the lounge and a new music centre in the conservatory. A computer has also been provided in the conservatory for residents to use whenever they wish. Residents commented: I do the exercises to try and keep fit. Its a bit of fun. There is always plenty to do here. You could never be bored. I would like to see even more activities available, especially for those unable to go out of the home. There are lots of things to do here, but you dont have to join in if you dont want to. Religious services are held on the Sabbath and on holy days and rabbis from both local synagogues visit the home. Residents are able to maintain contact with the local Jewish community, as well as with family and friends. Hannah Levy House Trust has links with the Jewish Day School and Jewish youth group. Members of the local Jewish community organise monthly birthday teas for residents throughout the year, celebrating all birthdays that fall within a given month with a special tea and presents. Some residents also like to participate in activities outside of the home, which are organised by the local synagogues. Miss Wareham says relatives and friends are encouraged to visit as often as possible and no restrictions are placed upon them. This was confirmed in discussion with residents and staff and by viewing the Visitors Book. Residents are encouraged to choose their own lifestyle within the home and make choices wherever possible. These include choosing when to get up or go to bed, what to wear, what to eat or drink and to come and go as they please. They are able to bring their own possessions into the home to personalise their bedrooms. Residents confirmed that their individual preferences and routines are respected. Regular meetings are held where residents can express their views and opinions and influence the running of the home. Hannah Levy House provides a kosher diet under strict supervision. All prospective residents are made aware of this prior to admission. The chef has considerable experience in kosher catering. Lunch on the day of inspection was lentil soup, followed by chicken chasseur, with new potatoes, carrots and sprouts. This was followed by plum crumble, ice cream or fresh fruit. Alternatives, such as chicken and fish, are always available to suit individual taste and preference. The list for the evening meal showed a wide variety of food available. The chef says his policy is, as far as possible, to provide residents with whatever they want. All meals are usually taken in the dining room or in the residents own bedroom. The lunchtime meal in the dining room took place in a relaxed, unhurried atmosphere with discreet staff assistance provided wherever necessary. Mealtimes can be flexible to fit in with care needs, appointments etc. The menu shows that residents enjoy a healthy, well-balanced diet. Good stocks of dried, tinned, fresh and frozen foods were seen.
Hannah Levy House Trust DS0000003944.V263344.R01.S.doc Version 5.0 Page 18 Residents commented, I enjoy most of my meals, we have a good standard of food here. The food is not bad. We have a chef who is very obliging if we want something different to the menu. I think it is difficult to please everyone all of the time, but we are really very fortunate with our meals. I enjoy all mine. We have very nice home-made cakes. The food is satisfactory for our needs. I have no complaints about the food. Hannah Levy House Trust DS0000003944.V263344.R01.S.doc Version 5.0 Page 19 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 A system is in place for dealing with any complaints. Residents are confident that complaints would be listened to and dealt with appropriately. Not all staff have received training in Adult Protection issues. The policy and procedure alone are not sufficient to ensure residents are fully protected from the possibility of abuse. EVIDENCE: The home has a complaints policy that is included in the information provided to residents or their representatives and is also displayed on the notice board in the dining room. No complaints have been received by the home or the Commission since the last inspection. Residents spoken to said they had no concerns, I have never had to complain about anything here.” I have no complaints about this place.” Residents commented, If I was concerned about anything I would tell the staff. We each have a special member of staff to help us, (Key Worker). I can share any little problems with her and she soon sorts everything out for me. If I had a serious problem I would go to the office and see the manager. Residents and staff confirm that the manager and senior staff are always approachable and willing to talk about any problems that might arise. If something is not right, then you go to the office and tell them. They soon put it right. Hannah Levy House Trust DS0000003944.V263344.R01.S.doc Version 5.0 Page 20 The home has an Adult Protection policy, which is currently being updated. The policy makes reference to the Department of Health No Secrets guidance and will be in line with this guidance, ensuring that any allegations of abuse will be managed effectively. However, not all staff have yet received Adult Protection training, to ensure a proper response to any suspicion or allegation of abuse. Miss Wareham is currently planning such training. Hannah Levy House Trust DS0000003944.V263344.R01.S.doc Version 5.0 Page 21 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, 22, 24 and 26 Continuous investment in the upkeep of the home results in a well-maintained, comfortable and safe environment for residents, where standards are constantly improving. Residents have access to comfortable communal areas, including a garden. Appropriate equipment is provided to assist residents in maintaining their independence. Bedrooms are comfortably furnished and individually personalised to suit their occupants. The home is clean and pleasant with no unpleasant odours, making daily life more pleasant for all in the home. EVIDENCE: The home has an annual development plan with an ongoing (rolling programme) of internal redecoration and replacement of furnishings and fittings, as and when required. Recent work includes the fitting of new carpets in some corridors, the fitting of covers to radiators in communal areas,
Hannah Levy House Trust DS0000003944.V263344.R01.S.doc Version 5.0 Page 22 redecoration of the lounge, replacement of the medication cupboard, the fitting of brighter light fitments in ensuite facilities, some new tables and chairs in the lounge, new gates to the car park and redecoration of the front door and exterior paintwork to windows. A full-time maintenance person is employed to deal with minor repairs. Records confirm that equipment, such as hoists, the passenger lift and portable electrical appliances etc are regularly serviced to ensure resident safety. The fire records show appropriate checks and maintenance being carried out on the fire warning system, emergency lighting and fire fighting equipment. Staff take part in regular fire training and drills so that they are fully aware of what to do in the event of fire. Risk assessments are in place for all parts of the building, including the car park. Risk assessments are also carried out for any contractors working in the home. Miss Wareham carries out regular checks on water temperatures, window restrictors, wheelchairs, thermostatic mixing valves and showerheads to help ensure resident safety. The communal rooms at Hannah Levy House are all located on the ground floor. These comprise a dining room, lounge, conservatory, hairdressing/chiropody/therapy room and an enclosed garden. The total area of communal space available within the home is in excess of the 4.1 square metres per person detailed in the National Minimum Standards. The lounge is comfortably furnished with chairs of differing heights to suit the needs of residents. The conservatory is accessible from both the dining room and the lounge and also provides access to the garden. A range of garden furniture is available to residents. A suitably qualified person has undertaken an assessment of the premises and facilities to ensure they meet the needs of residents and that appropriate equipment is provided. A through floor lift is provided to all floors and there is also a stair lift on each flight of stairs. Assisted baths, a Standaid, hoists, raised toilet seats, toilet frames, grab rails, commodes etc are provided to assist residents in maintaining their independence. An alarm call system is also installed, permitting residents to summon staff assistance if necessary. A tour of the building confirms that residents bedrooms are comfortably furnished and personalised to varying degrees. Residents commented, I have my own things about me. “I am very pleased with my room, I am very comfortable.” Bedrooms have suitable locks fitted, which can be opened from the outside in case of emergency. A lockable facility is provided within each bedroom for personal items etc. A Housekeeper and dedicated laundry and domestic staff are employed at Hannah Levy House. The home is clean and there are no unpleasant smells, Hannah Levy House Trust DS0000003944.V263344.R01.S.doc Version 5.0 Page 23 making life within the home more pleasurable. A well-equipped laundry is sited on the ground floor. The home has a detailed infection control policy. Suitable facilities and procedures are in place for the disposal of clinical waste. Residents commented, The laundry service is good. We get everything back very quickly. I think the staff work hard to keep the home clean and tidy. There are no horrible smells here, like you get in some places. Hannah Levy House Trust DS0000003944.V263344.R01.S.doc Version 5.0 Page 24 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 numbers and skill mix of staff are sufficient to meet the present care needs of residents. The home understands the importance of NVQ level 2 training in ensuring that residents are in safe hands at all times. Employment and recruiting procedures are in place to ensure the protection of residents. Training is provided to make sure that staff are equipped with the knowledge and skills necessary to meet the assessed needs of residents. EVIDENCE: Miss Wareham heads a team of experienced care, catering, cleaning and maintenance staff. On the day of inspection, care staffing was as follows: 07.30. -- 13.30 1 Team Leader and 5 Care Assistants 13.30. -- 20.30 1 Team Leader and 4 Care Assistants 17.00. -- 20.30 1 Care Assistant 20.30. -- 08.00 2 Care Assistants (wakeful) 20.30. -- 08.00 1 Team Leader sleeping in, on call. A key worker system is in operation, where each member of care staff has particular responsibility for several residents. This gives them an opportunity
Hannah Levy House Trust DS0000003944.V263344.R01.S.doc Version 5.0 Page 25 to really get to know residents and ensure all their needs are met. Residents said, My key-worker is very good to me. She does my personal shopping and is so very helpful.” I feel I am well looked after.” The staff are very helpful when you need them. The staff here are wonderful. Nothing is too much trouble for them.” Miss Wareham emphasised the importance of training in ensuring the safety and wellbeing of residents. Over 50 of care staff have now achieved National Vocational Qualifications (NVQ) at level 2 or 3 and 2 more staff are currently training for NVQ level 3. A full range of policies and procedures is in place to offer advice and guidance to staff and these are regularly reviewed and updated as necessary. The home has a thorough recruitment procedure in place, based on equal opportunities and ensuring the protection of residents. The two files examined for recently employed staff showed that the necessary documentation, e.g., Criminal Records Bureau disclosures, references etc had been obtained. Where staff are coming from abroad, the files demonstrate that appropriate information is gathered about the right to work in the UK and any possible restrictions on that work. A staff training and development programme is in place, which aims to ensure that all staff receive appropriate training so they can fulfil the objectives of the home and meet the needs of residents. Copies of all training certificates are being retained to provide evidence that staff receive a minimum of three paid days training per year. Miss Wareham is aware of the recently introduced Skills for Care Common Induction Standards and will be implementing these at Hannah Levy House, in conjunction with the homes own induction and foundation training programme. Since the last inspection, some staff have undertaken training in moving and handling, basic food hygiene, Adult Protection, medication awareness, dementia awareness, continence, health and safety and first aid. Infection control training is now being planned. It is recommended that a training audit be carried out to ensure that all staff have received the training they need, with particular reference to moving and handling, Adult Protection, first aid and infection control. Discussions with staff show that they are well motivated, keen to learn and value the training that is being offered. I have learned a lot since I started working here. I enjoy my job and like working in this place. I went to work somewhere else, but came straight back to Hannah Levy House. I have had lots of training opportunities here which I did not have where I worked before. Hannah Levy House Trust DS0000003944.V263344.R01.S.doc Version 5.0 Page 26 Twelve comment cards were completed by relatives and visitors to the home. All were positive in their assessment of the care provided and comments, such as Excellent friendly staff, The care and attention are excellent, and The staff are helpful and friendly were received. One relative commented, I am 100 pleased with the standard of care provided. Hannah Levy House Trust DS0000003944.V263344.R01.S.doc Version 5.0 Page 27 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, 33 and 36 The registered manager is qualified and experienced in care and provides clear leadership throughout the home. The home regularly reviews its performance and actively seeks the views of residents, staff and relatives to ensure the home is run in the best interests of residents. Staff are well supervised and able to demonstrate an awareness of their roles and responsibilities towards residents. EVIDENCE: Miss Wareham has successfully completed her NVQ level 4 in management and care. She also undertakes periodic training to ensure she is continually up-todate with her professional development. Recent training includes first aid,
Hannah Levy House Trust DS0000003944.V263344.R01.S.doc Version 5.0 Page 28 dementia awareness, infection control, diabetes awareness and catheter and stoma care. Miss Wareham says she has an Open door policy, ensuring that anyone can come to the office and speak with her or the deputy manager whenever they wish. This was seen in action throughout the day. Working relationships between the management, staff and residents were directly and indirectly observed throughout the course of the inspection. They were amicable, yet professional, contributing to a welcoming and relaxed atmosphere, which was beneficial to all in the home. Discussions with staff show that they are confident about their roles and responsibilities within the home and feel well trained for the work they have to carry out. They speak positively about the management approach at Hannah Levy House. Miss Wareham is a very good manager. She always has time to listen. The manager is very good, very supportive. She is always very approachable, you can talk to her. Miss Wareham and her staff spend time talking with residents informally to obtain their views. Formal residents meetings are also held. Quality Assurance questionnaires are completed annually by residents, staff, relatives and other visitors to the home. Feedback on the questionnaires is given at residents and staff meetings, where comments or suggestions are discussed and actioned wherever possible. Formal staff supervision takes place every two months and staff meetings also provide opportunities for staff to express their views and ideas. Staff appraisals are carried out annually to ensure they are fulfilling their role satisfactorily and meeting the needs of residents. Hannah Levy House Trust DS0000003944.V263344.R01.S.doc Version 5.0 Page 29 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 3 3 2 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 X 10 3 11 4 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 4 4 X 3 X 3 X 4 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X X 3 X X Hannah Levy House Trust DS0000003944.V263344.R01.S.doc Version 5.0 Page 30 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. 1 Standard OP3 Regulation 14(1)(d) Requirement It is a requirement that the registered person confirm in writing to the prospective resident that, having regard to the assessment, the care home is able to meet his/her care needs in respect of health and welfare. It is a requirement that staff receive Adult Protection training, to help ensure residents are protected from the possibility of abuse. Timescale for action 28/02/06 2 OP18 13(6) 28/02/06 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 Refer to Standard OP30 Good Practice Recommendations It is recommended that an audit of staff training be carried out to ensure all staff are receiving the training they need. Hannah Levy House Trust DS0000003944.V263344.R01.S.doc Version 5.0 Page 31 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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