Inspection on 24/11/06 for Hannah Levy House Trust

This inspection was carried out on 24th November 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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.

Other inspections for this house

Hannah Levy House Trust 04/09/08

Hannah Levy House Trust 25/06/07

Hannah Levy House Trust 24/02/06

Hannah Levy House Trust 02/11/05

Hannah Levy House Trust 09/03/05

Hannah Levy House Trust 31/08/04

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

CARE HOMES FOR OLDER PEOPLE Hannah Levy House Trust 15 Poole Road Bournemouth Dorset BH2 5QR Lead Inspector Marjorie Richards Key Unannounced Inspection 09:50 24th November 2006 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.V320475.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. 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.V320475.R01.S.doc Version 5.2 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 hlhtrust@onetel.net.uk Hannah Levy House Trust Mrs Judith Mary Rabjohns 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.V320475.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Mrs Rabjohns must complete an NVQ Level 4 in Management by September 2007. Evidence of successful completion must be forwarded to the Commission. 24th February 2006 Date of last inspection 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, Mrs Judith Rabjohns 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, or to 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 Hannah Levy House Trust DS0000003944.V320475.R01.S.doc Version 5.2 Page 5 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 individual’s age and state of health. The objectives through which this aim may be achieved are: To provide a strictly kosher environment in which facilities are available to meet the emotional, religious, spiritual and cultural needs of all residents. 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. To create a safe, secure and pleasant home for residents and a good atmosphere in which to work for staff. To involve relatives and friends, where possible, in all aspects of the residents care, keeping them informed and encouraging them to maintain family life. To facilitate the interaction between residents and the local Jewish community by participation in communal activities and maintaining an open visiting policy. The fees for the home, as confirmed to the Commission for Social Care Inspection (CSCI) at the time of inspection, are set at £465 per week and include chiropody. Additional charges are made for hairdressing, dry cleaning, toiletries and newspapers. The Office of Fair Trading has published a report highlighting important issues for many older people when choosing a care home, e.g., contracts and information about fees and services. The CSCI has responded to this report and further information can be obtained from the following website: http:/www.csci.org.uk/about_csci/press_releases/better_advice_for_people_c hoosing a care home .aspx A copy of the home’s inspection report will be made available to anyone wishing to read it, upon request to the manager’s office. Hannah Levy House Trust DS0000003944.V320475.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. Mrs Blooman made herself available for the latter part of the inspection, on behalf of the Board of Trustees and this was appreciated. This unannounced inspection took place over 9.75 hours on the 24th November 2006. The main purpose of this first key inspection was to review all of the key National Minimum Standards, check progress with two recommendations made at the last inspection and ensure that the residents living in the home were safe and properly cared for. On the day of inspection, 32 residents were accommodated. A tour of the premises took place and records and related documentation were examined, including the care records for three residents. Pre-inspection information had been completed and submitted before the inspection. In addition, the Commission received fifteen completed comment cards from relatives, one from a General Practitioner, two from health and social care professionals and three from care managers. All expressed satisfaction with the care provided. Time was spent observing the interaction between residents and staff, as well as talking with a total of eleven residents. The daily routine was also observed during the inspection. In the absence of the registered manager, discussion took place with the deputy manager, one of the Trustees and members of staff on duty. The Responsible Individual, Mrs Blooman OBE, also made herself available for part of the inspection and this was greatly appreciated. For the purposes of this report, people who live at Hannah Levy House Trust are referred to as residents as this is the term generally used within the care home. The Inspector was made to feel very welcome in the home throughout the visit. What the service does well: When a person moves into the home a thorough assessment of needs is carried out. A letter is then written to the prospective resident confirming that the home is able to meet their needs. Health care needs are well met, with evidence of good support from community health professionals. Hannah Levy House Trust DS0000003944.V320475.R01.S.doc Version 5.2 Page 7 Residents say that they enjoy living at Hannah Levy House Trust. They say that they are well cared for and their privacy is respected. Residents commented, I think I am fortunate to be here really.” When I arrived here they asked me how I wished to be addressed. The staff show respect for us, which they should do at our age. A comment card from a relative states, The care is excellent. Staff make time to chat with residents. Residents are looked after in a dignified and courteous manner. The lifestyle of those living in the home offers varied individual and shared social opportunities, which reflect people’s interests and preferences. Residents commented: There is always plenty to do here if you want to join in. I enjoy some of the activities. We dont have to take part if we dont want to. We have a bit of a laugh with the exercise class. There is always something going on here. I enjoy the outings best of all, it is nice to get out sometimes. Residents confirmed that their individual preferences and routines are respected. 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. Some residents also like to participate in activities outside of the home, which are organised by the local synagogues. Religious services are held on Shabbat and on Holy Days. Rabbis from both local synagogues visit the home. Hannah Levy House Trust 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. Residents commented, I think the meals are first-class. The food is very good on the whole. We can always have something different if we dont like what is on the menu. We have plentiful food to satisfy our needs Residents and staff confirm that the deputy manager and senior staff are always approachable and willing to talk about any problems that might arise. Residents commented, I have no complaints, but if I did I would expect the people in the office to sort it out. I have never had to complain about anything. I have no concerns, I can always speak with the staff or managers. Residents live in comfortable surroundings and have access to pleasant communal areas, including gardens. These communal areas are well used by residents. A resident commented, We have everything we need here, the standard of accommodation is very high. Hannah Levy House Trust DS0000003944.V320475.R01.S.doc Version 5.2 Page 8 A tour of the building confirms that residents bedrooms are comfortably furnished and personalised to varying degrees. Residents commented, I have all that I need in my room. “I am very comfortable here. It is nice to have ones own things around, it makes it more like home.” A Housekeeper and dedicated laundry and domestic staff are employed at Hannah Levy House Trust. The home is clean and there are no unpleasant smells, making sure that residents live in pleasant surroundings. A wellequipped laundry is sited on the ground floor. Residents commented, We have a very efficient laundry service. The home is kept very clean, which is important to me. I dont want to live somewhere that smells unpleasant. A relative commented, The home is very pleasant and clean when I come in. The home employs a team of experienced care, catering, cleaning and maintenance staff. There are sufficient staff to meet the current needs of residents and to ensure their safety and comfort. Staff demonstrated a warm and caring approach when dealing with residents. A key worker system is in operation, where each member of care staff has particular responsibility for several residents. This gives them an opportunity to really get to know residents and ensure all their needs are met. Residents spoke very positively about the staff. We are well looked after here. It is nice to be here, the people are good to me. They do their best for us so we cant complain. I think they look after us very well. Hannah Levy House Trust has a welcoming atmosphere, which is beneficial to residents, staff and visitors alike. Although there is currently no registered manager in post, the deputy manager has worked in the home for many years and is very experienced. A number of comment cards from relatives spoke highly of the management of Hannah Levy House Trust. The home is extremely well-run. I have nothing but praise for the staff, the care, attention, cleanliness and food at the home. We are extremely happy with this care home. Many thanks Hannah Levy. What has improved since the last inspection? 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 corridors and many bedrooms. • The redecoration of some bedrooms. • • • The provision of new curtains, bedspreads and duvets in bedrooms. The fitting of new flooring in two bathrooms. The refurbishment of the hair salon. DS0000003944.V320475.R01.S.doc Version 5.2 Page 9 Hannah Levy House Trust • • • Fifteen new chairs purchased for the lounge. New tablecloths provided for the dining room. Two recommendations from the previous inspection have been met. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. Hannah Levy House Trust DS0000003944.V320475.R01.S.doc Version 5.2 Page 10 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. Hannah Levy House Trust DS0000003944.V320475.R01.S.doc Version 5.2 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.V320475.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Standard 6 is not applicable at Hannah Levy House Trust. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to Hannah Levy House Trust. Pre-admission assessments are carried out so residents are assured that only those whose needs can be met are offered places there. The home confirms in writing with prospective residents that their needs can be met. EVIDENCE: Prospective residents and their relatives or representatives are always invited to visit the home prior to admission to meet with staff and residents. A copy of the most recent inspection report is always available from the main office, on request. It is suggested that it would be good practice for a copy of the on report be available to residents and visitors, without them having to ask to see it. The deputy manager says that prospective residents are always fully assessed, prior to making a decision as to whether the home is able to meet their needs. Hannah Levy House Trust DS0000003944.V320475.R01.S.doc Version 5.2 Page 13 A form has been developed for this purpose. The files for two residents who had recently moved into Hannah Levy House Trust were examined. These confirmed that clear pre-admission assessment information had been recorded. A letter of confirmation is then written to the prospective resident so that they may feel assured their care needs can be met. Copies of such letters were evidenced on file. The information contained in pre-admission assessments and also any assessments supplied by Social Services, is then used to help draw up a plan of care. Hannah Levy House Trust DS0000003944.V320475.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to Hannah Levy House Trust. Hannah Levy House Trust has a care planning system in place, but some improvements are needed to ensure that staff have all of the information they require to meet the social and personal care needs of residents. Health needs are well met, with evidence of good support from community health professionals. The arrangements for storing and handling medicines in the home ensure residents’ safety. Residents are treated with respect and their privacy and dignity is promoted at all times. Hannah Levy House Trust DS0000003944.V320475.R01.S.doc Version 5.2 Page 15 EVIDENCE: Following admission to the home, further assessments are carried out and a care plan is drawn up, identifying the needs of each resident and how staff are to meet these needs. Care records for three residents were examined and each contained a full range of assessments, which form the basis for care plans. However, the information recorded on social assessments is currently rather limited. The use of “Life Histories” is being considered, which will provide background information about each resident’s life before coming to Hannah Levy House Trust. To aid correct identification, each record contains a recent photograph of the resident. Occasionally, care plans make general statements, for example, “Needs all care.” Such statements are not personalised to the individual resident’s needs. They do not provide specific information about the interventions needed from staff nor identify the resident’s preferred routine or what he or she may be able to contribute themselves etc. The deputy manager says that residents or their representatives are involved in care planning and review wherever possible. There is a space for the resident to sign the back of the care plan when it is first agreed. The deputy manager confirmed that any changes to the care plan are always discussed with the resident or their representative, but this cannot always be evidenced. Staff regularly review care plans, at least monthly but more frequently where necessary and update them to reflect any changing needs. Good daily records are written by both day and night staff to evidence the care being provided. These show that residents have access to General Practitioners, district nurses, dentists, chiropodists, opticians etc and attend hospital appointments as necessary. This was later confirmed in discussion with residents and staff. Staff demonstrated that they have a good knowledge of residents’ individual care needs. Staff feel there is very good communication about residents needs. The home has systems in place for managing medicines. Only senior staff deal with medication and they first have to undertake a course of related training. Medicines are stored securely. Observation of the staff administering medication and examination of the records indicates that medicines are given as prescribed, to ensure the protection of residents. Hannah Levy House Trust DS0000003944.V320475.R01.S.doc Version 5.2 Page 16 Staff were seen to knock at bedroom doors and to offer personal care discreetly. Staff interact with residents in a friendly and caring manner. It was clear from the time spent with residents that they feel comfortable and at ease with staff and appreciated their caring approach. Staff were seen throughout the inspection to be treating service users with courtesy and kindness, with due regard for dignity and respect. Personal care, e.g. toileting is offered discreetly. Residents commented, I think I am fortunate to be here really.” When I arrived here they asked me how I wished to be addressed. The staff show respect for us, which they should do at our age. A comment cards from a relative states, The care is excellent. Staff make time to chat with residents. Residents are looked after in a dignified and courteous manner. Residents confirm that they are able to go to their own bedrooms whenever they wish, thereby offering an opportunity to be on their own or allowing privacy for any visitors or personal care needs. Residents commented, I enjoy being in my room, but I like to go to the lounge sometimes, if I feel like some company. I enjoy my own company, so stay in my room for much of the time. Hannah Levy House Trust DS0000003944.V320475.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. 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. A range of Kosher foods 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 armchair exercises to music, arts and crafts and music therapy. Regular entertainment is arranged. 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 Hannah Levy House Trust DS0000003944.V320475.R01.S.doc Version 5.2 Page 18 participate in the regular weekly outings in the homes minibus to local places of interest, such as Mudeford Quay, the New Forest, Swanage steam railway and local garden centres. A trip to the local pantomime has been planned for December. A computer is provided in the conservatory for residents to use whenever they wish. The introduction of Life Histories will help to ensure that social care is always person centred, meeting the individual needs, preferences and expectations of residents. Residents’ birthdays are celebrated, and such a celebration was taking place on the day of inspection, with the chef providing a special birthday cake and candles. Residents commented: There is always plenty to do here if you want to join in. I enjoy some of the activities. We dont have to take part if we dont want to. We have a bit of a laugh with the exercise class. There is always something going on here. I enjoy the outings best of all, it is nice to get out sometimes. Religious services are held on Shabbat and on Holy Days. 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 children from the religious classes of both synagogues and a 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. 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 confirm that their individual preferences and routines are respected. Meetings are held where residents can express their views and opinions and influence the running of the home. Hannah Levy House Trust provides a kosher diet under strict supervision. All Hannah Levy House Trust DS0000003944.V320475.R01.S.doc Version 5.2 Page 19 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 quiche, or egg with chips. Tinned fruit and ice cream or fresh fruit followed this. The evening Shabbat meal was chicken soup with knaidlach, then roast chicken, or salmon with roast potatoes, Brussels sprouts and parsnips, followed by apricot compote or a selection of fresh fruit. Alternatives, such as jacket potatoes, chicken and fish, are always available to suit individual taste and preference. The chef says his policy is, as far as possible, to provide residents with whatever they want. Special diets are catered for and the chef demonstrated a good knowledge of residents’ dietary needs, likes and dislikes. One resident has very particular dietary requirements and a list of these is displayed in the kitchen and the office. Excellent stocks of dried, tinned, fresh and frozen foods were seen. Fresh fruit and vegetables are delivered six days a week. All meals are usually taken in the dining room (in two sittings) 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, wellbalanced diet. Residents commented, I think the meals are first-class. The food is very good on the whole. We can always have something different if we dont like what is on the menu. The food is very reasonable here. I enjoy my meals. The food is not bad, I enjoy most of it. The food is very good, all the better because I dont have to cook it. We have plentiful food to satisfy our needs We do very well at mealtimes. We had a piece of birthday cake this afternoon which was very nice. Hannah Levy House Trust DS0000003944.V320475.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A system is in place for dealing with any complaints. Residents are confident that complaints are listened to and dealt with appropriately. The home has an Adult Protection policy in place to ensure residents are protected from possible abuse, but not all staff have received training to ensure a proper response to any suspicion or allegation 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. A complaints box is also positioned in the entrance hall. Three complaints have been received by the home in the last year. These were investigated and found to be substantiated. Appropriate action was taken subsequently. Residents and staff confirm that the manager and senior staff are always approachable and willing to talk about any problems that might arise. Residents commented, I have no complaints, but if I did I would expect the people in the office to sort it out. I have never had to complain about anything. I have no concerns, I can always speak with the staff or managers. Hannah Levy House Trust DS0000003944.V320475.R01.S.doc Version 5.2 Page 21 The home has an Adult Protection policy in place to protect residents from possible abuse. This makes reference to the Department of Health No Secrets document, which is also available to staff. Staff sign to show they have read and understood the policy. Adult Protection is also covered during induction training for new staff and in formal supervision sessions. The home arranges for staff to receive Adult Protection training to ensure a proper response to any suspicion or allegation of abuse. However, records show that six care staff have not yet received Adult Protection training, including one of the Team Leaders. Hannah Levy House Trust DS0000003944.V320475.R01.S.doc Version 5.2 Page 22 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 24 and 26 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. 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. Bedrooms are comfortably furnished and individually personalised to suit their occupants The home is clean with no unpleasant odours, making daily life more pleasant for all in the home. Hannah Levy House Trust DS0000003944.V320475.R01.S.doc Version 5.2 Page 23 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 corridors and many bedrooms. • The redecoration of some bedrooms. • The provision of new curtains, bedspreads and duvets in bedrooms. • The fitting of new flooring in two bathrooms. • The refurbishment of the hair salon. • Fifteen new chairs purchased for the lounge. • New tablecloths provided for the dining room. 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. Only one page of the Certificate of Registration was displayed in the home and not both, as required. 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 home also has a small synagogue where services are held on Shabbat and Holy Days. 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 resident commented, We have everything we need here, the standard of accommodation is very high. A tour of the building confirms that residents bedrooms are comfortably furnished and personalised to varying degrees. Residents commented, I have all that I need in my room. “I am very comfortable here. It is nice to have ones own things around, it makes it more like home.” I like my room, I am very comfortable here. 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 Trust. The home is clean and there are no unpleasant smells, making life within the home more pleasurable. A well-equipped laundry is sited on the ground floor. Hannah Levy House Trust DS0000003944.V320475.R01.S.doc Version 5.2 Page 24 The home has a detailed infection control policy. Suitable facilities and procedures are in place for the disposal of clinical waste. Residents commented, We have a very efficient laundry service. The home is kept very clean, which is important to me. I dont want to live somewhere that smells unpleasant. A relative commented, The home is very pleasant and clean when I come in. Hannah Levy House Trust DS0000003944.V320475.R01.S.doc Version 5.2 Page 25 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The numbers and skill mix of staff are sufficient to meet the present care needs of residents. The home is working towards the recommended ratio of 50 NVQ level 2 trained staff, to help ensure residents are in safe hands. Employment and recruiting procedures need improvement to ensure the protection of residents. Further work is needed to ensure that all staff have the necessary skills to carry out their work. EVIDENCE: The home employs a team of experienced care, catering, cleaning and maintenance staff. On the day of inspection, care staffing was as follows: 07.30. -- 20.30 1 Team Leader and 5 Care Assistants 20.30. -- 08.00 2 Care Assistants (wakeful) 20.30. -- 08.00 1 Team Leader sleeping in, on call. Hannah Levy House Trust DS0000003944.V320475.R01.S.doc Version 5.2 Page 26 The home also employs two chefs, a housekeeper, a maintenance person, and domestic and laundry staff. A key worker system is in operation, where each member of care staff has particular responsibility for several residents. This gives them an opportunity to really get to know residents and ensure all their needs are met. Residents spoke very positively about the staff. We are well looked after here. It is nice to be here, the people are good to me. They do their best for us so we cant complain. I think they look after us very well. A number of comment cards from relatives also spoke highly of the staff. I could not be more satisfied by the care my relative is getting. She is very well looked after and all the staff are fantastic. The standard of care seems to me to be beyond reproach. A well staffed home with a high standard of care. I view Hannah Levy House as one of the best run homes Ive encountered. There is always a warm and welcoming atmosphere in the home. Residents are treated with care and respect and always listened to. My relative has been very happy and well looked after for many years. The staff are very pleasant. The home places great emphasis on the importance of training in ensuring the safety and wellbeing of residents. Two care staff have now achieved National Vocational Qualifications (NVQ) at level 2, seven have NVQ level 3 and one has NVQ level 4. Two more staff are about to commence NVQ training. A total of twenty-two care staff is employed, so the home has almost achieved its target of having 50 NVQ trained staff, to help ensure that residents are in safe hands. The home has a recruitment procedure in place, based on equal opportunities. Three staff files were examined and some serious gaps in the recruitment process noted. For example, one reference was addressed “To whom it may concern.” This reference was accepted, even though it was not from the named referee provided by the applicant. Staff had also been employed prior to receiving a satisfactory Criminal Records Bureau or POVAfirst (Protection Of Vulnerable Adults) check. A more robust recruitment process must be implemented to ensure the protection of residents. 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. Not all staff have yet received mandatory training e.g. moving and handling and first aid. Further training is being arranged. It is suggested that the home obtains the Skills for Care Common Induction Standards so that their induction and foundation training programme will ensure best practice. (See below.) Hannah Levy House Trust DS0000003944.V320475.R01.S.doc Version 5.2 Page 27 Further information about staff training can be obtained from the following websites: www.picbdp.co.uk This is the Partners in Care web site and provides lots of information about funding streams for training including NVQ, Life skills and Leadership & Management. www.skillsforcare.org.uk This is the Skills for Care web site and there are downloadable knowledge sets and learning logs for: Dementia, Infection Control, Medication and also Workers not involved in direct care. These knowledge sets are the first 4 of approximately 30 that are currently planned. They are designed to improve consistency in underpinning knowledge for the adult social care work force in England. They identify learning outcomes and are designed to be used alongside the Common Induction Standards, which are also available from this web site. They also count as underpinning knowledge towards NVQs and link to the Health & Social Care National Occupational Standards. www.traintogain.gov.uk This is a programme and funding stream supported by the Learning and Skills Council and Business Link, who provide a skills brokerage role. (This project takes off from 1st August in Dorset.) www.lsc.gov.uk/bdp/employer/eggt_intro.htm This is the Employer Guide to Training website, which is aimed at assisting employers to choose the most suitable training provider to meet their workforce needs by the use of a search facility. Hannah Levy House Trust DS0000003944.V320475.R01.S.doc Version 5.2 Page 28 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 and 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There is currently no registered manager in place. The home is seeking to appoint a new manager. The home has a quality monitoring system in place, based on seeking the views of residents, relatives, staff and other visitors to the home each year. However, questionnaires have not been distributed during 2006. Residents are assured of sound management of their financial interests. Formal staff supervision is taking place to ensure good practice, but this is not always at the recommended intervals. The home works to ensure the health, safety and welfare of residents. However failure to carry out fire drills at the appropriate intervals has the potential to place vulnerable residents at risk in the event of fire. Hannah Levy House Trust DS0000003944.V320475.R01.S.doc Version 5.2 Page 29 EVIDENCE: The manager, Mrs Rabjohns, took up her post earlier this year and was registered in August 2006. However, she has recently resigned and a new manager is now being recruited. Once appointed, an application will be made to the Commission for registration. The deputy manager is currently in charge. She has worked in the home for many years and is very experienced. Hannah Levy House Trust has a welcoming atmosphere, which is beneficial to residents, staff and visitors alike. A number of comment cards from relatives speak highly of the management of Hannah Levy House Trust. The home is extremely well-run. I have nothing but praise for the staff, the care, attention, cleanliness and food at the home. We are extremely happy with this care home. Many thanks Hannah Levy. The home has a quality monitoring system in place, based on seeking the views of residents, relatives, staff and other visitors to the home on an annual basis. However, questionnaires have not been distributed during 2006. Quarterly resident and staff meetings are held but these have lapsed a little since the changeover of managers. A suggestions box is available in the entrance hall and residents and visitors are able to access the main office at any time during the day to speak with the deputy manager if there is any matter they wish to discuss. This open door policy was seen in action throughout the inspection. In order to protect residents the home prefers wherever possible to have no involvement in personal finances. Therefore, those residents who are unable or have no wish to handle their own affairs, have a relative or other representative to deal with their finances. The home does look after small amounts of money for some residents. An account book is maintained showing all transactions and receipts retained, as necessary. This record was checked during the inspection. All monies and related records are held securely. Care staff should receive formal supervision at least six times a year, as a means of ensuring good practice, emphasising the philosophy of care within the home and looking at individual career development needs etc. Examination of three staff records shows that supervision is not always taking place on a regular basis. For example, one member of staff has received supervision regularly every two months until April 2006, but only one session since this time. In some files, the supervision record is not dated. From touring the premises, looking at records and discussions with staff and residents, it is evident that measures are in place to promote the health and Hannah Levy House Trust DS0000003944.V320475.R01.S.doc Version 5.2 Page 30 safety of residents. Records confirm that equipment, such as hoists, passenger lift and portable electrical appliances etc are regularly serviced to ensure resident safety. Radiator surfaces are guarded in bedrooms and communal areas to prevent direct contact with very hot surfaces. All substances that could be potentially hazardous to health are handled and stored safely. Staff demonstrated an awareness of health and safety issues. Examination of the fire records shows that regular maintenance of the fire warning system, emergency lighting and fire fighting equipment is taking place. Routine checks of emergency lighting, fire fighting equipment and the fire warning system are carried out at appropriate intervals and staff confirm this. Records show that staff usually receive regular fire training and fire drills but, on this occasion, the fire drill is overdue. The Deputy manager undertook to arrange this as soon as possible. The importance of carrying out fire drills cannot be overstressed in ensuring that all staff know what to do in the event of fire. (Since the inspection, the deputy manager has confirmed that a drill has taken place.) Hannah Levy House Trust DS0000003944.V320475.R01.S.doc Version 5.2 Page 31 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 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 4 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 2 4 X X X 3 X 4 STAFFING Standard No Score 27 3 28 2 29 1 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 1 X 2 X 3 2 X 2 Hannah Levy House Trust DS0000003944.V320475.R01.S.doc Version 5.2 Page 32 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 All aspects of each resident s personal and social care needs must be recorded. Care plans are to be agreed and signed by the resident or their representative wherever possible. The registered person must ensure that staff receive appropriate training in the Protection Of Vulnerable Adults. Both parts of the certificate of registration must be displayed in a conspicuous place. The registered person must operate a thorough recruitment procedure to ensure the protection of residents. All staff must be properly checked before being employed. The registered person must ensure that staff receive training, which is appropriate to the work they are to perform. This should include all mandatory training and suitable induction training. The registered person shall ensure that the home is managed by a person who is fit DS0000003944.V320475.R01.S.doc Timescale for action 1 OP7 14 and 15 31/03/07 2 OP18 13(6) Care Standards Act 28(1) 19(1) Schedule 2 31/03/07 3 OP19 31/01/07 4 OP29 31/01/07 5 OP30 18(1) 31/03/07 6 OP31 9 31/03/07 Hannah Levy House Trust Version 5.2 Page 33 7 OP36 18(2) 8 OP38 23(4)(e) to be in charge and able to discharge his or her responsibilities fully. An application to register a new manager with the Commission must be made as soon as possible. The registered person must ensure that staff are appropriately supervised at the recommended intervals. The registered person must ensure, by means of fire drills and practices, that persons working in the home are aware of the procedure to be followed in the event of fire. 31/03/07 31/01/07 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 OP28 Good Practice Recommendations It is recommended that a minimum ratio of 50 per cent trained members of care staff at NVQ level 2, or equivalent be achieved. It is recommended that quality assurance questionnaires be sent out to residents, relatives, staff and other visitors to the home, to obtain feedback about the service provided. 2 OP33 Hannah Levy House Trust DS0000003944.V320475.R01.S.doc Version 5.2 Page 34 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF 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 Hannah Levy House Trust DS0000003944.V320475.R01.S.doc Version 5.2 Page 35 - 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. 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