Inspection on 22/06/05 for Harbledown Lodge Nursing Home

This inspection was carried out on 22nd June 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Harbledown Lodge Nursing Home 15/05/08

Harbledown Lodge Nursing Home 16/05/07

Harbledown Lodge Nursing Home 31/08/06

Harbledown Lodge Nursing Home 13/12/05

Harbledown Lodge Nursing Home 14/04/04

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

CARE HOMES FOR OLDER PEOPLE Harbledown Lodge Nursing Home Upper Harbledown Canterbury Kent CT2 9AP Lead Inspector Tina Thomas Unannounced 22/06/05 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Harbledown Lodge Nursing Home H56-H05 S26096 Harbledown Lodge V233503 220605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Harbledown Lodge Nursing Home Address Upper Harbledown, Canterbury, Kent, CT2 9AP Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01227 458116 01227 453737 Unique Help Group Registered Care Home 56 Category(ies) of Care Home for Older People - 56 registration, with number of places Harbledown Lodge Nursing Home H56-H05 S26096 Harbledown Lodge V233503 220605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 19/10/04 Brief Description of the Service: Harbledown Lodge is an elegant Georgian Country House. It is set within 50 Acres of grounds. The Home is approached by its own private drive. Also within the grounds is a day centre. The Home has access to the centres facilities. The Home has parking spaces for visitors. Harbledown Lodge offers nursing care for up to 56 Service Users. It has forty-two single rooms and seven double rooms. Many rooms have en-suite facilities. Each room has a call system, telephone and TV Harbledown Lodge Nursing Home H56-H05 S26096 Harbledown Lodge V233503 220605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Unique Help Group has been recently purchased. The new Registered Individual is Mr K Rajakanthan. Letters have been sent to relatives to inform them of the change. The Manager verbally informed people that live in the home of the changes. This was an unannounced inspection. The Inspector arrived at 11.30 am. The Inspector toured the building, spoke with some people who live at the Home, Staff and Managers. The Home has a new Manager who is awaiting registration. The Staff team have worked well to improve work practices in the home. The Home looks clean and uncluttered. Requirements from the last inspection have been met. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Harbledown Lodge Nursing Home H56-H05 S26096 Harbledown Lodge V233503 220605 Stage 4.doc Version 1.30 Page 6 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Harbledown Lodge Nursing Home H56-H05 S26096 Harbledown Lodge V233503 220605 Stage 4.doc Version 1.30 Page 7 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3,4 People have their needs assessed and can be sure they can be met. EVIDENCE: As previously mentioned in the summary Unique Help Group has been bought by a new owner. Insufficient time has elapsed for the new owner to prepare an updated Statement of Purpose or Service User Guide. The area Manager expressed that this would occur soon. Service Users only move into the home after having a comprehensive, holistic assessment, conducted by the Manager or on some occasions, another manager within the group. The assessment looks at health care, psychological and social needs. The Home does not offer intermediate care Harbledown Lodge Nursing Home H56-H05 S26096 Harbledown Lodge V233503 220605 Stage 4.doc Version 1.30 Page 8 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,10, Care plans describe people’s health, personal and social care needs. Care needs are fully met. Service Users are treated with dignity. EVIDENCE: A number of care plans were viewed. They were well written, well reviewed, held appropriate information to enable staff to care for the people who live in the Home. Suitable risk assessments are in place to ensure as far as reasonably practicable the safety of people living in the home. People who live in the Home and are able, have signed their agreement of their care plans. The Inspector had previously been concerned regarding the number of people who spent a lot of time sitting in wheel chairs. The Inspector was pleased to see that people were spending time sitting in a selection of comfortable chairs. The home has ten people with pressure sores, although the Manager told the inspector that nine of these people did not get their pressure sores from the home. All of these sores are healing. The Inspector spoke with some people who live in the Home and some staff who all agreed that the people who live in the home have their privacy and dignity maintained. Staff knock on doors before entering peoples rooms, they use peoples preferred names, and ensure that people wear only there own clothes. Harbledown Lodge Nursing Home H56-H05 S26096 Harbledown Lodge V233503 220605 Stage 4.doc Version 1.30 Page 9 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13, 15 Service Users cultural, social, and religious needs are considered and met. Service Users maintain contact with people they chose to. Meals are wholesome and appealing. EVIDENCE: The Home has an activities co-ordinator who works 10-4 Monday to Friday. People in the Home were going to go to the beech the day after inspection. People that live in the home enjoy activities including baking. Staff commented that they felt the people in the home had plenty of activities and they also commented that they felt they had enough time to engage with people who live in the Home. The Inspector observed from the visitor’s book that people in the Home have visitors at a selection of times. The Kitchen caters for several diets including diabetic. People that live in the home and the staff all said that the meals were of good quality and plentiful. Harbledown Lodge Nursing Home H56-H05 S26096 Harbledown Lodge V233503 220605 Stage 4.doc Version 1.30 Page 10 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 Complaints are dealt with in an appropriate manner. EVIDENCE: The Home has had two complaints since the last inspection. These were dealt with through the Homes own complaints procedure. The Commission has not received any complaints regarding this home since the last inspection. People that live in the home have access, on a daily basis, to a number of senior staff, including the trained nurses, the Manager, administration staff and group managers. Therefore minor problems can be dealt with at source, service users expressed confidence that their complaints would be suitably dealt with. Harbledown Lodge Nursing Home H56-H05 S26096 Harbledown Lodge V233503 220605 Stage 4.doc Version 1.30 Page 11 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,20,21,22,23,24,25,26 Service Users live in a safe and well-maintained environment. People have access to safe indoor and outdoor communal facilities. Washing and toilet facilities are suitable. Specialist equipment to promote independence is in place where necessary. Individual rooms meet people’s needs and are comfortable. The Home is clean pleasant and hygienic. EVIDENCE: The Inspector observed that the Home is suitable for its purpose. The inspector observed that the Home is clean and far less cluttered than on previous inspections. The Small dining room looked considerably improved. Some furniture had been removed. The dining room has been painted. The upstairs lounge is used as a function room. The Inspector was pleased to see that eight people were enjoying the gazebo in the garden. Bathroom and toilets were clean and uncluttered. All bathrooms have suitable locks. Harbledown Lodge Nursing Home H56-H05 S26096 Harbledown Lodge V233503 220605 Stage 4.doc Version 1.30 Page 12 The home has suitable equipment including mobile hoists to maximise Service Users independence. The Inspector viewed a number of people’s own rooms and found them to be clean and personalised. Some people had bought items of their own furniture to the home and have items such as pressure relieving mattresses to meet their needs. Harbledown Lodge Nursing Home H56-H05 S26096 Harbledown Lodge V233503 220605 Stage 4.doc Version 1.30 Page 13 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,29,30 Service users needs are met by the numbers and skill mix of staff. The homes recruitment and selection process protects Service users. Staff are trained and competent to do their jobs. EVIDENCE: There are thirty five people currently living at the Home The numbers of staff on duty has significantly improved since the last inspection and numbers of people living in the Home have decreased. The inspector had previously been particularly concerned regarding the numbers of staff employed of a night. The staff rota showed that there are now two trained nurses and three care staff on duty each night. All Staff the inspector spoke with agreed that the home was currently well staffed. Staff discussed that they work more effectively, given the size of Harbledown Lodge, now that each floor of the building has its own staff team, led by trained nurses. The Inspector spoke with staff who had completed training such as manual handling, health and safety, food hygiene and fire safety and the prevention of abuse. The inspector viewed staff files that were well maintained and in line with national minimum standard. All staff have current CRB checks. Harbledown Lodge Nursing Home H56-H05 S26096 Harbledown Lodge V233503 220605 Stage 4.doc Version 1.30 Page 14 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33,36,38 The Manager is trained and competent to be in charge of the Home. The Home is run in the best interests of the Service User. Staff are appropriately supervised. Policies, procedures and good record keeping protects the best interests of Service Users. The Health, safety and well being of staff and service users are promoted and protected. EVIDENCE: The manger is a trained nurse. She is awaiting registration by the Commission to become the Registered Manager of Harbledown Lodge. She was previously registered as the Manager of another Home within the group. Staff and people who live at the home agreed that the Manager was approachable. The Home has meetings for night staff, day staff, maintenance, the people who live in the Home, and the groups Managers. These are all minuted and actioned. The Inspector viewed a selection of minutes. Harbledown Lodge Nursing Home H56-H05 S26096 Harbledown Lodge V233503 220605 Stage 4.doc Version 1.30 Page 15 The staff are well supported through supervision and senior staff will be attending a supervisors training course within the next month. The inspector viewed a number of records including staff and service user files that were well maintained in line with the homes own policies. The Inspector observed that the Home is kept in a secure manner. The Manager as far as reasonably practicable ensures compliance with relevant legislation to ensure that the health, safety and welfare of Service User and staff is promoted and protected. Harbledown Lodge Nursing Home H56-H05 S26096 Harbledown Lodge V233503 220605 Stage 4.doc Version 1.30 Page 16 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x 3 3 3 x x 3 x x Harbledown Lodge Nursing Home H56-H05 S26096 Harbledown Lodge V233503 220605 Stage 4.doc Version 1.30 Page 17 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations Harbledown Lodge Nursing Home H56-H05 S26096 Harbledown Lodge V233503 220605 Stage 4.doc Version 1.30 Page 18 Commission for Social Care Inspection 11th Floor International House Dover Place Ashford Kent TN23 1HU National Enquiry Line: 0845 015 0120 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. 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