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Inspection on 03/05/05 for Harbour House

Also see our care home review for Harbour House for more information

This inspection was carried out on 3rd May 2005.

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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Newly arrived residents at the home said they were positively involved in the arrangements leading up to their move and were warmly and well received by the managers and staff at the home. The arrangements to support residents when they are unwell and to access health services are very positive. The residents spoken to were very complimentary about the flexible and caring approach staff have at these times. Residents were also very complimentary about the way staff undertook their duties and said they had great confidence in the provider, managers and staff of the home. The number of staff on duty is determined by the needs of residents and staff are well supported by the provider and managers. Staff at the home are well trained and the majority have NVQ 2 or above. Excellent arrangements are in place to recruit and select new staff. Visitors are welcomed to the care home and a range of interesting activities is provided each week. The managers regularly meet with residents as a group to talk about the care and accommodation provided and discuss any future plans for the home. Any concerns or complaints are dealt with positively and the staff and managers are committed to making sure that residents are protected from abuse. The home is well managed and run for the benefit of the residents. Residents are encouraged to comment upon the management arrangements in order to further improve the services and facilities provided.

What has improved since the last inspection?

The care planning arrangements continue to be improved so that residents and staff know what care is planned to be given. The dining arrangements have been improved and residents said they were very satisfied. The records about residents continue to be developed but further improvement is necessary so that all staff are making comprehensive records.

What the care home could do better:

The assessments of residents needs undertaken before anyone moves to the care home need to be more detailed. This will make sure that all individual needs and preferences are met. The home provides care to residents who may experience varying levels of physical and mental frailty. In order to maintain independence and safety staff need to identify and respond to risks. These arrangements need to be recorded and where risks are identified an appropriate risk assessment and prevention plan must be completed. The choice at mealtimes has improved and the majority of residents are satisfied but a few residents would like a more varied menu. The kitchen is well managed but the flooring needs to be replaced. All staff should be provided with a job description or written information about their duties. This will make sure the staff member is clear about the duties and expectations of their post.

CARE HOMES FOR OLDER PEOPLE Harbour House Penberthy Road Portreath Redruth Cornwall TR16 4LW Lead Inspector Paul Freeman Unannounced 3 May 2005 0930 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. Harbour House D52-D04 S53837 Harbour House V215874 030505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Harbour House Address Penberthy Road Portreath Redruth Cornwall TR16 4LW 01209 843276 01209 843276 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) Mrs Mary Allison Anson & Mr John Robert Anson Sarah Joanne Eustice Care Home 18 Category(ies) of Dementia - over 65 years of age (5), Old age, registration, with number not falling within any other category (18) of places Harbour House D52-D04 S53837 Harbour House V215874 030505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Service users to include up to 5 adults aged over 65 with dementia (DE(E) To accommodate one named service user outside the registered categories of the home To accommodate a second named service user outside the registered categories of the home Total number of service users not to exceed a maximum of 18 Date of last inspection 29 November 2004 Brief Description of the Service: Harbour House cares for 18 older people and is a two story detached property that has been extended and stands in its own grounds close to the harbour. It is set in a residentail area near to local amenites and a reliable bus service provides access to local towns. There are three lifts, one a full shaft lift, the second a stair lift providing access to the bedrooms on the first floor and a third upstairs to compensate for the didffernt levels on the first floor. Sixteen of the bedrooms are single and two have en-suite facilities. The one double bedroom exceeds of the recommended size. Communal space is good with a choice of two sitting rooms and two dining rooms and toilets and bathrooms are located throughout the care home. The home are committed to delivering care in a manner that meets the needs of each service users and recognises individual choice and preference. Harbour House D52-D04 S53837 Harbour House V215874 030505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over five hours. The Inspector looked over the building and at a number of records and documents. Eight of the residents, four of the staff, the provider and registered manager were spoken to. The provider Mrs Anson plays an active role in the management and support provided at the home. The Inspector found the requirements and recommendations set at the last inspection had been worked upon. What the service does well: Newly arrived residents at the home said they were positively involved in the arrangements leading up to their move and were warmly and well received by the managers and staff at the home. The arrangements to support residents when they are unwell and to access health services are very positive. The residents spoken to were very complimentary about the flexible and caring approach staff have at these times. Residents were also very complimentary about the way staff undertook their duties and said they had great confidence in the provider, managers and staff of the home. The number of staff on duty is determined by the needs of residents and staff are well supported by the provider and managers. Staff at the home are well trained and the majority have NVQ 2 or above. Excellent arrangements are in place to recruit and select new staff. Visitors are welcomed to the care home and a range of interesting activities is provided each week. The managers regularly meet with residents as a group to talk about the care and accommodation provided and discuss any future plans for the home. Any concerns or complaints are dealt with positively and the staff and managers are committed to making sure that residents are protected from abuse. The home is well managed and run for the benefit of the residents. Residents are encouraged to comment upon the management arrangements in order to further improve the services and facilities provided. Harbour House D52-D04 S53837 Harbour House V215874 030505 Stage 4.doc Version 1.30 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Harbour House D52-D04 S53837 Harbour House V215874 030505 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Harbour House D52-D04 S53837 Harbour House V215874 030505 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 and 6. The admissions procedure needs to be developed further to ensure care needs are met. EVIDENCE: The admission procedure needs further development to ensure the new residents are properly assessed and planned for. There are occasions when resident’s needs are not adequately explored in order that staff can have clear guidance about the care and support required. It is positive that a number of residents are able to direct their own care and this promotes independence and choice. Residents that had recently move to the home said they were consulted and positively welcomed when they arrived. The care home do not provide a dedicated intermediate care service but are keen to help residents maintain their independence. Harbour House D52-D04 S53837 Harbour House V215874 030505 Stage 4.doc Version 1.30 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8 and 9 Care planning arrangements continues to improve but further improvements are required. This will help to make sure that each resident’s health, personal and social care needs are fully met. The arrangements for helping resident with their mobility and to manage risk also require improvement. Good arrangements are in place to support residents when they are unwell and to access health services. Medicines are well managed. EVIDENCE: Individual care plans have continued to be improved and are generally appropriate for residents who are able to direct their own care. For residents unable to direct their own care their plans need to be more detailed to make sure all their needs are taken account of and staff have a clear picture of the care and support required. Care plans are regularly reviewed with residents. The residents spoken to were very complimentary about the manner their health needs are met. The records confirm that health services are promptly and efficiently accessed. Harbour House D52-D04 S53837 Harbour House V215874 030505 Stage 4.doc Version 1.30 Page 10 There was lack information about the assistance certain residents require with mobility and where this was available there were occasions when it had not been included in the care plan. All accidents that occur to residents are recorded but there was no record of any risk assessments, associated plans or preventative measures that had been taken. Residents are able to administer their own medication when it is safe to do so and this is their choice. The arrangements for care staff to administered medicines are safe, well organised and accurate records are maintained. The staff responsible for this task have all been appropriately trained. Harbour House D52-D04 S53837 Harbour House V215874 030505 Stage 4.doc Version 1.30 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13 and 15 Social activities are well organised and provide stimulation and interest for people living in the home. Visiting arrangements are flexible and visitors to residents are positively welcomed. Meals are nutritional and balanced but the menu needs to be improved for some residents. The kitchen is well organised and hygienic but the flooring needs to be replaced. EVIDENCE: The majority of residents spoken to were very satisfied with the menu provided, the quality and quantity of the food and the choice they had at each mealtime. Other residents wanted the menu to offer wider choice and be more varied. Menus were found to be balanced and there are flexible mealtimes to suit the needs of residents. The kitchen area is well managed and the equipment is in good working order. The flooring is showing signs of wear and tear and requires replacement. Visitors are welcomed to the care home and there is no visiting restriction during waking hours. Residents said there are no restrictions to accessing the local community providing it is safe to do so. Some of the residents regularly visit local amenities and group outings are provided at least once a month. Other Harbour House D52-D04 S53837 Harbour House V215874 030505 Stage 4.doc Version 1.30 Page 12 activities are provided during each week at the care home for residents. Some resident do not wish to participate in the activities and said they were very pleased that staff respected this and did not try to make them join in. The manager’s meet with the residents on regular basis and the meetings are well attended. Residents have opportunities to comment on the care and accommodation provided and to discuss potential developments at the home. Harbour House D52-D04 S53837 Harbour House V215874 030505 Stage 4.doc Version 1.30 Page 13 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 and 18 Arrangements are in place to protect residents and respond to all concerns in a positive manner. EVIDENCE: Robust policies and procedures are in place to deal with complaints and make sure that residents are protected. Residents and staff comments showed that people are very comfortable about discussing any concerns with the owner or the registered manager. No complaints have been received by the home or the CSCI. The staff are clearly aware of the action they are required to take if any complaints are made or any concerns arise about a residents protection. Harbour House D52-D04 S53837 Harbour House V215874 030505 Stage 4.doc Version 1.30 Page 14 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) 0 The facilities are well maintained to a high standard. EVIDENCE: The environment is maintained to a high standard and the owners continue to improve the facilities provided. Harbour House D52-D04 S53837 Harbour House V215874 030505 Stage 4.doc Version 1.30 Page 15 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 and 30 Staff at the home is trained and employed in sufficient numbers to meet to meet the resident’s needs. Thorough arrangements are in place to select suitable staff in order that a quality service can be provided to residents. EVIDENCE: Staffing levels meet the minimum requirements and additional staff are provided when this is needed to meet the needs of residents. Residents said they were extremely well looked after by the staff who approached their work in a flexible manner. Training is provided to all staff and the majority hold NVQ 2 or above. The training is planned according to the individual needs of the staff and this helps to meet the varied needs of residents. Staff files were sampled and showed that excellent arrangements are in place to select and recruit staff. Staff are also provided with terms and conditions of employment but for some this does not detail the duties and responsibilities of the post they hold. Harbour House D52-D04 S53837 Harbour House V215874 030505 Stage 4.doc Version 1.30 Page 16 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 37, 38 The home is well run and organised for the benefit of the residents. Residents are encouraged to contribute and comment on the manner the home is run on a regular basis. This provides residents with the opportunity to improve the services and facilities provided. Staff are well managed and supported in their duties by the provider and managers which results in an enthusiastic workforce who work positively with residents to provide a positive quality of life. Attention needs to be given to improving the record keeping arrangements for residents. This will further improve the quality of life provided. EVIDENCE: The registered manger and owner have run the care home since December 2003. Residents are very positive about the way the services and facilities are managed and commented on a number of improvements that have occurred. Harbour House D52-D04 S53837 Harbour House V215874 030505 Stage 4.doc Version 1.30 Page 17 Staff are supported by the provider and manager for all waking hours and the provider or nominated manager is on call each night to deal with any concerns or emergencies. The home is managed in an open manner and residents are encouraged to contribute and comment upon the management and running of the service. Residents commented about the confidence they have in the management and the manner in which the home is organised to take account of their views, preferences and choices. The owner does not regularly provide the Commission with a monthly report about the services and facilities provided as required by regulation. Records about residents continue to develop but further improvement is required. Apart from the unsatisfactory arrangements to minimise risks to residents other health and safety issues were managed satisfactorily. The records about fire detection and prevention were in good order. Harbour House D52-D04 S53837 Harbour House V215874 030505 Stage 4.doc Version 1.30 Page 18 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 2 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 2 COMPLAINTS AND PROTECTION x x x x x x x x 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 x 3 x x x x 2 2 Harbour House D52-D04 S53837 Harbour House V215874 030505 Stage 4.doc Version 1.30 Page 19 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. 2. Standard 3 7 Regulation 14 15 Requirement More detailed assessments must be completed. Care plans must set out in detail the action which needs to be taken by care staff to ensure that all aspects of the health, personal and social care needs of the service user are met. Risk assessments must be completed when any situation arises that could potentially compromise the health and well being of the service users. (previous timescale of 30.1.05 not met). The kitchen flooring must be replaced. Arrangements to formally supervise staff and maintain suitable records must be established. Service users daily records must detail the events that have occurred, any accidents or incidence, the action taken by the management and staff and the outcome of the action taken. The Commission must receive regulation 26 reports from the registered person each month. Timescale for action 30.8.05 30.9.05 3. 8 and 38 13 30.6.05 4. 5. 15 36 13 18 30.12.05 30.10.05 6. 37 12, 17 30.9.05 7. 8. 37 26 30.8.05 Harbour House D52-D04 S53837 Harbour House V215874 030505 Stage 4.doc Version 1.30 Page 20 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard 15 29 Good Practice Recommendations Service users should be consulted about the menu provided. All staff should be provided with a job descriptrion or written information that deatiols the duties and resposibilties of post before they commence employment. Harbour House D52-D04 S53837 Harbour House V215874 030505 Stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection John Keay House Tregonissey Road St Austell Cornwall PL25 4AD 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. Extracts may not be used or reproduced without the express permission of CSCI Harbour House D52-D04 S53837 Harbour House V215874 030505 Stage 4.doc Version 1.30 Page 22 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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