Inspection on 01/11/07 for Harbour Rise Rest Home

This inspection was carried out on 1st November 2007.

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

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

CARE HOMES FOR OLDER PEOPLE Harbour Rise Rest Home 18 Roundham Road Paignton Devon TQ4 6DN Lead Inspector James Rose Key Unannounced Inspection 1st November 2007 9:00 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 Harbour Rise Rest Home DS0000069357.V350301.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. Harbour Rise Rest Home DS0000069357.V350301.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Harbour Rise Rest Home Address 18 Roundham Road Paignton Devon TQ4 6DN 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) 01803 551834 01803 401201 enquiries@harbourrise.co.uk www.harbourrise.co.uk Harbour Rise Limited Mrs Alison Elizabeth Harding Care Home 26 Category(ies) of Dementia - over 65 years of age (26), Old age, registration, with number not falling within any other category (26), of places Physical disability over 65 years of age (26) Harbour Rise Rest Home DS0000069357.V350301.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home providing personal care only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following categories: Dementia, aged 65 years and over on admission (Code DE(E) maximum 26 places Physical disability, aged 65 years and over on admission (Code PD(E) maximum 26 places Old age, not falling within any other category Code OP) - maximum of 26 places The maximum number of service users who can be accommodated is 26. 22/11/06 2. Date of last inspection Brief Description of the Service: Harbour Rise is a semi detached building with bedrooms over four floors. The home has 18 single rooms and 4 doubles; all rooms have on suite facilities. The home has a large communal lounge; meals are taken in a separate dining room. A vertical lift is available for the ground floor, first floor and second floor. The lower ground floor has two single bedrooms, which can be accessed via a flight of stairs that have been equipped with a stair lift. Off road parking is available and well-tended gardens are found to the front and side of the building. The home is Registered for service users in the categories of Old Age, not falling into any other category, Dementia, Learning Disability and Physical Disability. Day care is also provided. The weekly fees payable at the home are: Lowest £303.00 and the highest £375.00. Harbour Rise Rest Home DS0000069357.V350301.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and was undertaken over 7 hours during November 2007. Samples of care records were examined and four residents were consulted individually in private and others were seen in groups. Evidenced was also taken from returned questionnaires that had been completed by residents and their relatives. A detailed pre inspection questionnaire had also been undertaken by the home and returned to the Commission. Healthcare professionals were also consulted about the service provided and observations were made of the way care was delivered to residents. A complete tour of the building was undertaken and three of the care team were interviewed individually in private. The registered manager and the new proprietor of the home assisted throughout the inspection process. What the service does well: What has improved since the last inspection? Since the time of the last inspection the proprietor of the home has changed and the then care manager is now the registered manger of the home. The development of he care planning continues and particular attention is paid to the review process; this is undertaken with the resident concerned by their key worker and the whole of the plan is explained and agreed. The home continues to have an active maintenance and redecoration programme in place and two bedrooms have been redecorated with new Harbour Rise Rest Home DS0000069357.V350301.R01.S.doc Version 5.2 Page 6 carpets fitted. Soft furnishings have been replaced for residents and a new sound system has been provided in the lounge. A new mini bus has also been purchased which will be used to take residents out on trips. 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. The summary of this inspection report can be made available in other formats on request. Harbour Rise Rest Home DS0000069357.V350301.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Harbour Rise Rest Home DS0000069357.V350301.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6. Quality in this outcome area is good. Harbour Rise undertakes detailed and comprehensive assessments of prospective residents that covers all their needs. Standard 6 refers to a service not provided at the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Four residents assessments that had been undertaken by the new registered manager were examined at this inspection these were detailed and covered the needs in the areas of health, personal and social. As previously mentioned some further development is going to be undertaken to enable the home to adopt a more client centred approach. All the assessments examined were completed prior to the home offering a service. If a resident has been admitted into the home as an emergency and no opportunity has been available to undertake an assessment the process is completed as soon as is practicable. Harbour Rise Rest Home DS0000069357.V350301.R01.S.doc Version 5.2 Page 9 Four residents were consulted individually in private during the inspection and they all confirmed that all their needs were met by the service provided at the home. Harbour Rise Rest Home DS0000069357.V350301.R01.S.doc Version 5.2 Page 10 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. Comprehensive care plans were available for each resident that covered their needs in the areas of health, personal and social. Residents were able to self medicate subject to a risk assessment and the administration of medication undertaken by the home is appropriate. All the residents consulted advised that they were always treated with respect and care was taken to maintain their privacy. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Four care plans were examined as part of the inspection, they demonstrated how needs were considered in the areas of health, personal and social and how these needs should be met. The home ensures that a residents’ key worker goes through the whole of the care plan on a monthly basis with the individual concerned to ensure that they understand and agree to receive the service they require. The care plans are working documents that are regularly used by all the care team who also maintain a running record. The care plans are always held in secure conditions to ensure confidentiality. The residents consulted during the inspection process advised that their needs were well met at the home and that they had good access to healthcare professionals when they required it. Harbour Rise Rest Home DS0000069357.V350301.R01.S.doc Version 5.2 Page 11 The district nursing service said they felt they were able to work well with the care team in the home and one of the doctors consulted was particularly complimentary about the service provided. Residents are able to self medicate in the home subject to a risk assessment approach to ensure they have the capacity and are safe. The recordings of the administration of medication undertaken by the home were examined and were found to be clear, accurate and up to date. The records demonstrated that medication was checked and booked in when received. Complete issue records were in place and unused medication was returned to the pharmacist and a receipt obtained. Low temperature storage was available where required and an appropriate system was in place for medication subject to the controlled process. All medication was stored under secure conditions. These processes ensure residents are safe. Residents advised that they were treated with respect by all the staff in the home and their privacy was maintained, one resident remarked “This couldn’t be better for me” and another said, “Help is always on hand and nothing is too much trouble”. From observations made during the inspection it was clear that care was taken by staff to ensure residents privacy was maintained particularly when giving personal care. Residents confirmed in conversation that they felt quite happy with the way care was delivered to them. Harbour Rise Rest Home DS0000069357.V350301.R01.S.doc Version 5.2 Page 12 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 good. The lifestyle in the home meets the expectations of the residents - they have enough activities available for them and are able to have visitors at anytime. Residents are encouraged to make their own decisions. A wholesome and balanced diet is provided with choice always available. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Four residents were consulted individually in private and others were seen in small groups around the home about life at Harbour Rise. They were all complimentary about the service provided and praised their carers and the management of the home. One resident said, “This couldn’t be better, the food suits me fine” another resident said, “The girls (carers) are very good, they will always help you”. The home has an activities and entertainment programme running, which is well advertised in the home and carers make sure residents are aware of what is available. However, the approach taken by the home is moving to a more client centred approach, which will ensure a suitable service for everyone. Currently residents are able to make suggestions and were encouraged to ‘join Harbour Rise Rest Home DS0000069357.V350301.R01.S.doc Version 5.2 Page 13 in’ but no undue pressure was put on them, some residents’ said that they preferred their own company. The home has an unrestricted visiting policy and procedure in place and visitors were always made welcome. If a visit was undertaken at a mealtime it was possible for the visitor to have a meal with their relative and no charge was made by the home. A wholesome balanced diet was provided for residents in the home with choice always available on the day of the inspection several different choices were provided for the main meal. Sherry or other drinks are offered to residents before the main meal at weekends and holidays. Meals are served in the home’s spacious dedicated dining room at tables that seat up to four persons. If preferred a resident can take their meal in their own room. All the residents consulted were complimentary about the meals provided at the home and did not wish to suggest any additions to the menu. Harbour Rise Rest Home DS0000069357.V350301.R01.S.doc Version 5.2 Page 14 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. Residents can be confident that if they raise concerns they would be taken seriously by the home and resolved for them. An appropriate adult protection policy and procedure is in place and carers are trained in its use. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Residents are given a copy of the complaints procedure in the welcome pack they receive on arrival and a copy is always available in the home. Residents consulted were confident that if they raised an issue with the management of the home it would be taken seriously and resolved quickly for them. There is a detailed adult protection policy and procedure in place in the home that is based on current legislation and carers are trained in its use. Three of the care team on duty at the time of the inspection were interviewed and they were all clear on the details of the policy and what action should be undertaken if they discovered an abuse taking place. Harbour Rise Rest Home DS0000069357.V350301.R01.S.doc Version 5.2 Page 15 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 and 26. Quality in this outcome area is good. Harbour Rise is comfortable and well maintained and is safe for residents; it is clean with high standards of hygiene evident. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A complete tour of the building was completed with all rooms seen, the home was clean and high standards of hygiene were evident. No outstanding maintenance was apparent. The home has an ongoing maintenance programme running and the gardens were well tended. Since the time of the last inspection two bedrooms had been redecorated and new carpets had been fitted. New soft furnishings had been provided and a sound system had been purchased for the lounge area. The residents consulted during the inspection stated that they found the home comfortable and liked their rooms; they further advised that they thought the Harbour Rise Rest Home DS0000069357.V350301.R01.S.doc Version 5.2 Page 16 facilities at the home were appropriate. One resident said, “It’s very good here and you have got everything you could need”. Harbour Rise Rest Home DS0000069357.V350301.R01.S.doc Version 5.2 Page 17 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 good. There are sufficient numbers of experienced carers on duty to ensure residents’ needs are met appropriately. The home’s recruitment practice ensures residents are safe and carers are trained to fulfil their role. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The care hours remain at their previous level and there are always adequate staff available to ensure that all residents’ needs are met. In addition to the care team the home has kitchen, laundry and cleaning personnel. Residents were very complimentary about the staff in the home and confirmed that if they called for assistance their request was always answered promptly. This was also confirmed from observations made during the inspection that the call system was given priority by carers and was answered without delay. Three records of carers were examined as part of the inspection process and they demonstrated that two references are taken out on new carers before they are able to take up their post in the home and that appropriate checks are undertaken to ensure residents are in safe hands. An active training programme is running to provide the home with competent carers. New carers undertake appropriate induction and formal supervision is provided by the management of the home a minimum of six times per year. Harbour Rise Rest Home DS0000069357.V350301.R01.S.doc Version 5.2 Page 18 Three carers were interviewed in private; individually during the inspection and they all demonstrated an understanding of their role and were clear on the policies and procedures in the home. Harbour Rise Rest Home DS0000069357.V350301.R01.S.doc Version 5.2 Page 19 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 and 38. Quality in this outcome area is good. Harbour Rise is managed by a person who is experienced and of good character. The home is run in the best interests of the residents who are consulted to ensure they have the service they require. People’s financial interests are appropriately safeguarded. Welfare and health and safety issues are given priority by the management of the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Since the time of the last inspection the home has changed hands and has new proprietors. The member of staff that was head of care is now the registered manager. All the healthcare professionals contacted at this inspection expressed their confidence in this person. Residents are regularly consulted about the service they receive to ensure this is want they want and require. Consultation is undertaken with the use of Harbour Rise Rest Home DS0000069357.V350301.R01.S.doc Version 5.2 Page 20 questionnaires and through meetings. Residents’ views are taken seriously and acted on. An example of this is at the last meeting residents suggested that it would be helpful if staff had a nametag displayed and this has been adopted. Currently the home assists one resident with the administration of their pocket money, as they are unable to manage this themselves. The expenditure is in excess of the pocket money available and additional support is provided by the home. Details of these arrangements are in the individuals care plan. The management of the home takes health and safety issues seriously and these are acted on without delay. The fire precautions recordings were examined and were well maintained and up to date this will ensure the safety of residents and staff. Appropriate action was taken for the storage of harmful cleaning materials and the reporting of dangerous occurrences were undertaken appropriately. The water used in the home is tested for unwanted bacteria and work has been completed to enable the home to have a certificate for the electrical installation. Equipment in the home was serviced regularly and electrical items were tested as required. Harbour Rise Rest Home DS0000069357.V350301.R01.S.doc Version 5.2 Page 21 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 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Harbour Rise Rest Home DS0000069357.V350301.R01.S.doc Version 5.2 Page 22 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 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. Refer to Standard Good Practice Recommendations Harbour Rise Rest Home DS0000069357.V350301.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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. 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