Inspection on 10/08/05 for Harbour View Nursing Home

This inspection was carried out on 10th August 2005.

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

Harbour View Nursing Home 01/09/09

Harbour View Nursing Home 30/04/07

Harbour View Nursing Home 15/02/06

Harbour View Nursing Home 08/11/04

Harbour View Nursing Home 26/07/04

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

CARE HOME ADULTS 18-65 Harbour View Nursing Home Bransty Road Whitehaven Cumbria CA28 6HA Lead Inspector Lorraine Frost Unannounced 10 August 2005 09:10 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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 View Nursing Home F58 F10 s10109 harbour view v215028 100805 ui stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Harbour View Nursing Home Address Bransty Road Whitehaven Cumbria CA28 6HA 01946 599963 01946 599964 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) Tamaris Healthcare (England) Ltd Gillian Margaret McAllister Care Home 50 Category(ies) of 50 PD - Physical Disability registration, with number 50 OP - Old Age of places 6 DE(E) - Dementia, over 65 Harbour View Nursing Home F58 F10 s10109 harbour view v215028 100805 ui stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 50 service users to include: up to 50 service users in the category of OP (older people not falling within any other category) up to 50 service users in the category of PD (younger adults with a physical disability) up to 6 service users within the category of DE(E) (Dementia over 65 years of age 2. The service should at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection.) Date of last inspection 08 November 2004 Brief Description of the Service: Harbour View is a purpose built care home registered to provide nursing care for up to 50 residents from the age of 18 years. The home was built on Bransty hill overlooking Whitehaven harbour. The residents said that they had many things to see from the home including small children in the play area, dogs being walked, boats out at sea and the comings and goings around the harbour.There is a good-sized car park in front of the home. Accommodation and care is povided in single en suite bedrooms on two floors. The décor was in very good condition and residents had been involved in choosing the colour schemes for their bedrooms. Redecoration and refurbishment was ongoing. The facilities are accessible and meet the needs of residents and aids and equipment are in place to assist where necessary.There were four vacancies on the day of inspection and an admission was expected later in the day. Harbour View Nursing Home F58 F10 s10109 harbour view v215028 100805 ui stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection commenced at 09.10hrs and finished at 15.30hrs. The inspection was focussed entirely upon the outcomes and experiences of the residents. The information was gathered through talking with residents their visitors and staff, and relevant records were read. There were seven requirements made at the last inspection. All these had been complied with and no further requirements were issued. Of the three good practice recommendations only one of them had been completed. There were four empty beds with an admission to the respite bed being expected later in the day. The home was fully staffed with two Registered General Nurses on duty and eight care assistants. Also on duty was the housekeeping staff, the kitchen staff, the maintenance person, the Registered Manager and the administrator. What the service does well: The inspection was a very positive one with lots of comments from residents confirming that they felt they were well looked after, had good relationships with staff and that they were happy with their choice of home. One resident said, when asked about her choice of home, “I couldn’t have found anything better” and “everything is tops here.” Staff responded promptly to requests and when they were busy they informed the resident that they would return but that they were busy. This was said to be “very reassuring” by one resident who appreciated being told that she would be helped, but that there might be a delay. Residents are encouraged to continue to follow hobbies and interests that they had before. One person who had a particular interest had been too unwell on admission to continue with this but was later encouraged to do so, and now thoroughly enjoys her previous hobby and benefits mentally and physically from it. Residents are encouraged to maintain their independence and if there is a risk involved then this is discussed and ways to reduce the risk is sought. A resident said, “they encourage me to do what I can for myself and when I need help they do it without embarrassing me.” Another resident said, “nothing is too much trouble for them and they get me what I want when want it.” Harbour View Nursing Home F58 F10 s10109 harbour view v215028 100805 ui stage 4.doc Version 1.40 Page 6 Religious beliefs are respected and a resident confirmed that she saw her priest regularly and had the opportunity to receive communion in private. Throughout the day staff approached residents in a kindly way and did not talk down to them. The staff give a lot of themselves personally to the job and said that they enjoyed their work. Staff chatted with residents and kept them informed of what was going on. One resident said, “there is never a shortage of people to talk to.” Others confirmed that they did not feel bored because “there is always something going on.” Residents are treated as individuals and that was clear from the observed interactions, the comments made, and the documentation read. 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 View Nursing Home F58 F10 s10109 harbour view v215028 100805 ui stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Harbour View Nursing Home F58 F10 s10109 harbour view v215028 100805 ui stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2 and 4 Residents’ needs are thoroughly assessed before they are offered accommodation in the home ensuring that staff will know the assistance each person will need on admission. Residents’ and their families are able to visit the home prior to making a decision to move to Harbour View making the move an informed one. EVIDENCE: The manager and or her deputy assess prospective residents prior to admission. The information is detailed and highlights specific needs and individual preferences and routines. Residents and visitors said that they had been given the opportunity to visit the home giving them the opportunity to make an informed choice. One resident had been unable to visit the home, but the manager said that the relative had been allowed to take photographs of key areas and to photograph the vacant rooms so that she could choose the room she would prefer. The service user guide, which was very interesting, clearly stated that there was a trial period to enable the resident to settle into the home after which there would be review meeting to ensure the person was happy and suitably placed. Harbour View Nursing Home F58 F10 s10109 harbour view v215028 100805 ui stage 4.doc Version 1.40 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7, 9, and 10 The care plan and risk assessment forms are very good, encouraging staff to record in a way that shows the resident as an individual. Residents are very well supported by staff to make choices and decisions and this results in them leading individual lifestyles. Good observation by staff leads to prompt referrals for consultation and treatment. The staff ensure that the privacy and dignity of residents is upheld. EVIDENCE: There has been a marked improvement in the quality and content of the care plans and risk assessments. They are comprehensive and up to date giving staff the information they require to care for the resident in the way that they prefer. They also show where choices have been made by the resident to not follow a course of treatment and to what extent the resident can be independent. The signatures of residents or where applicable their relative were seen on the care plans to show that they had been consulted with and agreed with them. Independence is encouraged especially around daily routines and sometimes this might involve a degree of risk, however the risk is identified with Harbour View Nursing Home F58 F10 s10109 harbour view v215028 100805 ui stage 4.doc Version 1.40 Page 10 safeguards put in place to reduce the risk without removing the persons right to be independent. Personal information regarding residents was held secure with restricted access. This is an improvement since the last inspection. Staff were aware of their responsibility regarding confidentiality and the sharing of information with others and it was not automatically accepted that the next of kin had the “right to know without the consent of the resident. Harbour View Nursing Home F58 F10 s10109 harbour view v215028 100805 ui stage 4.doc Version 1.40 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 14 and 17 Residents are supported and offered opportunities to take part in varied activities based on individual choice and interest leading to each person having interesting and individual life styles. The meals offered in the home are very good, and well-balanced giving residents’ choice, and variety. EVIDENCE: Many positive comments were heard throughout the day regarding social activities and how residents spent their day. Residents are encouraged and assisted to attend day centres and clubs appropriate to their needs. For example one lady was out during the inspection at an aerobics class. Others attended the Multiple Sclerosis Society centre, COSC, the Hospice day centre and the Rehabilitation centre. Residents said that they had plenty to do to occupy themselves and that they didn’t “have time to be bored.” Another person said. “There is always someone to talk to.” Residents had been to the carnival, watched the Maritime festival from the comfort of the home, and others are encouraged to continue hobbies that they had previously enjoyed. Harbour View Nursing Home F58 F10 s10109 harbour view v215028 100805 ui stage 4.doc Version 1.40 Page 12 There is a three-week activities programme displayed and residents are positively encouraged to take part. One to one sessions in the therapy room continue to be enjoyed. The residents said, “The meals are great.” When asked about the choice of meals one resident said, “I am always asked what I want.” Breakfast was served until everyone had eaten. For some residents this was quite late in the morning. Lunch was observed as being a very busy part of the day for the staff who coped very well. A number of residents needed help and observation and staff did this sensitively and discreetly. Others were given equipment such as plate guards so that they could be independent. Harbour View Nursing Home F58 F10 s10109 harbour view v215028 100805 ui stage 4.doc Version 1.40 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 19, and 20 A skilled staff team, who are sensitive and knowledgeable about the needs of each individual, expertly manages their personal and health care according to the choices and decisions made by the resident. EVIDENCE: Residents confirmed that they thought that they were well looked after. The documentation showed prompt referrals to specialists and other professionals and on going monitoring of changing needs. Results of consultations and tests were shown and residents were informed of their results. One resident said, “I am treated like a Queen. Whatever I want I can have and I don’t have to wait for it.” Another said that her son had told her that she “had never looked better since moving to Harbour View.” Residents described how staff dealt with their personal care in a way that kept their “dignity intact.” Throughout the day staff spoke appropriately to residents and did not talk down to them. They quietly assisted them and if they were busy they went back to the resident and apologised saying that they would be back to them. Residents appreciated this because they said, “at least I know they are coming to me and haven’t forgotten me.” Residents who wish to continue self-medicating are encouraged and assisted to do so. Harbour View Nursing Home F58 F10 s10109 harbour view v215028 100805 ui stage 4.doc Version 1.40 Page 14 The medication trolley was not left unlocked at anytime as had been seen at the last inspection. Harbour View Nursing Home F58 F10 s10109 harbour view v215028 100805 ui stage 4.doc Version 1.40 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 The complaints procedure was prominently displayed ensuring that anyone who might wish to complain was fully aware of how to do so. EVIDENCE: The complaints procedure was readily available with a simplified plain English style procedure included in the Service User guide. One person said. “I haven’t had to make a complaint, but if I did, then I would speak to the manager as it is better to deal with things face to face.” The manager has said in the past that she would make herself available out of hours if necessary to speak to someone who had a complaint. Residents said that they would talk to the manager if they had concerns. The Commission for Social Care Inspection has not received any complaints about Harbour View since the last inspection. Harbour View Nursing Home F58 F10 s10109 harbour view v215028 100805 ui stage 4.doc Version 1.40 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 25, and 30 Residents’ benefit from a safe, clean, comfortable, and well-maintained home that is decorated to a very high standard throughout. EVIDENCE: On going redecoration and refurbishment has continued to improve the home for the residents. The lounges have been redecorated and refurbished and they are very pleasant to sit in. Many bedrooms have been redecorated and these are very welcoming and have been personalised by the residents making every bedroom completely different. They reflect the tastes of the residents who had been involved in choosing the colour scheme for their room. The maintenance person said that it was an ongoing programme and that he liked to help the residents have their rooms, as they would like them. The door locks have not been fitted to promote the privacy of the residents. However, no issues were raised by the residents or their families regarding this. Four Seasons policy is that should someone request a lock then they can have one fitted. The bathrooms had been redecorated and the staff had been involved in the choice of colours for these. Again these were very tasteful and non clinical. Harbour View Nursing Home F58 F10 s10109 harbour view v215028 100805 ui stage 4.doc Version 1.40 Page 17 The housekeeping staff worked hard throughout the day and staff said that if they told the housekeepers of spillages etc. then they quickly attended to them ensuring that the home was kept safe and free from unpleasant smells. Harbour View Nursing Home F58 F10 s10109 harbour view v215028 100805 ui stage 4.doc Version 1.40 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32 and 35 Residents receive good quality care from staff who are trained and competent and who enjoy working at the home. EVIDENCE: Residents praised the staff saying that they felt they were well looked after and had good relationships with them. The staff have attended a number of relevant training courses since the last inspection including: Dementia Care, Wound Care, Death and Dying, Diabetes and Tracheostomy Care. Thirty staff attended a basic food hygiene course and more than 50 of the care staff have either NVQ level two or three in care. Staff helped residents at a suitable pace for the resident and had a good attitude and nice approach. Harbour View Nursing Home F58 F10 s10109 harbour view v215028 100805 ui stage 4.doc Version 1.40 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37 and 40 There is clear leadership, guidance and direction to staff ensuring that residents receive consistent good quality care and are treated as individuals. Ongoing monitoring and evaluation of the service through good Quality Assurance systems ensure that the service continues to improve and remains focussed on the residents’ needs. EVIDENCE: The manager keeps a tight control on the home, but remains approachable and open. The manager conducts regular audits of systems and documentation including the care plans, and medication resulting with the staff being clearer as to what is expected. Staff promptly attend to the documentation where shortfalls are identified. Questionnaires are distributed and the results are published. The most recent one was dated August 2005 and this was included in the Service User guide Harbour View Nursing Home F58 F10 s10109 harbour view v215028 100805 ui stage 4.doc Version 1.40 Page 20 that is kept in every bedroom. A questionnaire is also included in the Service User guide gives residents the opportunity to feedback at anytime their experience of Harbour View. The Requirements from the previous inspection have all been met with no Requirements being made following this inspection. The manager intends to complete her Management qualification by September 2005. The manager and the maintenance person are responsible for ensuring that any hazards are identified and dealt with promptly. There were no hazards seen during this visit. Staff worked safely throughout the visit and have received the mandatory training such as Fire Safety and Moving and Handling. Harbour View Nursing Home F58 F10 s10109 harbour view v215028 100805 ui stage 4.doc Version 1.40 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x 4 x Standard No 22 23 ENVIRONMENT Score 3 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 4 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 4 x x x x 3 Standard No 11 12 13 14 15 16 17 x x x 4 x x 3 Standard No 31 32 33 34 35 36 Score x 3 x x 4 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Harbour View Nursing Home Score 4 3 3 x Standard No 37 38 39 40 41 42 43 Score 4 x x 3 x x x F58 F10 s10109 harbour view v215028 100805 ui stage 4.doc Version 1.40 Page 22 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 Harbour View Nursing Home F58 F10 s10109 harbour view v215028 100805 ui stage 4.doc Version 1.40 Page 23 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith, Cumbria CA11 9BP 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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