Inspection on 12/05/05 for Harefield Hall

This inspection was carried out on 12th May 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

Harefield Hall 06/09/07

Harefield Hall 14/12/06

Harefield Hall 07/12/05

Harefield Hall 31/01/05

Harefield Hall 17/09/04

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

CARE HOMES FOR OLDER PEOPLE Harefield Hall Harefield Hall 171 Bath Road Willsbridge South Glos BS30 9DD Lead Inspector Odette Coveney Announced 12 May 2005 09:30 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. Harefield Hall D56_D05 S3326_Harefield Hall_V217307_120505_Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Harefield Hall Address 171 Bath Road Willsbridge South Glos BS30 9DD 0117 9323245 0117 9328884 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) Banff Securities Ltd Ms Susan Anne Evans Care home for Older People 21 Category(ies) of OP Old age (21) registration, with number of places Harefield Hall D56_D05 S3326_Harefield Hall_V217307_120505_Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: May accommodate up to 21 persons aged 65 years and over requiring personal care only Date of last inspection 31/01/05 Brief Description of the Service: Harefield Hall is a well-established care home situated in its own large grounds, between the villages of Longwell Green and Willsbridge. The centre of Bristol is six miles away and can be accessed by the buses that stop at the bottom of the driveway. The home is easily accessible to the local shops and the post office, plus there are two areas of interest nearby, namely the Willsbridge Mill and the Bitton Railway Station. Both have tearooms and provide a pleasant area where visitors can take their relative. The house has been extensively adapted to provide accommodation for 21 people, both male and female. The private rooms are spread over three floors and there is a passenger lift ensuring that all areas are accessible.The home has a pleasant lounge and dining room and the large hallway is also able to accommodate seating for several of the service users. The kitchen is on the ground floor; the laundry and the storerooms are in the basement. There is self-contained private accommodation in the basement. The home provides care for older people and aims to do this in a personalised way, ensuring that as much independence is retained and that a fulfilling and meaningful lifestyle is offered Harefield Hall D56_D05 S3326_Harefield Hall_V217307_120505_Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection conducted as part of the annual inspection process to examine the care provided, and monitor the progress in relation to the three requirements and two recommendations from the last inspection that was conducted in January 2005. The inspection took place over seven hours. During the process ten residents, five staff, the registered manager and visitors to the home were spoken with. The inspector looked around some of the building and a number of records were examined. Following consultation with the manager and the staff team it was agreed that those living at the home would prefer to be referred to as residents within the inspection report, rather that service users and therefore this has been reflected within this report. The Commission for Social Care Inspection has produced a leaflet for those living in care establishments entitled ‘Is the care you need, the care you get?’; a copy of this was left at the home to be put on the homes notice board. What the service does well: What has improved since the last inspection? The home has worked diligently in order to meet the requirements and recommendations made at the previous inspection and are to be commended for their commitment in meeting the National Minimum Standards and care homes regulations. Harefield Hall D56_D05 S3326_Harefield Hall_V217307_120505_Stage 4.doc Version 1.30 Page 6 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. Harefield Hall D56_D05 S3326_Harefield Hall_V217307_120505_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 Harefield Hall D56_D05 S3326_Harefield Hall_V217307_120505_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) 1, 2, 3, 4, 5 The home’s statement of purpose, brochure and licence agreements are well written, providing residents and prospective residents with details of the services the home provides enabling an informed decision about admission to be made. EVIDENCE: The Statement of Purpose was in place and this was found to be fully comprehensive and contained all of the relevant information required as stated in Schedule 1, Regulation 4(1)(c). The Statement of Purpose contained the aims and objectives of the home and spoke of treating individuals with dignity and respect, to promote independence and encourage individuals to make choices with aspects of their lives. The document also contained the relevant qualification and experience of the registered manager, and staff team, the range of needs that can be supported at the home, the complaints and admission procedures along with fire precautions. Harefield Hall D56_D05 S3326_Harefield Hall_V217307_120505_Stage 4.doc Version 1.30 Page 9 The registered manager fully explained the admission procedure, she explained that referrals are often received at the home from a care manager and can also be through word of mouth, individuals are supported in a manner and pace appropriate to them. The brochure for the home is well written and provides information about the aims and objectives of the home, the home’s history and provides an outline of the day to day routines within the home, local amenities and support that individuals living at the home will receive. The manager explained that prospective residents are given a copy of the homes brochure and that the manager will then visit them, either in their own home or at hospital, she spoke of meetings with prospective residents, their carers and social workers prior to the initial months assessment period in order to determine whether the home is able to meet the needs of the individual. During this assessment period the staff make extensive notes and use this information in order to draw up a care plan tailored to the specific needs of the individual. The manager told the inspector that if there were uncertainties as to whether the home was able to meet the needs of the individual then the trial period would be extended. The inspector viewed the licence agreements for a number of the residents, all of these had been signed by the resident and the Manager, all residents receive a copy of this document. The licence agreement outlines the rights and responsibilities of both the resident and the home. Harefield Hall D56_D05 S3326_Harefield Hall_V217307_120505_Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9, 10, 11 Resident’s health, personal, social and individual needs are well documented and clearly show how these needs are to be met. EVIDENCE: On the day of the inspection one of the residents returned from hospital having had a cataract removed, both the resident and their family told the inspector that they were confident that the staff would support them and provide the necessary assistance in order to aid their recovery. One of the residents told the inspector that he had have recent surgery on their knee, he said that the home maintained contact with him during the hospital stay to enquire after his health and wellbeing, the resident told the inspector that he had been well supported by staff at the home to return to a level of independence. There was a record of visits to the doctor and these were up to date and sufficiently detailed. The inspector saw correspondence from health professionals, including consultants to evidence that advice is sought when Harefield Hall D56_D05 S3326_Harefield Hall_V217307_120505_Stage 4.doc Version 1.30 Page 11 necessary from specialists. The inspector saw that support is also accessed from specialist services, when required. It was evident that the home has established professional relationships with others such as; GP’s, staff working in other care homes, care managers and members of the primary healthcare team in order to work together to ensure that the needs of those living at Harefield Hall are identified and met. The systems for administration of medication are good with clear and comprehensive arrangements in place to ensure that resident’s medication needs are met. A recommendation was made at this inspection that in order to maintain a clear audit trail all stock medication must be accounted for and recorded. The home has sought individual’s wishes in the event of their death and specific requests of individuals are recorded. Harefield Hall D56_D05 S3326_Harefield Hall_V217307_120505_Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14, 15 The meals in the home are good offering both choice and variety along with catering for special dietary needs. Activities are arranged and provided at the home on a regular basis. EVIDENCE: The inspector viewed the home’s visitor’s book, which records that there are a number of visitors who visit on a regular basis. Comment cards received from relatives prior to the inspection were very positive about the staff and standards of care in the home; comments received included ‘ The management and staff are excellent, nothing is too much trouble’, ‘it is a warm and happy atmosphere’ ‘there are plenty of activities and outings on the homes mini-bus’. Comment cards received from residents prior to the inspection recorded that residents like living at the home, they are treated well, they feel safe and know who to speak with if they are unhappy. This information was also confirmed throughout the day from the numerous comments received from those living at the home. The home was able to demonstrate that daily living routines and activities provided are flexible and varied to suit resident’s preferences and capacities. Residents spoken with gave the inspector examples of their own preferred routines and choices made as part of daily living in the home. Harefield Hall D56_D05 S3326_Harefield Hall_V217307_120505_Stage 4.doc Version 1.30 Page 13 There are a varied range of activities which are provided in which residents are able to participate or not depending on their choice, residents told the inspector that they enjoy bingo sessions (particularly when they win prizes), and also enjoy participating in quizzes, ‘floor cards’ and skittles. Many of the residents were keen to tell the inspector about their recent day trip to Clevedon, residents said that many wonderful memories came flooding back of previous trips and holidays enjoyed at the resort. One of the residents stays with their family over the weekend, another resident told the inspector that they receive visits from family and friends. There were a number of visitors at the home during the inspection, all of those spoken with were very complimentary about the care provided at the home and of the commitment from the staff team. The systems for resident’s consultation in this home are good with a variety of evidence that indicate that resident’s views are both sought and acted upon. Residents told the inspector that meetings take place on a regular basis and their ideas and suggestions are listened to and acted upon, an example given was that when residents requested an unusual menu item the home sought to provide this. The kitchen was found to be clean and tidy at the time of the inspection. The dry stores cupboard and fridge were well stocked, it was found that dry foods stored are not labelled to show when they were first opened, in order to ensure food safety it is recommended that this is undertaken. Harefield Hall D56_D05 S3326_Harefield Hall_V217307_120505_Stage 4.doc Version 1.30 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16, 18. Complaints are handled objectively and residents are confident that their concerns will be taken seriously, listened to and actioned. The home does have in place measures to ensure that residents are protected from abuse. EVIDENCE: The complaints logbook for the home was viewed, it was found that reported incidents had been dealt with effectively to the satisfaction of those involved. No resident’s at the home are on the protection of vulnerable adults list. No areas of concern were recorded on care documentation. All of the resident’s spoke favourable of the care and attention they receive from staff. Relationships with the registered manager and staff are well-established and resident’s spoke of the staffs kindness and of they time they spend talking to them and getting to know how they feel. The registered provider has contacted the Commission for Social Care Inspection to inform of incidents that have affected the wellbeing and safety of those living at the home. Residents receive an annual allowance of travel tokens issued by the local authority, the home does not maintain a record to evidence that individuals have been given these, it is recommended that residents sign to indicate that they have received these. Harefield Hall D56_D05 S3326_Harefield Hall_V217307_120505_Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 21, 22, 23, 24, 25, 26. The home is well managed and safe and the quality of furnishings and fittings in the home is good, providing a warm comfortable and homely environment ensuring individuals needs are met. EVIDENCE: Harefield Hall is a spacious residential home and is furnished to a high standard; the home is situated in Willsbridge and blends in with the local community. The inspector did a tour of the home and viewed the lounge and dining area, the kitchen, a first floor bathroom and three bedrooms. The home is well maintained and at the time of the inspection, clean and odour free. All of those living at the home have access to their personal and communal space. The home has an array of comfortable spaces for shared use, residents were seen relaxing and making full use of these areas. The home has an extensive garden surrounding the property, these were seen to be well tended. Harefield Hall D56_D05 S3326_Harefield Hall_V217307_120505_Stage 4.doc Version 1.30 Page 16 There are a number of toilet, washing and bathing facilities provided at the home that are available for residents use, these are within close proximately to residents private accommodation. The number of facilities available are sufficient for the numbers of resident’s accommodated at the home. The home is appropriately adapted to meet the needs of the current resident group. Specialist equipment has been obtained for individual residents following identified need; examples of these include mobility, sensory and safety equipment. Harefield Hall D56_D05 S3326_Harefield Hall_V217307_120505_Stage 4.doc Version 1.30 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 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, 28, 29,30 The relationships between staff and residents are good, and this creates a warm, supportive environment which promotes a good quality of life for residents. EVIDENCE: There is a core of well-established staff with varying abilities most of which are skilled and experienced to meet the needs of the residents in the home. Records reviewed provided evidence that a robust recruitment procedure was in place at the home. Staff members spoken with were able to demonstrate a clear understanding of their role and responsibilities within the team. Harefield Hall D56_D05 S3326_Harefield Hall_V217307_120505_Stage 4.doc Version 1.30 Page 18 Observation of staff practice demonstrated that they were approachable, good listeners and communicators and were comfortable with residents who were at ease with them. Job descriptions were seen by the inspector; these were comprehensive and covered all aspects of staff role and responsibility, staff members spoken with demonstrated knowledge and understanding and told the inspector that those living at the home are treated as individuals, with the dignity and respect they are entitled to. Records viewed showed that supervision sessions are structured and covered areas of specific responsibility including key worker role and allocated duties, supervision discussions include training needs and as a result of the discussion an action plan is set. Staff signed supervision documentation to confirm what has been discussed in their supervision session. Resident’s comments about the staff included ‘The staff here are like friends’, ‘resident’s meetings are a good forum to air our views, we are listened to and changes do happen’. ‘staff here are like good friends’ ‘I am treated with respect and like an adult’. A requirement was made at the previous inspection that the home must work to achieve the 50 ratio of trained staff with National Vocational Qualification. The manager confirmed that three staff have achieved this qualification and eleven other staff are registered, an assessor for the process has been allocated to support the staff team and arrangements are in place for this assessor to visit the home and meet up with candidates every two weeks. Staff spoken with were very enthusiastic and appear very committed to achieving this award. Induction training for staff is very comprehensive, aspects of individuals’ role and responsibility, health and safety, individuals’ support requirements, correct use of equipment, medication administration and safety, correct use of cleaning products and policies and procedures. The inspector saw on records that staff have recently attended the following training; manual handling, food hygiene, first aid and fire safety instruction. Harefield Hall D56_D05 S3326_Harefield Hall_V217307_120505_Stage 4.doc Version 1.30 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 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,, 34, 35, 36, 37, 38. The home is well managed ensuring resident’s interests are promoted and protected by a confident, supported staff team, within a safe environment. EVIDENCE: Throughout the inspection process Mrs Susan Evans was able to demonstrate that she is qualified, competent and experienced to run the home and meet its stated purpose in addition to its aims and objectives. Evidence in place demonstrates that regular staff meetings are undertaken and that appropriate agenda items are discussed in order to develop the service and also to develop and meet the skills of individuals. The inspector saw that the home has in place a comprehensive range of in house and organisational policies and procedures; these are discussed with staff during team meetings and supervision. Harefield Hall D56_D05 S3326_Harefield Hall_V217307_120505_Stage 4.doc Version 1.30 Page 20 The inspector viewed supervision records, it was evident that this occurs on a regular basis, areas of discussion included: care practices, the well being of resident’s, personal development and review, the staff member spoken with spoke favourably of the supervision and support offered by the manager. The inspector viewed the fire logbook for the home. The home was completing the appropriate checks on the fire equipment and the recording of training, fire drills and the testing of equipment were satisfactory. The inspector saw the fire panel in working order. The most recent fire drill undertaken in the home took place on 23rd March 2005. Comprehensive, up to date risk assessments are in place, these assessments take into account the likelihood and the severity of a potential incident; assessments seen included stress management, use of domestic equipment, manual handling and the potential risk factors for pregnant staff. These assessments provide clear information in order to guide staff accordingly. Harefield Hall D56_D05 S3326_Harefield Hall_V217307_120505_Stage 4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 2 3 3 3 N/A 3 3 3 3 Harefield Hall D56_D05 S3326_Harefield Hall_V217307_120505_Stage 4.doc Version 1.30 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. 2. 3. 4. Refer to Standard OP 9 OP 15 OP 18 OP 30 Good Practice Recommendations Stock medication to be recorded and audited. Dry food stores to have a use by date written on them. residents to sign to record that they have their tralvel tokens. 50 of staff to achieve National Vocational Qualification at level 2 in care. Harefield Hall D56_D05 S3326_Harefield Hall_V217307_120505_Stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection 300 Aztec West Almondsbury South Glos BS32 4RG 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 Harefield Hall D56_D05 S3326_Harefield Hall_V217307_120505_Stage 4.doc Version 1.30 Page 24 - 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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