Inspection on 14/12/06 for Harefield Hall

This inspection was carried out on 14th December 2006.

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 07/12/05

Harefield Hall 12/05/05

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 171 Bath Road Willsbridge South Glos BS30 9DD Lead Inspector Jon Clarke Key Unannounced Inspection 14th December 2006 09:30 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 Harefield Hall DS0000003326.V323375.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. Harefield Hall DS0000003326.V323375.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Harefield Hall Address 171 Bath Road Willsbridge South Glos BS30 9DD 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) 0117 9323245 0117 9328884 Banff Securities Limited Ms Susan Anne Evans Care Home 21 Category(ies) of Old age, not falling within any other category registration, with number (21) of places Harefield Hall DS0000003326.V323375.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. May accommodate up to 21 persons aged 65 years and over requiring personal care only 7th December 2005 Date of last inspection 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 DS0000003326.V323375.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, which took place over two days, the manager was present throughout the inspection. As part of this inspection a number of documents were examined including care plans, pre-admission assessments and those relating to staffing and training. Also examined were the arrangements for managing medication and recruitment and selection of staff. There was an opportunity to discuss with residents and staff their experience of living and working at Harefield Hall. Pre-Inspection questionnaires were sent to the home 6 were returned by residents and 7 by relatives their comments have helped to inform this inspection and make a judgement about the quality of service provided in the home. What the service does well: What has improved since the last inspection? A number of recommendations were made at the last inspection and improvements have been made in managing medication, food storage. Since the last inspection the home has achieved over 50 staff completing NVQ2 Harefield Hall DS0000003326.V323375.R01.S.doc Version 5.2 Page 6 with additional 3 staff currently undertaking this qualification and further 7 staff completing NVQ 3 with 3 currently undertaking this qualification. This is to be commended. 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. Harefield Hall DS0000003326.V323375.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 Harefield Hall DS0000003326.V323375.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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home undertakes full and comprehensive assessment of prospective residents so that they are able to make an informed decision about the capacity of the home to meet health and social care needs. EVIDENCE: A number of admission records were examined and these included copies of the home’s assessment and where an individual was known to the local authority a copy of their assessment. A resident who had been admitted during the last month spoke of how staff had spoken to them about their needs and also had explained the “routines of the home”. They said how “very welcoming” staff had been. A relative of the same resident said how they had spent over an hour talking with a member of staff “we went though everything, it was very through” and how they had been “certainly more then pleased” with the way the admission to the home had been handled. Harefield Hall DS0000003326.V323375.R01.S.doc Version 5.2 Page 9 Harefield Hall DS0000003326.V323375.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): 7,8,9,10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care Planning and arrangements for meeting health care needs are good providing staff with the necessary information so that the health and social care needs of residents is met. Arrangements for making sure resident’s medication ensure that resident’s health needs are protected. The practice of staff and policies of the home help to make sure that residents are treated with respect and their dignity is upheld EVIDENCE: A number of care plans were looked at and showed good information about individuals. Included was Past History, Assessment of daily living, (routines, waking, meals, personal hygiene and diet) Risk assessment had been completed specifically where the individual was at risk of falls. Reviews had been held regularly and a yearly review takes place which includes resident and relative. No information was included in care plans about the wishes of the Harefield Hall DS0000003326.V323375.R01.S.doc Version 5.2 Page 11 individual on their death and whilst information about moving and handling was included as part of risk assessments there was not a clearly identified Moving and Handling assessment. Community based health services such as chiropody, dental are provided in the home and district nurses provide nursing care where this is required. In talking with a district nurse who was visiting the home at the time of this inspection they spoke very positively of the home’s approach to making sure the health needs of residents are met: “staff very helpful, always contact district nurse if any concerns, listen to advice and act on it”. She described the home as “a very caring establishment”. Residents are also referred for physiotherapy in one instance a resident who was experiencing frequent falls was referred to the falls clinic. The home has involved psychiatric service where a resident has mental health difficulties. In looking at the medication arrangements it was evident from records and procedures that there are safe systems in place. Administering records were completed as required, controlled drugs are witnessed by two members of staff as necessary. Returned medication is recorded and signed as being received by pharmacist or their representative. The home has a Homely Remedy logbook this was examined and it was confirmed that when individuals are given nonprescribed drugs this is also recorded on their medication record. Staff who have responsibility for medication have all received training in this area. Where able residents administer their own medication at the time of this inspection one resident was doing so a risk assessment had been completed. In talking with residents they spoke of the “always helpful staff” how they were treated “as I would want” “always treat us well” and when asked whether they felt they were respected by staff “definitely” “always”. Staff were also observed assisting residents in one instance encouraging resident to use the toilet this was done in a quiet and sensitive way. Staff were also observed knocking on resident’s rooms before entering and when asked a resident said they “ always did that”. Harefield Hall DS0000003326.V323375.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): 12,13,14,15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The arrangements for meeting the social and recreational needs of residents are good and there are opportunities for residents to maintain links with family, friends and the local community. The home’s practice and routines are flexible and enable residents to exercise choice and have control over their lives. The home provides meals, which are balanced and meet the dietary needs of individuals in the home. EVIDENCE: In talking with residents about activities in the home they spoke of there “being enough” “could be more”. This was identified by the manager as an area to try and improve. In the homes questionnaire 75 of residents who responded said social activities were good or excellent. Three of the residents who responded to pre-inspection questionnaire said there was always activities arranged and three said usually. The manager has now employed a member of staff who provides two sessions a week as well as care staff who aim to Harefield Hall DS0000003326.V323375.R01.S.doc Version 5.2 Page 13 provide two activity sessions daily. Included in activities are bingo, games, crafts, quizzes, word games, table skittles and outside entertainers. Where able residents are encouraged to maintain their contact with the local community to attend local church and clubs. There is an open visiting policy and the home recognises the importance of residents having contact with family and friends. Comments from relatives made to the CSCI in responding to questionnaire included: “exceptionally inviting and friendly, made us very welcome” All of the respondents (7) said that they were welcomed by staff when visiting the home. This was also confirmed by a resident who said they always felt their visitors were “made to feel very welcome, never a problem me having visitors”. The home places great importance in providing meals which are nutritious and appetising and this is clearly reflected in the menus examined. There is a wide range of choices available with an emphasis on homemade meals. Resident’s choices are available and in talking with the chef she was very aware of the resident’s likes and dislikes. Residents said the food was “always very good” “couldn’t fault it” “always a good choice”. One resident said, “if there’s something I don’t like they always give me something else”. The home is able to meet any special diets. On the day of this inspection the meal was presented in an attractive way with the dining room being inviting and relaxed atmosphere. Staff were available to give assistance if this was required and this was provided in a sensitive and quiet way. Harefield Hall DS0000003326.V323375.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): 16,18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has clear procedures in place and this enables individuals to make a complaint and voice their views about the service they receive and to know that they will be listened to and actions taken where necessary. The home makes sure that as far as possible residents are protected from harm by having policy and procedure about the Protection of Vulnerable Adults and providing training to all staff in this area. EVIDENCE: One complaint had been made since the last inspection this had been responded to appropriately. In talking to residents about how they voice their views and about making complaints they spoke of always “being able to speak to staff about anything” how the manager “was very approachable”. Importantly resident said how they felt “staff listen to what we have to say” and “will do something about it” if unhappy about anything. One resident when asked about if they would make a complaint or say if they were unhappy; “you couldn’t wish for a better place, if it wasn’t I would say something about it”. The home’s complaint procedure is displayed in the home and residents are provided with a copy of the procedure on coming into the home which they sign to say they have received. A copy is also included in information packs Harefield Hall DS0000003326.V323375.R01.S.doc Version 5.2 Page 15 held in resident’s rooms. One resident when asked said they were aware of the complaint’s procedure. All respondents to pre-inspection questionnaire (6) said they knew how to make a complaint; this also applies to relative respondents. The home has Adult Protection policy and procedure however they need to incorporate South Gloucestshire guidelines and procedures. Staff have completed Adult Protection training though there remains a number who still need to undertake this training. Harefield Hall DS0000003326.V323375.R01.S.doc Version 5.2 Page 16 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): 19,26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides a safe and hygienic environment for the residents and staff. EVIDENCE: In walking around the home it was evident that the home is well maintained and provides a safe environment for residents and staff. Recent improvements have been made to storage and laundry facilities. Residents described the home as “always clean” “they keep it all nice and clean all the time”. Procedures are in place to deal with potential infection and relevant staff undertake Infection Control training. Harefield Hall DS0000003326.V323375.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): 27,28,29,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staffing arrangements in the home are satisfactory so that the needs of residents can be met in an efficient way with care being provided by skilled and competent staff. The recruitment and selection of staff is undertaken to make sure that as far as possible the health and welfare of resident is protected. EVIDENCE: A strength of Harefield Hall is that there is a good history of retaining staff with a well-established staffing group. There were sufficient numbers of staff on duty at the time of this inspection. In talking with residents about staff and in particular their availability a number spoke very positively of the “caring and always there” “nothing too much trouble” “absolutely excellent”. One resident when asked about help from staff said “its always there if you want it”. Comments received from relatives about the staff of the home included: Care and consideration is superb” “staff excellent, caring and loving attitude”. A number of staff (14) have completed NVQ 2 or above others are continuing with this training to raise their level of knowledge and skills. At present this is not 50 of staff however with the ongoing NVQ training this will be achieved. Harefield Hall DS0000003326.V323375.R01.S.doc Version 5.2 Page 18 Recruitment and selection records were looked at and showed that the necessary checks are place ie 2 references and Criminal Record Bureau (CRB) (all current CRBs were signed off on this inspection and certificates can therefore be destroyed) Application forms provided full and detailed information about applicants including full employment history as required. Training records were looked at and evidenced that those inspected had undertaken the mandatory areas of training: Moving and Handling, First Aid, Food Hygiene and Health & Safety. Staff have also received COSHH training. There has been no specialised training relating to Caring for Older People such as Mental Health in Old Age, Disability Awareness and specific conditions such as Parkinsons, Stroke. Harefield Hall DS0000003326.V323375.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): 31,33,38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are good opportunities for residents and others to express their views about the service they receive. The practice of the home help to make sure that the health, safety and welfare of residents and staff is protected. EVIDENCE: The manager of Harefield Hall has extensive experience over a number of years caring for older people. Residents said they felt she was “very approachable” “you can talk to her about anything, any worries” Staff also stated that they felt she was “open and approachable” they felt always able to Harefield Hall DS0000003326.V323375.R01.S.doc Version 5.2 Page 20 discuss any concerns or issue they may have. Staff also stated that management had a “hands on approach” describing the atmosphere of the home as “good and friendly” Regular Quality Assurance questionnaires are sent to residents and relatives none have been issued to professionals who visit the home. In August 06 16 residents responded and the outcome was that 99 said the home was comfortable, received good or excellent quality of care. A comment from a relative “my family feel the service you provide is first class it would be very difficult to improve on it”. Residents meetings are held monthly providing a further opportunity for residents to make suggestions and comment about the service they receive. At previous meeting suggestions had been made about the menu in the home and these had been acted on. Health and Safety records showed good practice in this area. All equipment is maintained at frequent intervals: Fire 6/12/06, lift 6/01/06, hoists 10/04/06. A full electrical safety inspection was completed 08/03/06. Gas safety certificate issued 27/03/06. Weekly fire alarms tests are undertaken as are monthly emergency lighting; staff receive 3 monthly fire drills. There are full environmental and fire risk assessments in place as well as risk assessments for the use of potential hazardous chemicals. Harefield Hall DS0000003326.V323375.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 X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 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 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X X X X 3 Harefield Hall DS0000003326.V323375.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. 1. Standard OP7 Regulation 12 (3) Requirement Timescale for action 01/03/07 2 OP7 13 (4c) (5) 3 OP30 18 (1a,ci) Ensure that wishes of individuals on their death are established and recorded as part of care plan. (This refers to home having responsibility to make sure they are fully aware of resident’s wishes particularly where there are no relatives or representative. If an individual feels unable to state their wishes the home needs to establish there is someone who is aware and this is recorded) Ensure moving and handling 01/02/07 assessments are completed as part of resident’s care plan. (This refers to completing specific guidance for staff where risks are identified in moving, transfers, handling particularly where equipment is needed to ensure as far as possible safety of individual and staff) Ensure staff receive training 30/09/07 appropriate to the work they are to perform. (This refers to specialist training around working with older people) Harefield Hall DS0000003326.V323375.R01.S.doc Version 5.2 Page 23 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 Harefield Hall DS0000003326.V323375.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Bristol North LO 300 Aztec West Almondsbury South Glos BS32 4RG 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. Extracts may not be used or reproduced without the express permission of CSCI Harefield Hall DS0000003326.V323375.R01.S.doc Version 5.2 Page 25 - 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. 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