Inspection on 30/04/07 for Harelands House

This inspection was carried out on 30th April 2007.

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

Harelands House 02/06/09

Harelands House 04/01/06

Harelands House 03/08/05

Harelands House 10/02/05

Harelands House 13/07/04

Similar services:

Clover House

Parkside

Park Lodge

Mere Hall View

St Bonaventures

Hudson Road

Whitewalls

Home Farm

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

CARE HOME ADULTS 18-65 Harelands House Samson Street Belfield Rochdale OL16 2XW Lead Inspector Jenny Andrew Unannounced Inspection 30 April 2007 3:00 Harelands House DS0000049196.V334140.R01.S.doc Version 5.2 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 Harelands House DS0000049196.V334140.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 Adults 18-65. 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. Harelands House DS0000049196.V334140.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Harelands House Address Samson Street Belfield Rochdale OL16 2XW 01706 651712 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) Rochdale MBC Debra Jayne Wild Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Harelands House DS0000049196.V334140.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The home is registered for a maximum of 5 service users to include: up to 5 service users in the category of LD (Learning Disabilities under 65 years of age). The service should employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. The home can accommodate the brother of a service user already booked in for respite care, in the ground floor adapted bedroom, providing that the number of service users does not exceed five (5) in total. 4th January 2006 Date of last inspection Brief Description of the Service: Harelands House, which is owned by Rochdale MBC, offers short-term support accommodation for up to five service users over the age of 19 years, with a learning disability. The service’s aim is to provide respite to parents/carers of people who are cared for in their own home, to enable them to maintain their role as carers. The home is adapted to meet the needs of profoundly disabled individuals. Four beds are for short-term respite care and one bed is for emergency placements. Lengths of stay vary, dependent upon need, but the service is available 52 weeks a year. An outreach service is also provided. The bedrooms are single and have en-suite facilities. The home is situated close to local shops, pub and public transport. A safe enclosed garden area is provided which is accessible by people reliant upon wheelchairs. From 9 April 2007, the charges for the service were dependent upon the age of the person and how long they were staying. For people aged between 25-59 the first four weeks were £70.95 per week, reducing to £60.95. For those aged under 25 years, the charges were £58.65 reducing to £48.65 per week. Service users had to pay for their own outings and toiletries. The manager makes information about the service available in the form of a Respite Service Handbook, a copy of which is kept in each bedroom. Harelands House DS0000049196.V334140.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over four hours. The home had not been told beforehand the inspector would visit. The inspector looked around the building, at paperwork about the running of the home and the care given. In order to find out more about the home the inspector spoke with the senior support worker, one support worker and with the four service users presently using the service. The inspector also watched how the staff spoke to and supported the service users. Before the visit, comment cards were sent out to service users, relatives and other visitors to the home. Five service users and five relative/carer comment cards were returned and the information has been used in the report. Other information, which has been received about the service over the past year has also been included. What the service does well: Each service user who comes to stay at Harelands House has very different needs and the care and support they are given by the manager and staff team is of a high standard. The service users spoken to said they liked the staff who worked there and they looked forward to their visits to Harelands House. The care plans are good because they set out everything about each person in detail, saying what they need help with and what they can do for themselves. They also said what the person liked and didn’t like and this was important when coming on short stays. As the staff team had not changed very much over the last 18 months, this meant that the people using the service had been able to build up friendships with the staff who knew how to support them. Whilst staying at Harelands, the staff try to make sure that the service users have a good social life and make an effort to arrange activities that the person may not have tried before. As the service catered for people with different needs, the manager made sure that the staff had all the right training so they could support people safely. The home is good at checking out with other people, e.g., parents and the service users themselves, what they think about the service. Harelands House DS0000049196.V334140.R01.S.doc Version 5.2 Page 6 The manager was always trying to look at different ways of improving the service so that people coming in for short stays would receive the care and support they needed. 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. The summary of this inspection report can be made available in other formats on request. Harelands House DS0000049196.V334140.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Harelands House DS0000049196.V334140.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Any new service users were assessed in full prior to admission, ensuring staff were able to meet their identified needs. EVIDENCE: The files for the four service users currently on respite were looked at. Two of the service users had been coming on short stays over a period of ten years and therefore did not have level 4 assessments in place. Their files did however, contain all the information needed to ensure the staff were able to care and support them as they wanted. The files for the other two service users each contained a level 4 assessment of need, which had been done by a care manager. These were detailed and set out important information, such as preferred routines, health and personal care needs and hobbies/interests, etc. The senior said they used a lot of this information when writing the support plan and this was confirmed from checking the care plan files. Harelands House DS0000049196.V334140.R01.S.doc Version 5.2 Page 9 During the visit, the senior support worker on duty received a phone call from a care manager about someone they wanted to place on an emergency basis. The worker asked the care manager to fax through the level 4 assessment so she would have the right information to make a decision about whether or not they would be able to meet her needs. She also requested that all other information be brought to the service when they came with the service user. The staff already knew this service user as she had used the service before. The senior support worker said that as well as the mandatory training, they received training to meet specific needs of service users referred to the service. Examples given were training in epilepsy, Asperger’s Syndrome, cultural awareness of Asian communities and loss and bereavement. One support worker was also a member of a dementia working group, which she attended monthly. The staff files contained copy certificates of all the training the staff had attended. Harelands House DS0000049196.V334140.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Support plans accurately reflected each service user’s needs, choices and preferred routines so the staff could support them in the way they wanted. EVIDENCE: The support plans for the people currently receiving respite were looked at. All were detailed, easy to read and as well as giving information about the person’s physical and health care needs, they recorded likes/dislikes, routines and interests. Where people found it difficult to verbally communicate, as much detail as possible was recorded about how they made their needs known. This was seen during the inspection. One service user moved her head to indicate yes and no and used facial expressions and this was recorded on her plan. The staff used closed questions so that she would be able to answer them. Harelands House DS0000049196.V334140.R01.S.doc Version 5.2 Page 11 The senior support worker said that before each stay, they would get a verbal up to date briefing about what, if anything, had changed since the person last used the service. Additional updates were seen on two of the plans. New moving/handling assessments had been done for one person in November 2006 when their needs had changed. On the same plan, the time for sitting in their wheelchair had reduced and this had also been recorded. Upon coming home from the day centre, this service user was assisted to transfer from their wheelchair onto the settee in the lounge, in line with their care plan. Another person’s plan had been updated on 5 March 2007 to say their medication had changed. On the remaining two plans, a note stated there had been no change to the people’s needs since the last visit. The support plan of an Asian service user did not make any reference to her being of the Muslim faith although the information cards, kept in a separate box, did record this information. Her plan did however specifically record her wishes that she did not wish to be forced into cultural requirements. Her next of kin had signed a consent to treatment and activities form which listed places she could visit whilst on respite. Daily diary recordings were made for each person for the length of their stay. These were seen and the entries were detailed and gave a good idea of how the person had spent their day. They included information in respect of diet, activities, times of rising and retiring, etc. The good practice of recording any restrictions on choice/freedom was noted in respect of the use of listening devices. Parental consent had been obtained where such appliances were in use. There had been no changes in the staff team for almost 18 months and the team was small, only consisting of the manager, senior and four support workers. Two agency workers also worked for the service on a very regular basis. This low turnover meant that the staff knew each of the service users’ needs well and were able to use different ways of communicating with them. Good relationships had been formed between staff and service users and this was evident upon the visit when staff were greeted by the service users like old friends, with hugs and affection being shown. One of the more independent service users was spoken with. She said she really looked forward to coming to stay at Harelands House and liked all the staff. She said the staff let her help with household tasks and this was observed during the visit when she assisted in setting and clearing away the dining table. She said she did not hold her own medication as she did not do so at home. Information provided on the five returned service user comment cards confirmed choice in daily routines. When asked, “Can you do what you want to do”, the responses were all “yes”. One person commented, “We discuss what we would all like to do and where to go”. Harelands House DS0000049196.V334140.R01.S.doc Version 5.2 Page 12 It was usual for parents/carers to deposit money for safekeeping with the staff as part of the admission procedure. Any money spent on behalf of the service user was accounted for by the staff and receipts returned together with any balance of monies when the service user went home. Where service users could hold their own money, this was respected. Records and discussions showed that risks were assessed and balanced against the service users’ right to choice and independence. Where risk areas had been identified, risk assessments were in place and had been kept updated. Staff signatures showed they had read the assessments so they would know the action to take to lessen the identified risk. The two service users who were reliant upon wheelchairs had up to date moving/handling assessments in place. Other risk assessments were in place in relation to eating, falling out of bed, transport and the fitting of bed sides, etc. Harelands House DS0000049196.V334140.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. The people who used the service were able to make choices about their lifestyles and the varied community activities undertaken enabled people to try new experiences whilst on respite stays. EVIDENCE: The staff tried their best to make sure the people using the service had a full and stimulating lifestyle whilst on short stay visits and one of their aims was to ensure people continued to lead a valued life in the community. The staff team completed satisfaction questionnaires with everyone at the end of their stays, to see if anything could be improved upon and one of the questions was about whether they would have liked to have done anything on their stay that they hadn’t been able to do. This information was then used on their next respite stay. Harelands House DS0000049196.V334140.R01.S.doc Version 5.2 Page 14 The support plans contained details of people’s preferred routines, interests and hobbies but the staff also offered different activities that the service users may not get the opportunity to do at home. The outings and activities arranged were numerous. On the day of the visit, one of the newly admitted more independent service users went tenpin bowling with one of the Outreach Workers and had a meal out. On his return, it was evident he had really enjoyed himself. The other service users went for a trip out in the mini-bus. From checking daily diary recordings and speaking to the service users, it was evident they did lots of things, such as going to McDonalds for tea, shopping at supermarkets, visiting cafes, trips to the cinema, tenpin bowling, visits to pubs, trips to Southport, Blackpool, Manchester airport and other places of interest. One service user said “It’s a bit like being on holiday”. One comment from a relative acknowledged that the manager tried to book service users of similar skills and abilities in at the same time so they could enjoy a good social life. At previous inspections, it had been noted that where friendships had been made between service users, they tried to accommodate requests to arrange respite dates to coincide with their friends. Although the main aim of the service was to provide respite for parents and carers, the staff were really good at liaising with them when any problems occurred or decisions about health care needs were made. Comments from the five returned relative/carer comment cards were positive about the home keeping in touch with them, with four saying they always did and one they usually did. As the service users lead an active social life during their stays, carers are asked to ring to check the service user is in, before visiting. Good relationships had been formed with many of the carers, as a result of the outreach scheme, which the service offered to many of the service users utilising the respite service. All bedrooms were equipped with safety locks and the staff said the more independent people were offered a key to their room. One of the newly arrived service users who was very independent said she had not been offered a key to her room. The staff should make sure this is done as part of the admission process. Where keys are offered and refused, recordings should be made on each person’s support plan. If service users are assessed as not being able to hold their own key, then this should also be recorded, together with the reason why. This service user was however asked to choose which of the two vacant rooms she would like. She chose the one with the double bed and was delighted with the room. Harelands House DS0000049196.V334140.R01.S.doc Version 5.2 Page 15 The people staying at Harelands were encouraged to do as much as possible for themselves in accordance with their support plans. One of the service users made herself a drink as soon as she arrived at the house. Those who were more dependent were offered drinks by the staff. The one-week menu was geared towards the age range for which it catered and their dietary needs. Where service users did not like what was on the menu, the staff tried to accommodate their choices. As many service users had respite stays in excess of one week, a two-week menu should be written so that a wider choice of food will be available. As the majority of the service users had a main meal at the day centres they attended, the meals at teatime were lighter and choices consisted of something on toast, omelettes, toasted sandwiches, filled jacket potatoes, fish fingers, burgers/hot dogs, bacon/eggs, soup, sandwiches, lasagne, etc. On a Sunday, a roast dinner was cooked and once a week, usually on a Saturday, everyone would go out for a meal. This enabled people to try new foods from different cultures. On the evening of the visit, one service user, who had a poor appetite, was being tempted to have something his support plan said he really liked which was cheese on toast. One service user enjoyed an omelette filled with mushrooms, cheese and red peppers with chips and baked beans. Another service user asked for beef burger, chips and beans and also appeared to enjoy her meal. Two of the service users needed assistance with their meal and this was done by two of the staff on an individual basis. One person had a special feeding support plan in place that was being closely followed. The service user was comfortable in the way the worker was assisting her. Daily diary recordings were kept of what each person had enjoyed eating and these showed that people’s individual dietary needs were being catered for, as were cultural needs. For Muslim service users, Halal meat was purchased. The manager said they were currently preparing for a new service user to the scheme who was a devout Muslim. To ensure the needs of this person were able to be fully met, the manager and staff were meeting with her parents who were instructing them on what cultural issues they must follow. Harelands House DS0000049196.V334140.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. There was evidence of close working links with parents/carers to ensure the health and personal care needs of service users were fully met during their stay. EVIDENCE: The support plans contained specific details about the health and personal care needs of each person, including a pen picture and likes/dislikes. Service users’ preferred routines in relation to bathing/showering, eating and mobility were recorded. All the rooms had private en-suite facilities and two bedrooms were on the ground floor so that people with physical disabilities could be accommodated safely and use their rooms when they wanted to. The staff ensured that care was person-led, with flexible consistent support being offered. The staff respected each person’s preferences when providing intimate personal care. It was noted on their care plans whether they preferred male or female support workers to assist and their wishes were usually accommodated. The team of five workers was made up of three females and two males. Harelands House DS0000049196.V334140.R01.S.doc Version 5.2 Page 17 During respite stays, community health care services were accessed as required and the care plans inspected all had details of each person’s GP. However, it would not be usual for service users to come on respite stays if they were unwell. If the service user became ill or needed to see a health care professional during their visit, then the staff would support them if the person’s relative wanted them to do so. Any health care appointments that coincided with their respite visit would be kept. One service user who was staying at the time of the visit sometimes needed to see the District Nurse and, if required, this was arranged during his stay. It was noted from the training records that all the staff had done epilepsy training and first aid training was also being kept up to date. The home had a written draft policy/procedure in place in respect of medication. The manager said it was in the process of being finalised, as it had been written specifically for the respite service. Self-medication, homely remedies and the dispensing of controlled drugs were all included. A member of staff was responsible for the collection and return of all service users’ medication and any queries were addressed on the initial courtesy call to the parent/carer. Consent to treatment forms were signed and held on the service user’s file. Satisfactory storage arrangements were in place with staff having to account for all medication at each staff handover. The registered manager was responsible for ensuring that the staff who assisted in giving out medication continued to give it out as they had been trained to do. This was done on an annual assessment basis. The form, which was used to assess competency, did not include the giving out of controlled drugs and it is recommended this is included. The home had recently experienced the sad death of a service user whilst he was staying at Harelands House. From speaking to the staff, it was evident they had coped extremely well during this difficult time, following all the correct procedures. Harelands House DS0000049196.V334140.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is excellent. This judgement has been made using available evidence, including a visit to this service. There was a clear, understandable complaints system in place, which ensured that service users’ views were listened to and acted upon by a staff team who had received adult protection training. EVIDENCE: As well as the corporate complaints procedure, a user-friendly version had been written which was included in the service user guide. A copy of this guide was in each of the bedrooms so that the service users could use it during their stay. A requirement had been made at the last inspection for the manager to keep copy complaints in a file so they could be looked at. Since the last inspection, no complaints had been made to the manager and the Commission for Social Care Inspection (CSCI) had not had to undertake any complaint investigations at the home. The manager said she would make sure she kept copies in the future. There had, however, been several compliments recorded about the service. From speaking to the manager and staff, it was clear they knew the importance of taking the views of the service users seriously and responding immediately to any problems. The courtesy calls made at the beginning and end of each person’s stay enabled the carers/relatives to express their views before grumbles turned into complaints. Harelands House DS0000049196.V334140.R01.S.doc Version 5.2 Page 19 Feedback from the service user comment cards all indicated they would know who to speak to if they were not happy during their stay. One service user said, “I chose my own key-worker and I would tell her”. To the question, “Do you know how to make a complaint”, three people said they did, one said they were unclear but would ask and one said they did not know. Feedback from relative comment cards about their knowledge of the complaints procedure was good, with four stating they knew what to do and one saying they couldn’t remember. No allegations of abuse had been made to the home or to CSCI. The Rochdale MBC Inter-Agency Vulnerable Adult policy was in place, which gave clear guidance on action to take if abuse were suspected. The staff recruitment process was thorough, with the personnel department ensuring that all checks were completed before staff were able to start work at the home. Training in the signs and recognition of abuse was covered during The Learning Disability Award Framework (LDAF) training and in NVQ (National Vocational Qualification) training. The two newer staff and the two agency staff had all completed the LDAF training and the other staff had completed NVQ level 3 training. The manager had undertaken the Rochdale MBC Protection of Vulnerable Adult training course and was fully aware of the steps to take in the event of a suspicion or allegation of abuse. She said topics such as protection were discussed at staff meetings. Discussion took place with regard to the frequency of protection training. The manager was advised to ensure staff remained fully conversant with procedures and to update protection training every two years. Before any form of restraint was used, such as bed rails or listening devices, risk assessments were done and consent obtained from the service user’s next of kin. Harelands House DS0000049196.V334140.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. The house was clean, well maintained, decorated and furnished, providing a comfortable, safe environment for the service users staying there. EVIDENCE: The home was adapted to meet the needs of profoundly physically disabled service users and all the rooms had en-suite facilities. The exterior of the home was fitted with CCTV cameras for safety reasons. The home was close to local amenities and public transport and had good disabled access. There was a large enclosed garden with lawns and a patio area that could be accessed by people in wheelchairs. Since the last inspection one of the first floor bedrooms had been re-decorated and had a new carpet fitted. There were two ground floor bedrooms, which meant that those who could not access the stairs could be safely accommodated, as there was no passenger lift fitted. Harelands House DS0000049196.V334140.R01.S.doc Version 5.2 Page 21 The Environmental Health Department had recently visited the house and left a food safety manual for the staff to complete. This had been kept up to date. Responsibility for cleaning and housework was shared between the staff but the more able service users were able to help out if they wanted to. The comment cards returned from service users all recorded they felt the home was kept fresh and clean. One person commented, “The house is always nice and tidy and smells clean.” Satisfactory laundry facilities were in place and there was a supply of disposable gloves and aprons which staff were seen to use during the visit. Staff hand washing facilities were satisfactory. The staff had all completed infection control training and some had been booked on refresher training. Harelands House DS0000049196.V334140.R01.S.doc Version 5.2 Page 22 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 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 & 35 Quality in this outcome area is excellent. This judgement has been made using available evidence, including a visit to this service. The staff team had the collective skills, training and expertise to undertake their roles efficiently and effectively which ensured the needs of the service users were being well met. EVIDENCE: The home was staffed to meet the identified needs of the service users and this was done on assessed individual need, e.g., who needed one to one support and how many people needed assistance with moving/handling. The rotas were flexible and took into account what individual clients were doing during the day and at weekends. On the evening of the inspection, there were three staff on duty so that the needs of all four service users could be adequately met. One of the staff was on Outreach duty but had included one of the service users staying at Harelands, as this was a regularly booked session which he very much enjoyed. Harelands House DS0000049196.V334140.R01.S.doc Version 5.2 Page 23 Since the last inspection, there had been a review of staffing during the night. Previously there had been two waking night staff on duty. This was now dependent on the needs of the people using the service. If they were more independent and slept through the night, then one staff would be on waking duty and one would sleep in the building so that if assistance was needed, it was readily available. Of five returned relative/carer comment cards, four people felt there were always sufficient staff on duty and one felt there usually was. The following comments were made: “The staff are excellent”, “There is a good mix of gender and ages which I feel each individual can relate to”, “The staff act upon requests made by the family and very pleased with the staff” and “The care is excellent and staff are caring and considerate”. The staff team reflected the different ethnic backgrounds of the people using the service with one ethnic staff member being employed out of a team of five. The staff had also received cultural awareness training. The response to the question on the comment cards, “Does the service meet the different needs of people (including disability, ethnicity, etc.)”, four responded ‘always’ and one ‘usually’. The staff had worked together for a long time, with the two most recently recruited support workers having been in post for almost two years. This consistency had been good for the service users as they were being supported by the same staff, each time they came on respite stays. This had enabled the service users to develop trusting relationships with the staff team. In addition to the contracted staff, the same two agency workers were also used on a regular weekly basis. If additional cover was needed for staff absence due to sickness or annual leave, the existing staff would usually work additional hours. Of the five permanent staff working at the home, three had achieved the NVQ Level 3 qualification and one had completed her NVQ Level 2. This meant that 80 of staff had achieved a recognised qualification. The two newest support workers had both completed their Learning Disability Award Framework (LDAF) training, as had the two agency workers. Each staff member’s training and development needs were discussed at appraisal and supervision meetings. From checking the staff files, it was evident the manager prioritised training, ensuring the staff kept themselves abreast of current care practice. Only one of the team had not completed five days’ training since the last inspection but had been booked on two further courses in May. Harelands House DS0000049196.V334140.R01.S.doc Version 5.2 Page 24 Staff files showed evidence of the mandatory training being kept up to date except for moving/handling. Whilst all the staff had done this training, it had been in June 2004 and refresher training should now be arranged so the staff keep up to date with new methods. The manager said she would address this. The staff spoken to said they had regular team meetings and minutes of these meetings were seen, the last having taken place in January 2007. The manager said she tried to hold them every month. They also said they had annual appraisals and regular one to one supervision. The staff personnel files were checked and supervision recordings were in place. A corporate recruitment and selection policy/procedure was in place and the manager said the policy was observed. The files for the staff had been checked at previous inspections and all the required checks had been made before the staff had started work. However, since the last inspection one staff had started work and their file was checked. An application form, two written references and a Criminal Record Bureau check had been done. The file also contained a contract of employment and other required personnel information. The induction training pack issued to each new employee, contained useful policies/procedures and other documentation, which included a copy of the General Social Care Council’s Code of Conduct. Harelands House DS0000049196.V334140.R01.S.doc Version 5.2 Page 25 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 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent. This judgement has been made using available evidence, including a visit to this service. The manager provided clear leadership, guidance and direction to staff, which ensured service users received a consistent quality service. EVIDENCE: The manager had achieved her NVQ level 4/Registered Manager’s Award in April 2004 and in July 2005 became an assessor for the Learning Disability Award Framework training. She had worked in the learning disability field for many years and during this time had provided a reliable and consistent service for the people using the Harelands House respite scheme. She was extremely committed and motivated to providing a respite care service, which met the needs of a diverse client group and co-operated fully with the Commission for Social Care Inspection in respect of implementation of requirements, which were within her remit. Harelands House DS0000049196.V334140.R01.S.doc Version 5.2 Page 26 In order to ensure she kept up to date with management issues, she made sure she attended any training courses she felt would benefit her. Since the last inspection she had undertaken a first aid two-day refresher course in March 2006, done employee development in June 2006, attended a four-day training the trainer course in July 2006 and had training on the Mental Capacity Act in September 2006. She had previously done all the required recruitment training, including equal opportunities legislation, protection of vulnerable adults and risk assessment. Equality and diversity issues were addressed within staff meetings and staff were encouraged to attend relevant courses to increase their knowledge. Record keeping was of a good standard with some records being securely stored in order to meet the Data Protection Act. Although the manager was on leave at the time of the visit, she came in during the visit so that staff files of a confidential nature, containing supervision and references could be accessed. Feedback about the manager was positive from both service users and staff. One service user said, “I like Debbie, she’s really nice”, and when the manager arrived on site, it was evident from her greetings that she had a really good relationship with her. The authority had a corporate strategic plan reflecting aims and outcomes for service users and an effective quality assurance system was in place. A continuous self-monitoring evaluation system, which involved service user surveys being circulated after each stay, had continued to be used. In order to ensure an independent person was involved in assisting the service user in completion of the form, it was previously sent to the service user’s key worker at the day care centre they attended. However, due to the forms not always being returned, the staff or the person’s relative were assisting in the completion of the forms. The manager said she was pursuing this, as she really wanted a more independent method of monitoring. On the three files inspected, many questionnaires were filed, with some very complimentary feedback being given. Previous inspections had also identified the service was really appreciated by the service users, as well as their parents/carers and the number of compliments on file also confirmed this. Where suggestions for improvement were made, they were discussed fully at the staff team meetings and staff endeavoured to implement ideas wherever possible. An example of this was given, which has previously been mentioned, where a service user questionnaire commented they would like to visit Blackpool on their next visit. Staff meeting minutes showed this had been discussed and two weeks ago when this person was on a respite stay, a trip had been organised. Harelands House DS0000049196.V334140.R01.S.doc Version 5.2 Page 27 The courtesy calls made before and after respite stays were also a way of obtaining parent/carer feedback and very often, this system prevented grumbles becoming complaints. Policies/procedures were reviewed and updated in the light of changing legislation and a new draft policy had recently been written in relation to medication. According to information recorded on the pre-inspection questionnaire, all necessary maintenance and associated checks had been made and accident report sheets appropriately completed and filed. Fire drills were held and one of the service users was able to say what she would do if the fire alarm went off. Staff files showed evidence of all the required health and safety training having been done. Some staff were due to do refresher training in first aid and infection control and this had been arranged. As highlighted above, although all staff had done moving/handling training, three people had not done refresher training since 2004 and this needed to be arranged. The manager was aware of this and said she would speak with her line manager. Harelands House DS0000049196.V334140.R01.S.doc Version 5.2 Page 28 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 Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 4 23 4 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 4 33 X 34 4 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 4 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 3 3 X 4 X 3 X X 3 x Harelands House DS0000049196.V334140.R01.S.doc Version 5.2 Page 29 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. 1 2 3 4 Refer to Standard YA6 YA17 YA18 YA20 Good Practice Recommendations The support plans should record cultural and religious needs to make sure that staff were aware of specific needs of each person. A two-week menu should be written so that people staying for more than a week will have a better choice of food. Service users should be offered keys to their rooms and where they are refused or risk assessed as not being able to hold keys, this should be recorded. The medication assessment sheets should include how to dispense all controlled drugs. Harelands House DS0000049196.V334140.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection Greater Manchester Local Office 11th Floor West Point 501 Chester Road Old Trafford M16 9HU 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 Harelands House DS0000049196.V334140.R01.S.doc Version 5.2 Page 31 - 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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