Inspection on 21/04/05 for Harewood Court Nursing Home

This inspection was carried out on 21st April 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

Harewood Court Nursing Home 20/01/10

Harewood Court Nursing Home 21/01/09

Harewood Court Nursing Home 29/01/08

Harewood Court Nursing Home 22/02/07

Harewood Court Nursing Home 15/09/06

Harewood Court Nursing Home 07/03/06

Harewood Court Nursing Home 13/10/04

Harewood Court Nursing Home 08/07/04

Harewood Court Nursing Home 24/02/04

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

CARE HOMES FOR OLDER PEOPLE Harewood Court 89 Harehills Lane Leeds West Yorkshire LS74HA Lead Inspector Karen Westhead Unannounced 21st April 2005 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. Harewood Court J52 J03 S1345 Harewood Court V221589 210405 stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Harewood Court 89 Address 89 Harehills Lane Leeds LS7 4HA 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) 0113 2269380 0113 2285697 harewood.nursing@virgin.net Solutions (Yorkshire) Ltd Mrs Pearl Jackson Care Home with Nursing 40 Category(ies) of Old Age (40) Physical Disability (3) registration, with number of places Harewood Court J52 J03 S1345 Harewood Court V221589 210405 stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None applicable Date of last inspection 13 October 2004 Brief Description of the Service: Harewood Court opened in 1995. It is situated in a busy residential area of Leeds, which is well served by public transport. There are a range of local amenities within close proximity. Accommodation is provided for 40 older service users, three of whom may have a physical disability. The home is well proportioned. All bedrooms are for single occupancy and have en-suite facilities. The home is registered to provide personal and nursing care. Staff cover is provided throughout the day and night. The home covers three floors. Service user accommodation is situated on the first and second floor. Each floor has a separate lounge and dining room, with a kitchenette available for snacks and drinks. The main ancillary services, on the ground floor, do not intrude on the facilities and accommodation available to service users. There is a paved area accessible to service users, by means of a ramp. Level ground floor access is available for wheelchair users or service users and/or visitors with mobility problems. There is also a passenger lift. Harewood Court promotes a smoke-free environment and service users and visitors are made aware of this verbally and through the statement of purpose. A covered smoking area is available in the grounds. Service users and staff confirmed they preferred the term residents, therefore this term has been used throughout this report. Harewood Court J52 J03 S1345 Harewood Court V221589 210405 stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. All care homes regulated have a minimum of two inspections in every twelvemonth period, beginning on the 1st April. This was the first visit for this inspection year. The visit was unannounced and was carried out by one inspector. The inspection started at 10am and concluded at 2.45pm. The purpose of the visit was to ensure the home is managed and being run to a satisfactory standard in accordance with the National Minimum Standards for Care Homes for Older People. The inspector spent a good proportion of time speaking with residents, staff members, a volunteer and visitors. A number of key records were looked at, including resident’s care plans, wound treatment logs, medication sheets, accident forms and staff recruitment files. What the service does well: What has improved since the last inspection? The last inspection did not identify any requirements or recommendations for the standards assessed at that time. The home continues to run effectively. Staff were found to be enthusiastic and committed to their individual roles and strive to improve and develop care practices in line with current good practice. Harewood Court J52 J03 S1345 Harewood Court V221589 210405 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. Harewood Court J52 J03 S1345 Harewood Court V221589 210405 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 Harewood Court J52 J03 S1345 Harewood Court V221589 210405 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, 3, 4 and 5 The admission’s procedure is comprehensive and effective; therefore residents have the information they need to make an informed choice about the home. EVIDENCE: The home employs an administrator who is able to provide information and support prior to prospective residents visiting the home therefore enabling them to make an informed decision about their stay. The inspector viewed a random selection of resident files, six from each floor. This included the most recently admitted residents. All files contained a preadmission assessment. The unit manager, on each floor, confirmed that residents were visited prior to moving in; an assessment was carried out at this stage. Two residents and two visitors recalled their experiences of ‘moving in’, when talking to the inspector. They each said they felt the process had been conducted in a logical and straightforward manner. Each said they had not felt pressurised to make up their minds; one resident in fact had opted to length the trial period to ensure she was sure about her decision. Harewood Court J52 J03 S1345 Harewood Court V221589 210405 stage 4.doc Version 1.30 Page 9 Harewood Court J52 J03 S1345 Harewood Court V221589 210405 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 and 10. Care plans continue to be completed and maintained to reflect the delivery of care, progress and any changes in an individual’s condition. As a consequence, residents receive the care set out in their plan and their health and personal needs are met. The staff continue to provide a good standard of health care. Other professionals are consulted appropriately and brought into the home for advise and support when required. EVIDENCE: Staff spoken with during the course of the visit demonstrated their level of knowledge about residents living at Harewood Court. The home employs qualified nurses who are assisted by carers and a team of ancillary staff. On the whole carers report to the qualified staff, who then complete any paperwork required. Risk assessments are carried out as a matter of course and documented. It was evident that these are evaluated and reviewed regularly. Harewood Court J52 J03 S1345 Harewood Court V221589 210405 stage 4.doc Version 1.30 Page 11 All accidents and incidents are recorded in full and audited by the unit managers regularly to identify any trends or increased frequency of falls. Examples were seen on resident files of where a risk had been identified, e.g. the development of pressure sores, and an action plan had been devised which outlined the care required and any specialist equipment needed. At the time of the visit there were two residents who were receiving care and treatment for pressure sores. Records seen for both residents demonstrated that the wound had been identified at an early stage and appropriate action taken. Where wounds were slow to heal the unit manager had contacted the doctor and tissue viability nurse to carry out an assessment of the area and provide prescription medicine and advice. A small number of residents were aware of their care plan. Any visits to the home by health care professionals are recorded in the residents file. All residents, who were able to pass comment, and visitors spoken with, described the staff in the home as ‘caring, friendly, kind and doing their best’. Medication records were examined in detail. All entries were found to be up to date and clear. Harewood Court J52 J03 S1345 Harewood Court V221589 210405 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, 14 and 15. The arrangements around activities, recreation and community facilities are adequate, according to those residents able to give their view. Food provision, although not assessed fully, continues to be an enjoyable time for residents. EVIDENCE: There has been an unsettled time recently, due to the extended absence of the person responsible for organising the activities in and around the home. However, this has been overcome due to the commitment of staff who have been able to fill the gap. Residents spoken with confirmed they were satisfied with the level of in-house activity. A number of residents said they had enjoyed a music concert the previous evening. A couple of professional entertainers had been and provided music and songs. Some said they were well supported by their friends and relatives and managed to go out as frequently as they wished. The proprietor is keen to enlist the help of residents and their relatives in improving the service delivery. They are consulted either informally or through structured meetings. The proprietor is responsive to requests and acts on them if possible when they will enhance the quality of residents’ lives. It was evident when speaking to visitors and residents that they have the capacity to make decisions and exercise their rights. The home encourages Harewood Court J52 J03 S1345 Harewood Court V221589 210405 stage 4.doc Version 1.30 Page 13 resident’s relatives to take charge of their financial affairs, if they lack the capacity to do this for themselves. However, this is seen as a last resort and residents are encouraged to handle their own affairs for as long as they wish and are able. The majority of residents spoken with talked frankly about their experiences in the home. They confirmed they were able to ‘please themselves’ about such things as going to their room, going to bed, what they wished to eat and what they were going to spend their time doing. The minutes from recent relatives and residents meetings showed the variety of topics discussed and the action taken. On the morning of the visit, on one floor, there had been an incident requiring a resident to be escorted to hospital for treatment and this had impacted on the morning routine. Consequently breakfast had been delayed. Residents commented on this being a rare event and that they understood, with so many people to look after, that there were days when routines had to alter. It was evident that those rising early had been given a drink and the choice of a snack prior to the cooked breakfast being served. Of the residents spoken with, one was unhappy with the delay in breakfast. The inspector had a discussion with the chef about food provision. It is clear that he takes his role seriously and tries to ensure residents enjoy their food. He is an active member of staff and liaises directly with residents about menu choices and preferences. He stated that due to the delay in breakfast being served he would stagger the serving of lunch, which is usually soup and sandwiches. The main meal of the day is served in the evening. A couple of visitors confirmed their relative was given a liquidised diet due to failing health. They said this was served in an attractive way, with each portion liquidised separately allowing for recognition of different flavours and textures. Harewood Court J52 J03 S1345 Harewood Court V221589 210405 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) None of the standards in this section were assessed in full. EVIDENCE: None of the standards in this section were assessed in full. Harewood Court J52 J03 S1345 Harewood Court V221589 210405 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, 24 and 26. The home was found to be, well maintained with attention to detail, clean and tidy with no evidence of unpleasant smells, therefore providing a pleasant environment for residents to live. The maintenance schedule includes all routine repairs and regular checks of equipment and facilities to ensure the home is safe and well maintained. The home has access to suppliers of specialist equipment. A number of residents have had adapted beds and equipment provided in their rooms and communal areas as required. As a consequence residents are able to maximise their independence and maintain abilities and skills. EVIDENCE: During the course of the morning, a set of dining room doors were being rehung. A set of visitors commented about the untimely removal and re-hanging of dining room doors. It was unfortunate that at the same time breakfast had been delayed on this particular floor and consequently could have affected resident welfare. The inspector discussed this at feedback; however there did Harewood Court J52 J03 S1345 Harewood Court V221589 210405 stage 4.doc Version 1.30 Page 16 not appear to have been any health and safety issues. However, there was a commitment from staff to be mindful in future when repairs are being carried out. Harewood Court is a non-smoking building. Facilities have been provided for staff to the side of the building. The inspector asked a resident to show her round the communal areas. The inspector was able to view some resident bedrooms, if they were in and gave permission. These were found to be furnished and decorated in a variety of ways and maintained a domestic style. Some residents said they had brought cherished items with them from home and that the staff in the home had gone out of their way to help with this. There were plenty of ornaments, flowers, pictures and framed photographs around. The inspector was able to view some specialist equipment when speaking to visitors and residents. Some residents had specially ordered beds to enable them to be nursed properly; others had had adaptations made to their ensuite facilities and bedrooms. Fire doors were closed and there was no evidence to indicate any were being wedged open. The main kitchen, laundry and administration are situated on the ground floor and as such does not intrude on the facilities and accommodation available to service users. The policy referring to control of infection includes the safe handling and disposal of clinical waste, dealing with spillages and general hygiene instruction. Throughout the visit staff were seen to adhere to these instructions and were seen to wear appropriate protective clothing according to the task being undertaken. It was pleasing to note that consideration was being given to the appearance of residents during and after their meal times. Harewood Court J52 J03 S1345 Harewood Court V221589 210405 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 and 29. The staff team are working hard to achieve their National Vocational Qualifications and consequently are improving their understanding of care of older people and enhancing their skills. This is a positive effort on their part to ensure they are appropriately trained; residents are in safe hands and being cared for by competent staff. The manager and her administrative staff have put a lot of effort into their recruitment and selection processes to ensure they employ suitable staff. One requirement was raised with regard to voluntary workers, which was discussed at the close of the visit. EVIDENCE: The home has a minimum staffing level with which it can operate. This comprises of a total of two qualified nurses and five care assistants during the day, reducing to four care assistants in the evening and one qualified nurse and three care assistants during the night. Staff during the night are waking night staff. The rotas seen indicated they were running to this level and at times above. There is one night care assistant vacancy. A unit manager and support worker are currently on extended sickness absence. The manager has managed to cover for their duties in the interim period and is currently advertising to attract an applicant for the vacancy. The inspector checked the most recently appointed staff files to ensure all the necessary documentation was present and the appropriate checks had been made. These were in order. Harewood Court J52 J03 S1345 Harewood Court V221589 210405 stage 4.doc Version 1.30 Page 18 Staff of all designations receive one to one supervision. The inspector viewed a schedule of supervisions indicating that staff were receiving this at the required frequency. Eight members of staff are working towards achieving a NVQ at level 2 or 3. The newly appointed staff have also shown an interest and will be registered to start their qualification once they have completed their induction programme. Staff were found to be courteous and welcoming to the inspector. They radiated a caring and committed attitude to the residents and were seen to conduct themselves in a professional and friendly manner with visitors and each other. Staff spoke to the inspector about their work and made positive comments about the staff they worked with and the respective unit managers and manager. They confirmed their attendance at training sessions. They did not raise any concerns about their work and their ability to care for those living at Harewood Court. A relative comes to the home to carry out voluntary tasks. The situation is unique in that the relative also visits a resident in the home. Bearing in mind the tasks and contact with other residents, this person must have a criminal records bureau check in the same way as employed staff. This is listed as a requirement on page 22. Harewood Court J52 J03 S1345 Harewood Court V221589 210405 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, 37 and 38. The manager and two unit managers are highly respected and hardworking. The records viewed in connection with the standards assessed were found to be up to date and accurate. This gave the inspector the confidence to say the home is well managed and that the home is run effectively. Resident’s welfare is given a high priority and policies and procedures are written with resident care in mind. EVIDENCE: The staff spoken with during the visit spoke positively about the respective unit managers and the manager. They said they felt supported by the senior team and were given ample guidance to enable them to carry out their duties effectively. Harewood Court J52 J03 S1345 Harewood Court V221589 210405 stage 4.doc Version 1.30 Page 20 The manager and her administrative staff keep a tight hold on the training required and ensure the training schedule takes into account any basic course required by legislation. A number of records were examined during the course of the visit. These included care plans, recruitment files, accident forms, pressure area/wound care, medication, staff off duty sheets, supervision and training records. The records were all being maintained according to the regulations. All resident care is passed between staff during the scheduled handover period. An entry is made after each shift in the residents file, stating the care received and how the plan of care has been met. There were numerous examples in the files to demonstrate that care plans are reviewed regularly and clear guidance noted if the individuals care needs change. Staff spoken with had a clear understanding of the records being kept and the reasons behind them. Harewood Court J52 J03 S1345 Harewood Court V221589 210405 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 x 3 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 x 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 x x x 3 x 3 STAFFING Standard No Score 27 3 28 3 29 2 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x 3 3 x x x x 3 3 Harewood Court J52 J03 S1345 Harewood Court V221589 210405 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 OP29 Regulation 7,9,19 Schedule 2 Requirement All staff and volunteers working with any vulnerable group must have a criminal records bureau check. Timescale for action 30 July 2005 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations Harewood Court J52 J03 S1345 Harewood Court V221589 210405 stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection Aire House Town Street Rodley Leeds LS13 1HP 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 Harewood Court J52 J03 S1345 Harewood Court V221589 210405 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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