Inspection on 21/01/09 for Harewood Court Nursing Home

This inspection was carried out on 21st January 2009.

CSCI found this care home to be providing an Adequate service.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Harewood Court Nursing Home 20/01/10

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 21/04/05

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 19/06/2009.

CARE HOMES FOR OLDER PEOPLE Harewood Court Nursing Home 89 Harehills Lane Leeds Yorkshire LS7 4HA Lead Inspector Mary Bentley Key Unannounced Inspection 21st January 2009 10:00 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 Harewood Court Nursing Home DS0000001345.V373890.R02.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. Harewood Court Nursing Home DS0000001345.V373890.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Harewood Court Nursing Home Address 89 Harehills Lane Leeds Yorkshire LS7 4HA 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) 0113 2269380 0113 2285697 scouserdumont@hotmail.com Solutions (Yorkshire) Limited Miss Jennifer Louise Gordon Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (40), Physical disability (3) of places Harewood Court Nursing Home DS0000001345.V373890.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home with Nursing - Code N To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP, maximum number of places: 40 2. Physical disability - Code PD, maximum number of places: 3 The maximum number of service users who can be accommodated is: 40 24th June 2008 Date of last inspection Brief Description of the Service: The home is registered to provide care with nursing for up to forty people, this includes older people and up to three younger adults with physical disabilities. It is situated in a busy residential area of Leeds, which is well served by public transport. There is a range of local amenities nearby. The home is on 3 floors, accommodation is on the first and second floor, and the ancillary services are on the ground floor. All the bedrooms are single rooms with en-suite facilities. Each floor has a separate lounge and dining room, with a kitchenette available for making snacks and drinks. A passenger lift allows access to all floors and the home is accessible to people with disabilities. Harewood Court is a smoke-free environment, both inside the home and in the grounds. Information about the services provided by the home in the form of a Statement of Purpose and Service User Guide is available at the home. In January 2009 the weekly fees ranged from £424.56 to £570.00. Additional services such as chiropody and hairdressing are available for an additional charge. Harewood Court Nursing Home DS0000001345.V373890.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is One Star. This means the people who use this service experience adequate quality outcomes. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. The inspection process included looking at the information we have received about the home since the last key inspection in January 2007. Since then we have made 2 additional visits to the home. The first visit was in February 2008 and was done by our pharmacy inspectors specifically to look at how medicines are managed in the home. The second visit was in June 2008 and focused on the daily life experiences of people living in the home. In both cases new requirements were made following these visits. The reports are available on request. The purpose of this inspection was to look at how the needs of people living in the home are being met and to check what progress is being made on dealing with the requirements from previous inspection. This visit was done by 2 inspectors between the hours of 10:00 and 18:00. During the visit we spoke to people living in the home, visitors, staff, and management. We looked at various records including care records and looked at parts of the building. Before the visit we sent surveys to the home to give to some of the people who live there, staff and visiting health care professionals. In total 6 were returned. We asked the home to complete a self-assessment (AQAA); this was returned to us but did not contain all the information we asked for. We discussed this with the manager during our visit. We found that two of the requirements from previous inspections have not been dealt with. We will be asking the home to provide us with an improvement plan to show how they are going to address these issues. Harewood Court Nursing Home DS0000001345.V373890.R02.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? What they could do better: Last year we asked the home to look at the staffing levels and skill mix of staff to make sure that there were enough staff available to meet people’s needs. This has not been dealt with. We found that people are not always getting the care and support they need because there are not always enough staff available. The way medicines are managed must be improved to make sure that people get their prescribed medicines. This was raised with the home last year and continues to be an area of concern. More should be done to encourage people to share their views of the service and contribute to the development of the service. The management team should explore ways in which they give people confidence that their views are valued and will be acted on. More attention should be given to meeting the cultural needs of all the people living in the home. Harewood Court Nursing Home DS0000001345.V373890.R02.S.doc Version 5.2 Page 7 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. Harewood Court Nursing Home DS0000001345.V373890.R02.S.doc Version 5.2 Page 8 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 Harewood Court Nursing Home DS0000001345.V373890.R02.S.doc Version 5.2 Page 9 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, 4 & 5. Standard 6 does not apply to this service. People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. People’s needs are assessed before they move in. However, more needs to be done to make sure that the home has the right resources to meet people’s assessed needs. EVIDENCE: Three of the four people who completed surveys for us said they have contracts and were given enough information about the home before they moved in. One person said they had visited people in the home before choosing it for their relative, they said they didn’t have much time to find a place and Harewood Court is convenient for visiting. Another person said their choices were limited because their relative needs a lot of care and other homes were reluctant to offer them a place. Harewood Court Nursing Home DS0000001345.V373890.R02.S.doc Version 5.2 Page 10 We saw evidence that pre-admission assessments are done. However, information provided by the home shows that the people who live there have a wide range of needs. This includes some people with needs that do not fall within the categories of care the home is registered to provide. Having such a diversity of needs makes it difficult for the home to demonstrate it has the capacity to properly meet these needs. For example, the home has 10 people from Afro Caribbean backgrounds and 4 people from Eastern European backgrounds. During our visit we found that while staff have a good level of awareness of Afro Caribbean culture there is less awareness of Eastern European culture. This was discussed with the manager. Harewood Court Nursing Home DS0000001345.V373890.R02.S.doc Version 5.2 Page 11 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 People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. People’s health care needs are generally met, however people’s personal care needs are not always met because there are not always enough staff available. Improvements are needed to the way medicines are managed to make sure that people get the medicines that have been prescribed for them. EVIDENCE: Some people we spoke to said they like the home and feel the staff give them the care and support they need. One person said that everything was fine and the staff will always help them when needed. Some visitors said that the people they visit are well cared for and said the staff do their best. Other relatives said that people don’t always get the care and support they need. They said this is “due to staff shortages”. One person said the staff are Harewood Court Nursing Home DS0000001345.V373890.R02.S.doc Version 5.2 Page 12 very kind but are often “stressed because there are not enough of them”. Relatives said staff didn’t always have time to attend to details such as making sure people’s fingernails are clean and making sure people are helped to shave. We saw that some people didn’t seem to be getting the help they needed to maintain their hairstyles. The home told us they have problems with hairdressing but have just got a new hairdresser. We looked at three people’s care plans. The care plans have information about people’s personal, health and social care needs. The care plans are reviewed monthly and generally are kept up to date. When changes were made to the plan of care as a result of a review this was not always recording in the care plan. For example, one person’s review notes showed that they now have a soft diet and thickened fluids and the care plan had not been updated with these changes. The daily notes tend to focus on recording how physical care needs are met and give little or no indication of how people are or how they spend their time. This was discussed with the manager. We saw some evidence that people or those close to them are involved in planning and reviewing care and relatives confirmed this. Risk assessments for areas such as nutrition, falls and the risk of developing pressure sores are done and where necessary plans are in place to show how these risks will be managed. The manager told us the tissue viability nurse provides support and advice on the prevention and treatment of pressure sores. We saw that people have access to a range of NHS services such as GPs, podiatrists and physiotherapists. The company has an internal audit procedure for checking care plans. The records showed that the most recent care plan audit had been done in August 2008. The medicines and the Medicines Administration Record (MAR) charts are securely stored. Most medicines are supplied by the pharmacy in a monitored dosage system, but some are kept in the original packaging. The medicines supplied in the monitored dosage system appeared to be administered accurately, but some of the signatures to confirm that staff had administered the medicine were missing. The records of amounts received, administered and in stock of some medicines that were supplied in their original packaging were not accurate. For example, the quantities received of one person’s eye drops had not been recorded. Another person’s tablets had the date they were started recorded on the Harewood Court Nursing Home DS0000001345.V373890.R02.S.doc Version 5.2 Page 13 packet, but the quantity received was not recorded or dated on the MAR chart. In this instance, twenty-eight tablets had been dispensed, but when we checked there were eighteen left and fourteen signatures to confirm administration. This means that four tablets had apparently been signed for but not administered. We found similar problems with medicines belonging to two other people. The controlled drugs were stored safely and the records were accurate. It is essential that all the medicines received into the home are recorded and administered accurately, to make sure people are receiving their medicines exactly as prescribed. These issues were raised with the home in February 2008 when a detailed pharmacy inspection was done. This was discussed with the manager. We saw staff assisting people to transfer from their armchair to a wheelchair, using the appropriate moving and handling equipment. The staff knew what they were doing and reassured the people, to make sure they felt as safe and comfortable as possible. People’s dignity was preserved during these transfers and the staff approach was calm. Harewood Court Nursing Home DS0000001345.V373890.R02.S.doc Version 5.2 Page 14 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 People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. There are opportunities for people to take part in a variety of social activities and people are supported in maintaining contact with family and friends. More attention should be given to making sure the food provided is appropriate to the cultural needs of the people living in the home. EVIDENCE: The home employed a support worker with responsibility for activities about 4 months ago and people said activities are now taking place. She works approximately 20 hours a week; she said she works more if she is going out with people. During the morning of our visit she worked with people on the first floor, playing games and giving people hand massages. In the afternoon she spent time with people on the second floor. The support worker has started to gather information about people interests and abilities and intends to use this to plan activities appropriate to people’s needs. We saw from the Harewood Court Nursing Home DS0000001345.V373890.R02.S.doc Version 5.2 Page 15 records that as well as organising group activities she spends time with people individually, particularly people who prefer to stay in their rooms. The home has a church service once a month which people can attend if they choose. Staff said it is a Pentecostal service but people of all denominations are welcome. Ministers from the Baptist church visit people and staff told us there is a Roman Catholic Church nearby if people want to see a priest. Many of the staff are from Afro Caribbean backgrounds and this helps to promote an awareness of the cultural needs of the Afro Caribbean people living in the home. The home does not have any Eastern European staff, however the do have access to an interpreter if needed. Visitors are always welcomed to the home. There was a relaxed atmosphere and a good relationship between the people who live at Harewood Court, their visitors and the staff. We observed lunch being served on both floors. At lunchtime there is a choice of two main courses and desserts. There is also a choice of meals at teatime. The tables were laid with cutlery and napkins. Staff said lunch is served at 1:00 pm but on the first floor it was 1:20pm before any meals were served in the dining room. The meal service was slow and somewhat disorganised; there were 3 staff on duty but they did not seem to have any clearly defined roles. Two relatives were helping people to eat and a member of staff was helping a third person. It is not clear how the meal service would have been managed if relatives had not been there to help people because staff also had to attend to people who stayed in their rooms. The nurse was giving out lunchtime medicines and therefore was not available to help with meals. On the second floor lunch started earlier. One staff member’s shift finished just as lunch was being served. This meant there were not enough staff on duty to support all the people who needed help. As on the first floor staff also needed to spend time taking trays to the people who prefer to eat in their bedrooms. People seemed to enjoy their meals. Some people said they would like to see more choice, more cakes, scones and more choice of Caribbean food. The chef said he talks to people about the menus, makes changes and tries different dishes to see if people will like them. He was knowledgeable about peoples different dietary needs. He said he goes to the local market every week to buy fresh vegetables for the Caribbean dishes. He said he has tried some dishes that people from Eastern Europe may enjoy, but felt they had not turned out as well as he would have liked. The home does not employ kitchen assistants. This means that the chefs have limited time to prepare the food. A kitchen assistant would free up some of Harewood Court Nursing Home DS0000001345.V373890.R02.S.doc Version 5.2 Page 16 their time to allow them to produce a wider range of foods, in order to meet the very diverse cultural preferences of the people who live at the home. Harewood Court Nursing Home DS0000001345.V373890.R02.S.doc Version 5.2 Page 17 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 People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. The home has a complaints procedure but people are not always confident that complaints will be dealt with appropriately. There are suitable systems in place to make sure people are protected. EVIDENCE: We asked people if they know what to do if they have a complaint or concern and we got a mixed response. Some people said they know what to do and said the home always responded appropriately. One person said, “Sometimes it depends on the complaint”. Another person said they did not want to be seen as a troublemaker and therefore felt it was difficult to complain, they said they worried in case it would affect their loved ones. We have received 5 complaints about the service since the last key inspection; and four of these were anonymous. The complaints were sent to the home and dealt with by them. Any complaints or concerns are recorded in a complaints file. The actions taken and the outcomes are recorded and copies of letters are kept in the file. Harewood Court Nursing Home DS0000001345.V373890.R02.S.doc Version 5.2 Page 18 Staff said they know what to do if anyone has concerns. The training records showed that the majority of staff have done adult protection (safeguarding) training in 2008. Harewood Court Nursing Home DS0000001345.V373890.R02.S.doc Version 5.2 Page 19 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, 21 & 26 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. The home provides a safe and comfortable place for people to live. EVIDENCE: The home is clean and generally well maintained and people told us the home is usually kept fresh and clean. Some people said they thought there should be housekeeping staff on duty at the weekends. The entrance hall is attractive and welcoming. There was pleasant music playing in the lounges during the morning, although a wider choice reflecting people’s preferences would provide more interest. Harewood Court Nursing Home DS0000001345.V373890.R02.S.doc Version 5.2 Page 20 The home has recently added a conservatory and this is a very pleasant room. However, access to the conservatory is restricted and relatives told us it is very seldom used. Staff told us it is made available to people for private parties and the activities organiser said she would be using it for some group work, such as creative arts. The rooms are comfortably furnished and have a welcoming feel. There are sufficient, accessible toilets and bathrooms on both floors of the house. Some of the bathrooms and toilets did not have waste bins for the used paper hand towels and some bathrooms were being used to store larger items such as hoists, wheelchairs and a vacuum cleaner. The home told us they are planning improvements to the environment which will include upgrading the bedrooms and creating a beauty room/hairdressing salon on the ground floor. Staff are employed to help look after the maintenance of the house and grounds as well as keeping the gardens tidy. There is seating outside for people to use in the better weather. The homes kitchen had an inspection by an Environmental Health Officer in November 2008. The kitchen was awarded three stars (the maximum is 5). The chef said he has been working hard to make improvements to bring the kitchen up to a good standard. When we looked, the kitchen was clean, tidy and hygienic and there is a regular cleaning programme in place. This includes a ‘deep clean’ every month, to make sure that all areas are thoroughly hygienic. The laundry is as well organised and the staff make sure that peoples personal clothing, as well as bedding and towels, are properly cared for. Visitors confirmed this. Protective gloves and aprons are available for staff to use, as part of their infection control measures. The home told us that all staff have done infection control training since the last inspection. Harewood Court Nursing Home DS0000001345.V373890.R02.S.doc Version 5.2 Page 21 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 People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. There are not always enough staff available to make sure people’s meets are met in a timely way. People are protected because the home carries out the required checks before new staff start work. EVIDENCE: People told us they are worried that there are not always enough staff and that there are a lot of staff changes. Relatives said they do not have peace of mind because they cannot be confident there are enough staff to give people the care and support they need. People said the staff are “kind” and “caring” but said there are not always enough of them. One person said, “Senior carers and carers work really hard but they need more staff to help them care properly.” Some people said they had told the home’s management about their concerns but nothing had happened. Harewood Court Nursing Home DS0000001345.V373890.R02.S.doc Version 5.2 Page 22 The home told us that there is one nurse on duty all day and the manager, who is a nurse, is also in the building. However, the duty rotas provided by the home show that the manager only has 2 days a week when she is supernumerary and available in the building to provide support to the nurse on duty. For the remainder of her working week she works as a nurse. This means that on 5 days of the week there in one nurse in the building to take charge of the home and deliver nursing care. The home told us they have 6 care assistants on duty in the morning (8am to 2pm) and 5 in the afternoon (2pm to 8pm). The home provided us with copies of duty rotas showing the actual hours worked during the previous weeks. Looking at these rotas in detail we saw that the home is consistently working below these numbers. For example, the duty rotas for the weeks of January 5 and January 12 2009 showed that the home only had that number of staff on duty on 2 of the 14 days. This was a concern at the last key inspection and has not been dealt with. One member of staff described their recruitment procedure, which included an interview, two written references and Criminal Records Bureau (CRB) and Protection of Vulnerable Adults (POVA) register checks. The staff files we looked at confirmed that the home carries out the proper checks before new staff start work. There is plenty of training available for staff. The majority of staff said the training is good and keeps them up to date, but some felt they needed more training related to the needs of people living in the home. The records showed that some staff have attended training on caring for people with dementia. Fire safety training was planned for the day of our visit but did not take place due to illness. Approximately 66 of care staff have achieved an NVQ (National Vocational Qualification) in care. Some staff had recently attended some training on nutrition and on a new nutritional supplement that doctors are now prescribing. A recently recruited domestic assistant confirmed that she had taken the mandatory health and safety training, including the Care of Substances Hazardous to Health (COSHH) training, which is essential to her role. Harewood Court Nursing Home DS0000001345.V373890.R02.S.doc Version 5.2 Page 23 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, 32, 33, 35, 37 & 38 People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. The manager is hard working and motivated but the staffing levels in the home mean that there are many areas where people are not experiencing good quality outcomes. Therefore it is not possible to say that the home is run in the best interests of the people who live there. EVIDENCE: The home appointed a new manager in April 2008. She is an experienced nurse and manager and has successfully completed the registration process. Harewood Court Nursing Home DS0000001345.V373890.R02.S.doc Version 5.2 Page 24 The duty rotas show she works 4 days a week and she confirmed this. She has 2 days supernumerary time most weeks, but covers if they are short of nurses. This gives her very little time to deal with her management responsibilities. People told us they don’t really know the new manager and said they have not seen much change since she started. We talked to her about the lack of information in the self-assessment (AQAA) and she acknowledged she had been short of time. The manager told us a senior manager carries out monthly visits to the home to monitor the quality of the service. The records of these visits were available up to October 2008. The manager said visits had taken place since then and agreed to send us copies. To date we have not received them. The manager told us that questionnaires are sent to people using the service every six months. Questionnaires were last sent in August 2008 but none were returned, some more were sent later but again none were returned. Relatives told us there has only been one meeting for people living in the home and their relatives/representatives in the last 12 months, this was in September 2008. The manager confirmed this. She said people told her they would like to have meetings every 3 to 4 months and she said she would try to organise this. The manager said staff meetings are usually held every 2 months; however the last one which was due to take place on 13 January 2009 was cancelled because no one came. The manger said staff have regular supervision. The home told us they do not manage personal money for anyone, if people have extra services they are added to the monthly invoices. Personal information about the people who live at the home is not always stored securely. There were two items pinned to a notice board referring to individuals, and record books containing notes about people were kept on top of the staff desk in the corridor. This was discussed with the manager. We looked at a selection of maintenance records and they showed that all the regular health and safety checks for the home are carried out in a timely manner. On the day of our visit an engineer was checking the safety of the hoists and making sure they were still fit for their purpose, as well as servicing them. Harewood Court Nursing Home DS0000001345.V373890.R02.S.doc Version 5.2 Page 25 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 2 2 3 N/a HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 x 18 3 3 x 2 x x x x 3 STAFFING Standard No Score 27 1 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 2 2 x 3 3 2 3 Harewood Court Nursing Home DS0000001345.V373890.R02.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? Yes 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 OP9 Regulation 13(2) Requirement All medicines received into the home must be recorded and administered accurately, to make sure people are receiving their medicines exactly as prescribed. Previous timescale of 25/03/08 not met. There must be enough staff available at all times to meet the assessed needs of the people living in the home taking into account the size, the layout and purpose of the home. The deployment and supervision of staff must be reviewed to make sure they are working effectively for the benefit of people at the home. This is to ensure that people’s health; personal care and social care needs will be met. Previous timescale of 30/09/08 not met. Timescale for action 17/04/09 2.. OP27 18(1)&(3) 17/04/09 Harewood Court Nursing Home DS0000001345.V373890.R02.S.doc Version 5.2 Page 27 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 OP3 Good Practice Recommendations The pre-admission procedures should be improved to make sure that that home has the right resources to meet people’s assessed needs. A brought forward system would make it easier to check all quantities of medicines, to confirm that administration is accurate and the amounts in stock are correct. More attention should be given to making sure that people are offered a variety of food which is in keeping with their cultural needs and preferences. Waste bins should for the disposal of paper towels etc should be provided in all bathrooms/toilets. Bathrooms should be available for use and should not used for storage of equipment. The manager should be given more time to fulfil her management responsibilities so that she can provide clear leadership, promote a culture of openness and develop and implement ways of improving the service. The home should explore different ways of getting feedback from people using the service. All personal information should be securely stored in order to maintain people’s confidentiality. OP9 OP15 OP21 5. OP32 6. 7. OP33 OP37 Harewood Court Nursing Home DS0000001345.V373890.R02.S.doc Version 5.2 Page 28 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB 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. 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