This inspection was carried out on 7th March 2006.
CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.
The inspector made no statutory requirements on the home as a result of this inspection
and there were no outstanding actions from the previous inspection report.
CARE HOMES FOR OLDER PEOPLE
Harewood Court Nursing Home 89 Harehills Lane Leeds Yorkshire LS7 4HA Lead Inspector
Nadia Jejna Unannounced Inspection 7th March 2006 10:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Harewood Court Nursing Home DS0000001345.V255965.R01.S.doc Version 5.0 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.V255965.R01.S.doc Version 5.0 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 Solutions (Yorkshire) Limited Mrs Pearl Jackson 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.V255965.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 21 April 2005 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. The home is registered to provide care with nursing for up to forty older people and three younger adults with physical disabilities. All bedrooms are for single occupancy and have en-suite facilities. The home covers three floors. Resident’s accommodation is on the first and second floor. Each floor has a separate lounge and dining room, with a kitchenette available for making snacks and drinks. The main ancillary services, on the ground floor, do not intrude on the facilities and accommodation available to residents. There is a patio area accessible to service users, by means of a ramp from the first floor lounge. A passenger lift allows access to all floors and the home is accessible to people with disabilities. Harewood Court promotes a smoke-free environment; people are made aware of this verbally and through the statement of purpose. A covered smoking area is available in the grounds. Harewood Court Nursing Home DS0000001345.V255965.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. Over an inspection year from April until March, care homes have a minimum of two inspections a year; these may be announced or unannounced. The last inspection was unannounced and took place on the 21st April 2005. This inspection was unannounced. It started at 10:30am and ended at 4:00pm on 7th March 2006. The manager was not on duty so feedback at the end of the inspection was given to the administrator. The people who live in the home prefer the term residents, and this is the term that will be used throughout this report. The purpose of this inspection was to monitor the home’s progress and to assess whether the care given to residents meets minimum standards. During the inspection records were looked at and staff were seen carrying out their work. Discussions were held with staff, residents and visitors. Comment cards/questionnaires were left for residents and visitors so that they can share their views of the home with the CSCI. None had been returned when this report was written. What the service does well: What has improved since the last inspection?
Harewood Court Nursing Home DS0000001345.V255965.R01.S.doc Version 5.0 Page 6 Steps have been taken to make sure that enhanced CRB (Criminal records Bureau) disclosures and POVA (Protection of Vulnerable Adults) checks are in place for all staff, including volunteers. 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 Nursing Home DS0000001345.V255965.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Harewood Court Nursing Home DS0000001345.V255965.R01.S.doc Version 5.0 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 the following standard(s): Key standard 3 was assessed and met at the last inspection. EVIDENCE: Harewood Court Nursing Home DS0000001345.V255965.R01.S.doc Version 5.0 Page 9 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 the following standard(s): Key standards 7, 8, 9 and 10 were assessed and met at the last inspection. EVIDENCE: Harewood Court Nursing Home DS0000001345.V255965.R01.S.doc Version 5.0 Page 10 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 the following standard(s): 12 and 13. Residents cultural and religious needs have been identified but are not being met in all cases. EVIDENCE: Visitors to the home said that they could visit at any time and that they were made to feel welcome. They said their relatives could choose to see them in the privacy of their own rooms or in one of the communal areas. They said that they were satisfied with the services provided and that the staff were kind and caring. A support worker has been employed to help plan and provide social and recreational activities in the home. In order to help with this they also carry out a detailed social, religious and cultural assessment for each resident. Those seen in resident’s care plans were very detailed and informative and identified individuals social, religious and cultural needs and what action should be taken to meet them. For example one resident under the age of 65 had been very active with their church and it had been an important part of their life; the assessment said that links should be made with this church. The monthly evaluations showed that this had not happened. Another resident’s plan showed that they had been very active with community and church groups but that none of these links had been kept up. The support worker has twenty hours a week in which to fulfil their role and staff said that they are often
Harewood Court Nursing Home DS0000001345.V255965.R01.S.doc Version 5.0 Page 11 called to carry out other duties. This was seen during the inspection as they escorted a resident to a hospital appointment. Staffing levels in the home do not allow for staff to break away from caring duties to provide residents with social stimulation. The home has a multi cultural community with residents from a number of different ethnic backgrounds. It is important that appropriate actions are taken in order to make sure that their cultural and religious needs are met. Planned activity sessions take place each week provided by an external facilitator of motivational games and exercise sessions. One of these sessions took place after lunch and residents joined in with games of skittles. Staff said that these sessions are held in the lounge areas of each floor on alternate weeks. Harewood Court Nursing Home DS0000001345.V255965.R01.S.doc Version 5.0 Page 12 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 the following standard(s): 16 and 18 The homes complaints and adult protection procedures protect residents and they are confident that concerns raised will be taken seriously and acted upon. EVIDENCE: A complaints procedure has been produced. It is displayed in the reception area. It is also included in the information file kept in the reception area and the combined Statement of Purpose/Service user Guide. Four complaints have been received and responded to appropriately since the last inspection. A resident said that a complaint they had made had been dealt with promptly and that they were happy with the outcome. Posters were seen in each of the dining rooms encouraging people to talk to staff about any concerns they might have. Visitors said that they knew who to speak to and that they would not hesitate to do so if they had any concerns. Adult protection policies and procedures were in place. Staff said that they could access these in the policies file kept in the main office. Training about abuse is given to the staff by the manager as part of induction training and updated annually. Staff said that they would not hesitate to report suspected or actual abuse to the person in charge. During feedback the administrator was told that it would be useful to make sure that all staff knew that adult protection concerns could be reported direct to the local authority adult protection unit. Residents said that they felt safe, happy and comfortable living in the home.
Harewood Court Nursing Home DS0000001345.V255965.R01.S.doc Version 5.0 Page 13 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 the following standard(s): Key standards 19 and 26, as well as standards 20 and 24 were assessed and met at the last inspection. EVIDENCE: Harewood Court Nursing Home DS0000001345.V255965.R01.S.doc Version 5.0 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 29 and 30 There is a risk that resident’s needs might not be met because of reduced staffing levels in the evenings and at weekends. EVIDENCE: Staffing rotas for the week of the inspection showed that staffing levels were reduced at the weekends. But residents do not go home on weekend leave, therefore residents needs and numbers remain the same and staffing levels should not be altered. It has also been identified earlier in this report that staff do not have the time to meet residents social care needs. Staffing levels and numbers must be reviewed in order to make sure that residents physical, health and social care needs can be met appropriately. Consideration must also be paid to the size and layout of the building. Steps have been taken to make sure that enhanced CRB disclosures and POVA checks are in place for all staff, including volunteers. The training records showed that most areas of training around the health, safety and welfare of staff and residents were being provided but that not all staff had received annual updates where needed. Some of the staff had not received an update of moving and handling training and others needed training in first aid awareness and infection control. A care worker said that they showed new employees how to use moving and equipment until they could attend a formal moving and handling training course. Training of this type must only be provided by people qualified and competent to do so.
Harewood Court Nursing Home DS0000001345.V255965.R01.S.doc Version 5.0 Page 15 The manager provides staff with dementia training but care plans seen showed that this was not based around person centred dementia care. Other training sessions that some staff have attended included nutrition and Parkinson’s disease. Because residents in the home come from a variety of different cultural and ethnic backgrounds consideration should be made towards this when planning the training programme. Harewood Court Nursing Home DS0000001345.V255965.R01.S.doc Version 5.0 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33 and 35 Resident’s financial interests are safeguarded. The views of residents and their relatives are sought and taken into consideration. EVIDENCE: Quality assurance systems are in place. These include a system of sending out regular resident and relative’s surveys. The results are collated and made available to interested parties. A copy is also included in the Statement of Purpose. The home acts as appointee for three residents who have been at the home for a very long time. Steps have been taken to find advocates but not successfully. All residents’ monies are paid into a bank account and direct debits set up to pay fees. Appropriate records are kept of all financial transactions.
Harewood Court Nursing Home DS0000001345.V255965.R01.S.doc Version 5.0 Page 17 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 X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 X 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 X X X X X X X X STAFFING Standard No Score 27 2 28 X 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X 3 X X X Harewood Court Nursing Home DS0000001345.V255965.R01.S.doc Version 5.0 Page 18 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP27 Regulation 18 Requirement Timescale for action 30/04/06 2 OP30 18 The registered person must make sure that staffing levels in the home are reviewed and maintained at levels which take into account the numbers and identified needs of residents as well as the size and layout of the building. Meeting resident’s social and cultural needs must also be taken into account. 30/04/06 Steps must be taken to make sure that all staff receive training in order to maintain the health, safety and well being of themselves and residents and to meet the specialist needs of residents living in the home. Training must be provided by people who are qualified and competent to do so. Records must be kept. Harewood Court Nursing Home DS0000001345.V255965.R01.S.doc Version 5.0 Page 19 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 OP12 Good Practice Recommendations The registered person should make sure that the identified social, cultural and religious needs of residents are met. Harewood Court Nursing Home DS0000001345.V255965.R01.S.doc Version 5.0 Page 20 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
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