Inspection on 29/11/05 for Harewood House

This inspection was carried out on 29th November 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Harewood House 26/02/08

Harewood House 03/08/06

Harewood House 26/05/05

Harewood House 23/12/04

Harewood House 07/07/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Harewood House 8 Shrubbery Terrace Weston Super Mare North Somerset BS23 2JZ Lead Inspector Nicola Hill Unannounced Inspection 29th November 2005 2:00 Harewood House DS0000008116.V271350.R01.S.doc Version 5.0 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 House DS0000008116.V271350.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 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. Harewood House DS0000008116.V271350.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Harewood House Address 8 Shrubbery Terrace Weston Super Mare North Somerset BS23 2JZ 01934 620502 NONE 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) Mrs Valerie Murray Mrs Cheryl Peel Care Home 7 Category(ies) of Learning disability (7), Learning disability over registration, with number 65 years of age (7) of places Harewood House DS0000008116.V271350.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 26th May 2005 Brief Description of the Service: Harewood House is a converted Victorian house within a terrace set out on the hillside above Weston-Super-Mare seafront. The accommodation is set out over three floors with the first floor accommodation offering en-suite facilities; there are bathroom facilities on each of the other floors. This is a family run home, Mrs Valerie Murray the provider and Ms Cheryl Peel the registered manager. The home accommodates service users with learning disabilities aged 18-65 years and is also registered for service users with learning disabilities over 65 years of age. Harewood House DS0000008116.V271350.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection of Harewood House involved the registered provider, Mrs Murray, staff at the home and the residents. The inspection took place over the a period of three hours, and the inspector reviewed care documentation and records held at the home and spoke with staff and residents. The care documentation reviewed included: • • • • • • • • • Care files. Daily record. Medication records and administration systems. Health and safety implementation e.g. fire alarm systems. Staff rota. Risk assessments. The complaint procedure. Staff files and training records. Record of resident and staff meetings. The inspector did not tour the building on this visit, however it was noted that the additional stair banister had come away in places, Mrs Murray confirmed that she was waiting for the builder to return and complete the work. What the service does well: What has improved since the last inspection? Staff have received additional training in order to support residents specific needs. Harewood House DS0000008116.V271350.R01.S.doc Version 5.0 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 House DS0000008116.V271350.R01.S.doc Version 5.0 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 Harewood House DS0000008116.V271350.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4 The admission procedure at the home allows for potential residents to find out about the home before deciding to move in. EVIDENCE: Since the last visit to the home there has been one new admission. The file held on the new resident indicated that the resident had attended Harewood House on several occasions before being admitted. The resident is of similar age to the other residents at Harewood House, and had a full multidisciplinary assessment from the learning disabilities team prior to admission. The resident has specific medical needs, which the manager of the home discussed with the inspector prior to admission. In order that the resident could be fully supported, the manager arranged for additional training from the community nurse team for the administration of a daily hormone injection. The inspector was also able to see that the home had carried out a full care plan for the resident, and that included risk assessments. The inspector also spoke with the new resident, and they discussed their admission to the home that had taken place in October. They also explained why they had chosen to move to Harewood House. The procedure for admission followed at Harewood House is a staged process. All potential new residents are invited to meet the staff team and residents at Harewood House prior to admission. All new admissions are on a trial basis to ensure that the new resident can be supported, and that the community at Harewood House is suitable for them. Harewood House DS0000008116.V271350.R01.S.doc Version 5.0 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,8 The residents support needs and lifestyle choices underpin the daily activity of the home. EVIDENCE: The inspector spent part of the inspection talking with the residents at home to find out their views on their daily life. The residents are involved with their care planning, although they do not see this as a priority. The residents’ priority appears to be that the house in comfortable and that they get on with everybody there. The residents are very happy generally with all the support they receive from the staff at Harewood house. One resident raised the question of being more independent with activities, but was happy to go through the development plan towards independence as suggested by the manager of the home. At the time of the inspection there were two residents at home, and during the inspection four other residents returned. None of the residents expressed any concerns about their care and support at Harewood House, and generally the feeling in the home is that it is a good place to live. Harewood House DS0000008116.V271350.R01.S.doc Version 5.0 Page 10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11,12 Residents at Harewood House make decision about their lifestyle. EVIDENCE: Each of the residents at Harewood House has an individual weekly activities plan. The is planned on an individual basis to ensure that specific development needs are met, it also incorporates the different activities or job opportunities that the residents wish to follow. For example, one resident is currently expanding work experience to include weekends. The activity plan is changed to accommodate this, but also the staffing is changed in order that activity may be supported. The inspector was able to see evidence of the activity plans held on file, and also discussed with the resident what they liked to do. The residents attend a variety of different daytime activities, some have supported employment opportunities, others attend day centers and colleges. In the evenings and weekends when it is generally at leisure time the residents attend different groups such like Girl Guides, or the local Gateway club. Often Harewood House DS0000008116.V271350.R01.S.doc Version 5.0 Page 11 the residents will just go down to the local pub supported by a member of staff and to have the game of pool all just to have a drink. This is a very informal activity, which the residents enjoy. One resident was able to tell the inspector about when they went to the cinema, and one resident fell asleep through the film. The residents at Harewood House have their own friends, which they visit, and some have support from relatives. None of the residents, who spoke with the inspector, expressed any concerns or disliked about the activity followed. Harewood House DS0000008116.V271350.R01.S.doc Version 5.0 Page 12 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 20 To ensure the safety of the residents, medication in the home must be recorded so that there is a clear audit trail. EVIDENCE: The way in which health and social care needs of the residents are met has not changed. The inspector reviewed the medication administration system. Currently there are two residents at Harewood House who require regular injections, one for insulin and the other for a growth hormone. Both of these residents have cartridge pens, which measure the dose of medication to be given. The staff that take responsibility for administering these medication have received additional training from the community nurses who retain overall responsibility. The home uses the Nomad system for medication, and it is noted that the resident at Harewood House take very minimal medication; only three residents have regular medication. It was discussed with Heidi Statton that the when required medication held at the home is not always included on the MAR sheet. This means that the home could not easily provide an audit trail of ‘when required’ medication that had been given to the resident. The way in which the home record ‘when required’ medication is by use of the back of the Harewood House DS0000008116.V271350.R01.S.doc Version 5.0 Page 13 MAR sheet. However, it is good practice to include all ‘when required’ medication on every medication sheet that comes into the home. This would show a running total of medication. It would also be advisable to have a protocol indicating when the additional medication is used. For example, if medication is used prior to medical examination the protocol should state what dose and how many hours prior to the medical examination it should be given. The inspector was able to see that there is a burn bin available for discarded needles, and this is changed when necessary. Harewood House DS0000008116.V271350.R01.S.doc Version 5.0 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 The home has a complaints system, which is available to the residents to use. EVIDENCE: There have been no complaints made to the home, or to the Commission. The complaint procedure in place at the home ensures that anyone who complains has his or her views listened to. Harewood House DS0000008116.V271350.R01.S.doc Version 5.0 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Not inspected on this visit. EVIDENCE: Harewood House DS0000008116.V271350.R01.S.doc Version 5.0 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,33,34 The residents’ benefit from a staff team that understands their support needs. EVIDENCE: The numbers of staff at the home are sufficient to meet the needs of the residents, and there is a manager and two staff on duty except at night when one member of staff sleeps in. There has been a new member of staff appointed since last inspection, and the inspector was able to see evidence of the application form, the CRB check, the induction checklist, which was being completed, and that references have been applied for. Mrs Val Murray was able to inform the inspector that written references had been obtained, but were not at Harewood House, to verify telephone references, which she had obtained prior to the new member of staff starting work. The staff training records were not up-to-date as did not indicate that staff members had received training from the community nurse prior to the admission of the latest resident. This was brought to the attention of Mrs Murray who will ensure that record are up-to-date and reflect all the training of staff have undertaken. Currently two members of staff have NVQ 2 or above and three members of staff do not have NVQ qualifications. Harewood House DS0000008116.V271350.R01.S.doc Version 5.0 Page 17 Harewood House DS0000008116.V271350.R01.S.doc Version 5.0 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 38,42 The home is run so that residents support needs and wishes are given priority. EVIDENCE: The inspector was able to read the minutes of the last staff meeting and last residents meeting. Both of these meetings take place on a regular basis but are infrequent due to the small size of the staff team, and the regular daily contact that the manager has with both residents and all members of staff. There is a handover book with shift information in ready for new staff to read when they come on duty. At the time the inspection the manager Cheryl Peel was on sick leave. However, she was retaining oversight of the day-to-day running of their home supported by Mrs Val Murray the responsible individual. Harewood House DS0000008116.V271350.R01.S.doc Version 5.0 Page 19 The inspector checked the money held on behalf of residents at the home, and noted that all balances were correct; monies were well recorded with appropriate receipts provided. The fire record indicated that the weekly alarm test had not taken place and this needed to be done as a matter of urgency. This was bought the attention of Mrs Val Murray who stated she would a test that day. All other records within the fire logbook were up-to-date. It was also noted that in the accident book the last six recorded accidents resulted in minor injuries. Four of them were for one resident, and this because she spends the majority of her time at the home. There have been no accidents needing treatment, and therefore no regulation 37 notifications. Harewood House DS0000008116.V271350.R01.S.doc Version 5.0 Page 20 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 3 X Standard No 22 23 Score 3 X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 X 3 X X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X X X X X X LIFESTYLES Standard No Score 11 3 12 3 13 X 14 X 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score X 3 3 3 2 X CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Harewood House Score X X 2 X Standard No 37 38 39 40 41 42 43 Score X 3 X X X 2 X DS0000008116.V271350.R01.S.doc Version 5.0 Page 21 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 2 Standard YA20 YA42 Regulation 12,13 12,13 Requirement The home must keep records for all medication in the home to provide an audit trail. The fire safety procedures issued by Avon Fire Brigade should be fully implemented. Timescale for action 29/11/05 29/11/05 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 YA35 Good Practice Recommendations Training records should be updated to reflect the qualifications and experience of the staff team. Harewood House DS0000008116.V271350.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL 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 House DS0000008116.V271350.R01.S.doc Version 5.0 Page 23 - 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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