Inspection on 06/08/07 for Harewood House

This inspection was carried out on 6th August 2007.

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

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

CARE HOMES FOR OLDER PEOPLE Harewood House 47 West Street Scarborough North Yorkshire YO11 2QR Lead Inspector Ros Sanderson Unannounced Inspection 09:30 6 August 2007 th 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 DS0000068909.V335867.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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. DS0000068909.V335867.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Harewood House Address 47 West Street Scarborough North Yorkshire YO11 2QR 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) 01723 501477 01723 507298 TM & TR Ltd Mrs Sharon Norris Care Home 29 Category(ies) of Dementia - over 65 years of age (29), Old age, registration, with number not falling within any other category (29) of places DS0000068909.V335867.R01.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 only - Code PC 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; Dementia - Code DE(E) The maximum number of service users who can be accommodated is: 29 To provide personal care and accommodation for one named service user from the age of 60 years and over in the category DE. 2. 3. Date of last inspection Brief Description of the Service: Harewood House is a large Victorian building situated on the South Cliff in the town of Scarborough, a seaside resort. There is ramped access to the home. The home caters for up to 29 people that require personal care or who may suffer from a dementia type illness. Accommodation is provided over three floors with passenger lift access to all floors. The majority of bedrooms have private toilets and washbasins. There are two dining rooms and three lounges for people to use. The home is located approximately half a mile away from the local shops where there is access to a Post Office, a public house, hairdressers and grocery stores. There is close access to a regular bus service into the town that is approximately one mile away. The Esplanade, which affords beautiful views across the South Bay, is a five-minute level walk away from the home. People that express a wish to use this service and their representatives are provided with a brochure when they make initial enquiries. This gives them information about the services provided at Harewood House. The most recent copy of the Commission for Social Care Inspection report is also included with this information. The scale of charges that are made for the services range from £350 to £380 per week. Additional charges are made for hairdressing, chiropody and private toiletries. The fee information was provided on 6/8/07. DS0000068909.V335867.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is the first inspection carried out following the change of ownership of the home. This key inspection has used information from different sources to provide evidence for this report. These sources include: • • • • Reviewing information that has been received about the home since the new ownership. Information provided by the registered manager on a pre inspection questionnaire; Comment cards returned from 3 service users, 3 relatives, 1 GP’s and 1 health care professional. A visit to the home carried out by two inspectors. A site visit was carried out by two inspectors and lasted for three hours. Five service users, three relatives and eight staff were spoken with. Records relating to service users, staff and the management activities of the home were inspected. During the visit care practices were observed, where appropriate, and time was also spent watching the general activity within the home. This enabled the inspector to gain an insight of what life is like at Harewood House for the people that live there. The registered manager was available to assist the inspectors during the visit and was also available at the close for feedback. What the service does well: What has improved since the last inspection? DS0000068909.V335867.R01.S.doc Version 5.2 Page 6 This is the first key inspection since new ownership of the home. 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. DS0000068909.V335867.R01.S.doc Version 5.2 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 DS0000068909.V335867.R01.S.doc Version 5.2 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): 3, 6 is not applicable. People who use the service experience good quality outcomes in this area. The pre admission process ensures that people feel confident their needs will be met. We have made this judgement using a range of evidence, including a visit to the service. EVIDENCE: All people expressing an interest in living at the home are visited before they are admitted. A full assessment of their physical and mental health care needs is made. Information is gathered from relevant health care professionals when available. The manager and her staff then decide if they are able to meet the assessed needs of individuals. This pre-admission process makes sure that the staff at the home feel able to care and support the person properly and it reassures a prospective resident that their needs can be met if they choose to move to Harewood house. Intermediate care is not provided. DS0000068909.V335867.R01.S.doc Version 5.2 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): 7, 8, 9, 10. People who use the service experience good quality outcomes in this area. People’s healthcare needs are met. We have made this judgement using a range of evidence, including a visit to the service. EVIDENCE: All people living at the home have a written care plan that directs staff as to how care needs are to be met. The plans are based on the information obtained at the pre admission assessment and continue to be developed as staff become more aware of people’s needs. People who may show challenging behaviour have care plans in place to show staff how this may be managed. There is evidence in the care plans that the staff seek advice from other health care professionals when this is needed. The care plans are reviewed regularly and this ensures that people’s current care needs are addressed. A relative commented, ‘Staff are very caring, understanding, loving and affectionate.’ Another said, ‘Overall the staff do a remarkable job and are caring and professional.’ DS0000068909.V335867.R01.S.doc Version 5.2 Page 10 Medication policies and procedures ensure that people receive their prescribed medication safely. There is a policy for people wishing to self medicate and they are provided with lockable facilities should they choose to do this. DS0000068909.V335867.R01.S.doc Version 5.2 Page 11 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, 13, 14, 15. People who use the service experience adequate quality outcomes in this area. People may benefit from a more structured approach to day-to-day activities. We have made this judgement using a range of evidence, including a visit to the service. EVIDENCE: People that were spoken with stated they liked living at Harewood House and enjoyed the food. They stated they liked the staff. Staff were seen speaking respectfully to people and allowing them time to respond. The manager stated that there are no restrictions on people’s movements within the home and people can spend time in their rooms if they wish. There are not any structured activities organised. People’s leisure interests are not recorded in the care plans. However two people visit a day centre and other people go out on outings with relatives. Staff take people for walks ‘when there is time’. A relative commented that their relative ‘was not entertained in any way shape or form, they get up and go to bed and nothing happens in between’. They did however add that this is what the person had done prior to admission. DS0000068909.V335867.R01.S.doc Version 5.2 Page 12 Another person said, ‘A monthly entertainment programme of sorts would be nice, But appreciate may be difficult because of lack of concentration by some.’ People said they liked the food. There is a four weekly menu and alternatives are always available. Special diets are catered for including low salt and diabetic diets. A relative said, ‘There is a very good variety of meals. Plenty of vegetables and people are encouraged to eat.’ DS0000068909.V335867.R01.S.doc Version 5.2 Page 13 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, 18. People who use the service experience good quality outcomes in this area. People feel they are protected and listened to. We have made this judgement using a range of evidence, including a visit to the service. EVIDENCE: There have been no complaints since the change of ownership. Relatives knew how to make a complaint and said they would feel confident to speak with the manager or staff. The safeguarding adults policy is clear and gives good instruction to staff as to what action is needed should an allegation of abuse is made. The manager cascades the training to all staff during induction and at regular periods during their employment. Staff spoken with were clear about their responsibilities. DS0000068909.V335867.R01.S.doc Version 5.2 Page 14 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): 19, 26. People who use the service experience adequate quality outcomes in this area. People live in a comfortable environment however the management need to be more pro active to ensure continued safety within the home. We have made this judgement using a range of evidence, including a visit to the service. EVIDENCE: The home is clean and generally well maintained. There has been some redecoration and replacement of carpets since the new owners have taken over. The paintwork to the outside of the building is in the process of being repainted. There is a strong smell of urine in the main entrance hall. The staff are aware of this and have enlisted the help of the continence advisor to advice staff how best to help people with a continence problem. All doors are kept DS0000068909.V335867.R01.S.doc Version 5.2 Page 15 locked to prevent people going outside as there is no safe area for them to wander. Most bedrooms are en suite and double rooms are only occupied by people who choose to share. The call bell system was tested from a bedroom on the top floor. The staff were unable to tell from the console which room the call was originating from. They reported that this had been a problem with another bedroom in the past. Some toilets did not have hand washing or drying facilities in them and one toilet door would not close correctly. Light fittings in the lounge area did not have a full set of working bulbs. The fire fighting equipment in the home had last been serviced in March 2006. The manager was unable to find a current service certificate. DS0000068909.V335867.R01.S.doc Version 5.2 Page 16 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, 28, 29, 30. People who use the service experience good quality outcomes in this area. A staff team that are well trained, competent and enthusiastic care for people. We have made this judgement using a range of evidence, including a visit to the service. EVIDENCE: Staff rotas show that there is sufficient staff on duty to meet the physical care needs of people. However staff and the manager felt that they do not have sufficient time to meet the social care needs of people. Staff all receive comprehensive induction training and all other training needed to help them carry out their roles effectively. A member of staff said that they considered it a friendly home in which to work and felt well supported working in a team that had a good team spirit. Over 80 of staff have achieved a qualification in care at NVQ level 2 or above. Relatives commented, ‘This is a friendly, wonderful home where the staff are absolutely marvellous’. Another said, ‘I think most of the staff are good and caring but I do believe they are short staffed. They are always in a rush with no time to talk.’ Staff records showed that all staff are recruited following the guidelines and this ensures that only staff that are safe to do so look after residents. DS0000068909.V335867.R01.S.doc Version 5.2 Page 17 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): 31, 33, 35, 38. People who use the service experience good quality outcomes in this area. The registered manager manages the home well within the time constraints. We have made this judgement using a range of evidence, including a visit to the service. EVIDENCE: The registered manager has many years experience in care and management. She is suitably qualified and can evidence that she attends training to maintain her qualifications. She has one day where she is supernumerary to allow her to fulfil her managerial role. She operates an open door policy and staff and residents were seen to freely approach her during the day. Since the new ownership of the home the manager has had to review all paperwork relating to the administration of the home and this has taken up much of her time. DS0000068909.V335867.R01.S.doc Version 5.2 Page 18 The home has a basic quality assurance system in place where surveys are sent to relatives and health professionals annually. The results are looked at and a short report written. Following the most recent surveys mention had been made of the smell of urine in the home. This had prompted the manager to purchase a new carpet shampooer. Staff meetings are carried out twice a year and team leader meetings carried out monthly. Minutes of these are kept. The manager said that staff are supervised although completed records were not seen. The provider’s carry out monthly visits to the home and a record of these were seen. Risk assessments for the home were seen and these had been reviewed as needed. Some health and safety certificates were out of date. These included the electrical wiring certificate, the fire fighting equipment servicing and the gas safety certificate. DS0000068909.V335867.R01.S.doc Version 5.2 Page 19 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 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 2 DS0000068909.V335867.R01.S.doc Version 5.2 Page 20 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 OP12 Regulation 16(2(m)) Requirement People must be asked about what activities they would like to take part in. This must be recorded and the staff must endeavour to provide people with the opportunity to take part in their chosen activities. To make sure that people live in a pleasant environment the cause of the strong smell of urine in the entrance hall must be investigated and steps taken to eliminate the smell. The call bell system must be reviewed to ensure that staff are aware of which area in the home calls originate from. The staffing levels must be reviewed to ensure that there are sufficient staff on duty to meet people’s assessed social and recreational needs. Copies of the safety certificates that were not available at the inspection must be forwarded to DS0000068909.V335867.R01.S.doc Timescale for action 06/09/07 2 OP19 16(2(k)) 06/09/07 3. OP19 16(2(c)) 06/09/07 4. OP27 18(1(a)) 06/09/07 5. OP19 OP38 13(4(a)) 23(4)(c) (iv) 06/09/07 Version 5.2 Page 21 the CSCI for inspection. These include: • Gas Safety Certificate • Electrical fixed wiring certificate • Fire Equipment servicing certificate. 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. Refer to Standard OP31 OP33 Good Practice Recommendations Consideration should be given to allow the manager additional time to fulfil her role effectively. The quality assurance system must be further developed to ensure that the views of all stakeholders are sought and acted upon. DS0000068909.V335867.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ 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 DS0000068909.V335867.R01.S.doc Version 5.2 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. 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